The HSE has unveiled its National Service Plan for 2017.
Health chiefs have announced a Christmas recruitment drive for nurses and midwives on December 28, 29 and 30 as well as funds to drive down hospital waiting lists and to fund services for the homelessness.
The Health Service Executive will have just over €81m to expand and develop new services this year.
The executive is also planning for nearly 24,500 fewer medical cards and more than 50,000 more GP cards next year.
The HSE is getting the biggest health budget in the history of the state at almost €14bn, an increase of €458m over this year.
However, much of the extra money is already accounted for in terms of full-year costs for services introduced this year, pay rate funding and non-pay and demographic related costs.
The extra money will be used to fund acute hospitals, the ambulance service, cutting prescription charges for over 70’s with a medical card and providing an automatic medical card for all children in receipt of the domicillary care allowance.
Minister for Health, Simon Harris said: “Today’s Service Plan is based on an increased budget of almost €1 billion since last year bringing the total health budget to over €14 billion. This provides us with an opportunity to improve services for our patients and for the Irish public who have made it clear they want to see investment in public services.
“The National Service Plan will deliver on some of my key priorities in 2017. I have provided €20 million to the NTPF to work with the HSE to drive down waiting lists and this will increase to €55 million in 2018. The focus of this will be on reducing the length of time people are waiting for treatment.
The €40 million provided for the Winter Initiative in 2016 will continue in 2017 to implement measures to address overcrowding in our emergency departments. I am very conscious of the people who are on trolleys in our hospitals today, especially older people, and of the pressures and stress on staff working in this environment.”
The Minister said they have to tackle issues like staffing with immediate, practical measures now.
He said: “I welcome the announcement today by the HSE of an open recruitment event on the 28th, 29th and 30th of this month for nurses and midwives from all disciplines who are interested in working in the Irish health service. This will target nurses coming home for Christmas and allow walk-in interviews on the day. This will be the first in a series of career day events for nurses throughout 2017.”
- The HSE’s net non-capital determination of €13,948.5 million includes provision of €81.3m for specific service enhancements including:
Funding for each section of the HSE Service Plan
€36.5m is being held by the Department of Health for:
· Mental health services – €15m to initiate new developments in 2017.
· Primary care development – €18.5m for service developments including reduced prescription charges for over 70s.
· Social inclusion – €3m to invest in services relating to addiction and marginalised groups.
The Service Plan allows for the €6m in full year costs in 2018 on health-related actions for the homeless, in fulfilment of the funding commitment in Rebuilding Ireland.
Additional funding for the next phase of engagement with GP representatives on future contracts is included in the total funding available in 2017. This funding is part of the €18.5m held-back by the Department in respect of specific Primary Care service initiatives.
The HSE said that, in recognising the time lag in new staff taking up posts and the completion of other preparations for the introduction of these services, the Mental Health additional allocation will go up to €35m.
Summary of Service Provision developments in NSP 2017
Acute Hospital Services:
· The €40m made available for the Winter Initiative in 2016 has been rolled into the 2017 funding base and this should lead to improvements in patient experience times, numbers of patients on trolleys and access to appropriate homecare packages
· Capacity will be added to the system through the opening of new ED in Limerick, a new 75 ward block in Galway, additional critical care beds in Cork and a new Acute Medical Assessment Unit in Portlaoise.
· The continued implementation of the Maternity Strategy will be a priority for 2017
· New funding of €4m is provided for cancer services, including €3m for cancer drugs and €1m to support the expansion of services in line with the new strategy.
Primary Care:
· The NSP provides for the full year cost of the 2016 initiative focusing specifically on speech and language therapy waiting lists in Primary and Social Care for children up to 18 years old.
· Implementation of the Programme for Partnership Government proposal to provide medical cards to all children in respect of whom a Domiciliary Care Allowance (DCA) payment is made.
· Reduction in the prescription charge and monthly cap for medical card holders aged 70 and over from €2.50 to €2 per item and from €25 to €20 a month.
Disability:
· Additional funding of €10m is being allocated to meet the cost of providing day supports and services for approximately 1,500 young adults who will complete their education or life-skills training in 2017.
· Ongoing implementation of Transforming Lives, and support for the Taskforce on Personalised Budgets and continuing the positive work of the Service Improvement Team (SIT
Services for Older People:
· HSE will continue to support older people in their own homes and communities for as long as possible as well as well as providing enhanced services and prioritising transitional care resources to support acute hospital discharge
· The HSE expect to deliver, 10.57 million home help hours to 49,000 people, 16,750 Home Care Packages, 190 Intensive Home Care Packages and 7,820 approvals for transitional care to people in acute hospitals to alternative care settings.
Palliative Care:
Key priorities for 2017 include:
· Increase the specialist palliative care bed numbers in Kerry (15 beds in Kerry Hospice)
· Implement the model of care for adult palliative care services
· Implement a standardised approach to the provision of children’s palliative care in the community
Mental Health:
· Key priorities to be addressed in the Plan include youth mental health, further improvement to child & adolescent and adult services, older people’s services and specialist services, including eating disorders and CAMHS forensic services.
Homelessness:
· A total of €3.5m in funding has been provided in the Service Plan, to enable services initiated in 2016 to be continued and to allow for appropriate lead in-times for the development of new services in 2017. This will result in €6m in full year costs in 2018 on health-related actions for the homeless, in fulfilment of the funding commitment in Rebuilding Ireland
NTPF:
· The HSE will work with the National Treatment Purchase Fund (NTPF), in relation to the ring- fenced resources that will be made available to the NTPF in 2017 (€20m), to implement waiting list initiatives, reduce waiting times and provide treatment to those patients waiting longest
Patient Safety and Quality:
· Improving quality and safety for patients is a key element of the 2017 Service Plan.
· The NSP provides for the HSE National Patient Safety Programme which will work in collaboration with the new National Patient Safety Office in the Department of Health on national priority areas.
· The Service Plan reflects the priority of Healthcare Associated Infection (HCAI) and Antimicrobial Resistance (AMR) by making provision for improving co-coordination and governance structure to support prevention, surveillance and management of HCAIs and AMR
Health and Wellbeing:
· Implementing and supporting key initial actions under the new Obesity Policy and Action Plan (A Healthy Weight for Ireland) including planning for the provision of enhanced community-based and specialist services;
· enforcement of tobacco control statutory obligations to protect public health , and preparing for the enforcement of the Public Health (Alcohol) Bill
· maintaining uptake of screening programmes and implementing the current phase of age-extension for the BreastCheck Programme
Human Resources:
· The plan commits to ongoing implementation of the Strategic Review of Medical Training and Career Structure (MacCraith) Report; in particular it states that the task transfer initiative will be concluded.
· It also commits to maintaining and progressing European Working Time Directive (EWTD) compliance in respect of Non-Consultant Hospital Doctors (NCHDs).
National Health Innovation Hub:
· Specific funding of €.260 is being earmarked to support the National Health Innovation Hub, the joint initiative involving the enterprise and health sectors. The official launch of Health Innovation Hub Ireland was launched by the Minister for Health in September this year.
Activity Based Funding:
· The 2017 Service Plan acknowledges that Activity Based Funding will be a system-wide priority and a key component of the HSE’s approach to meeting financial challenges in 2017. It also provides a commitment to further embed ABF within hospitals and to implement the next phase of the ABF Programme
Activity Level Targets:
Some key targets, as set out in the Service Plan, for overall service levels next year are as follows:
Acute Hospitals
· Day cases – expected activity level in 2017 (1,056,792) is 4.2% above the 2016 NSP target (1,013,808).
· Outpatient attendances – expected activity level in 2017 (3,440,981) is 6.1% above the 2016 NSP target (3,242,424).
Primary Care
· A projected 1.4% reduction in numbers of medical cards in 2017 (reflecting current economic trends which has seen a drop of 1.7% in card numbers in the first 9 months of 2016)
· A 10.5% increase in projected GP visit cards numbers in 2017 on top of a 7.5% increase in the first 9 months of 2016..
· Community Intervention Teams – number of referrals in 2017 (32,861) is 36% above the 2016 NSP target (24,202).
· Therapies/Community Healthcare Network Services – number of patients seen in 2017 (1,549,256) is 24% above the 2016 NSP target (1,249,772).
· Paediatric Homecare Packages – expected activity level in 2017 (514) is 8.4% above the 2016 projected outturn (474).
Services For Older People
· No. in receipt of homecare packages (including delayed discharge initiative) – expected activity level in 2017 (16,750) is 1.8% above the revised 2016 target (16,450).
· No. of persons funded under Nursing Home Support Scheme (Fair Deal) in long term residential care at year end in 2017 (23,603) is 2 % above the 2016 target.(23,107).
Disability
· Personal Assistant (PA) Hours – expected activity level in 2017 (1.4m hours) is 8% above the 2016 NSP target (1.3m hours).
· Home Support Hours – expected activity level in 2017 (2.75m hours) is 6% above the 2016 NSP target (2.6m hours.
· Transition of up to 223 people from large institutional settings to homes in the community in line with Time to Move on from Congregated Settings (of which 63 are carried over from 2016 and will transfer in Q1 2017 and 160 are additional transfers in 2017)
· Specific provision for 185 new emergency residential placements and new home support/in-home respite supports for 210 additional emergency cases.
· Additional funding of €10m is being allocated to meet the cost of providing day supports and services for approximately 1,500 young adults with disabilities who will complete their education or life-skills training in 2017.
National Cancer Control Programme
· No. of patients presenting to symptomatic breast clinics – 2017 target activity level (18,000) is 7% above 2016 target (16,800).
· Tobacco
· No. of smokers receiving intensive cessation support from a cessation counsellor – 2017 target activity level (13,000) is 13% above the 2016 target (11,500).
Health and Wellbeing
· BowelScreen – 2017 target activity level (106,875) is the same as 2016.
