1 agenda introduction purpose of service plan underlying assumptions care group profiles questions
TRANSCRIPT
1
Agenda
Introduction
Purpose of Service Plan
Underlying Assumptions
Care Group Profiles
Questions
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Purpose of Service Plan
Details Type & Volume of service provided Directly by HSE Through Voluntary Agencies
Service Plan has a backdrop of New Challenges for 2010 Establishing Integrated Service Areas
Overarches Lower Level Plans Regional Performance Contract Dublin North East Level 1 Business Plan Local Service Plans
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Issues & Risks for 2010 Plan
Deliver on Vote Increasing Economic Constraint / Reduced
Income Impact of Recruitment Moratorium Introduction of Integrated Services Programme Continuation of Transformation Programme Increasing Population Trends in Community Demand Led Schemes Changing Health Technology Capital & ICT Plans
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FinanceDublin North East Budget
AllocationService Area 2009 2009
Re-stated
2010
€m €m €m
North Dublin Hospitals
791 748 691
North East Hospitals
282 266 242
Community Services
1,071 964 924
Major Voluntary Agencies
184 172 166
Population Health 21 20 20
Corporate Functions
81 74 61
Total €2,431 €2,244 €2,104
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Service Plan 2010
Presentation
Regional Health Forum – Dublin North East
22 February 2010
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Key National Service Developments 2010
Pandemic Vaccination - €55 million Ryan Report Implementation - €14 m / 200
WTEs Demand Led Schemes - €230 million Disability – Additional Day Services – 400 places NHSS – ‘Fair Deal’ - €117 million Home Care Packages - €10 million Cancer Services - €20 million / 79 WTEs* Innovation Funding €17m / 80 WTE’s * Demographic Funding - €70m / 410 WTE*
* To be confirmed
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Value for Money
Considerable success over last 3 years €500m efficiencies in 2008/2009
Target for 2010 €106m Nationally €22m Dublin North East
€12m Hospitals€9m Community€1m Corporate
Delivered from Non-pay Costs Not Intended to Impact on Service Provision
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Dublin North East Staffing – Dec 2009
Service Area Staff Number
Hospitals (Inc. Acute Voluntaries)
12,008
Ambulance 170
Major Voluntaries (Non-acute)
3,576
Community Services 7,785
Population Health 217
Corporate 324
Total 24,080
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Staff Category Hospitals
Ambulance
Major Vols (PCCC)
PCCC Pop Health
Corporate
Medical /Dental 1,505 0 26 358 7 3
Nursing 4,750 0 990 2,438 2 15
Health & Social Care
1,473 0 808 1,352 120 1
Mgt/Admin(Includes, medical Sec., welfare staff, receptionists and telephonists, primary care teams support etc)
1,969 5 331 1,190 72 248
Gen Support 1,632 41 517 505 11 56
Other Patient /Client Care
679 124 904 1,942 5 1
Totals 12,008 170 3,576 7,785 217 324
Dublin North East Staff Breakdown - Dec 2009
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Quality & Clinical Care
Quality & Clinical Care Directorate Established late 2009
Role Further Strengthen Clinical Leadership Improve Clinical Performance Programmatic Approach to
Improving CareReducing Costs
Key Result Areas 2009 Respiratory Diseases Cardiovascular Diseases Diabetes ED Functionality
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Primary Care
Support & Promote Health & Wellbeing Locally Based Services
In 2010 Continue to Support Standardisation Across All PCTs Chronic Disease Management Direct Linkages with Mental Health Hospital Integration & Avoidance Health Promotion / Immunisation
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Primary Care
Key Issues, Activity & Challenges - Dublin North EastPrimary Care Teams
59 New Teams will be put in place in Dublin North East
Projected Teams at 31 Dec 2010 – 84 TeamsImmunisations – 95% Target of Children in DNEOut of Hours GP Service
145,200 Contacts in Dublin North EastDelivering Primary Care Infrastructure
6 Centres in Dublin North East
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Community (Demand Led) Schemes
Government Funded GP, Pharmacy, Dental, Ophthalmic, Addiction & Special Payments GMS – Medical / GP Visit Cards Community Drugs – LTI, High Tech etc. Primary Care Schemes – Maternity & Infant
Recent Trends Unprecedented Increase in Uptake
Medical Cards – 200,000 Increase Nationally since 2005
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Community (Demand Led) Schemes
Key Issues, Activity & Challenges - Dublin North EastCentralisation of Medical Cards
PCRSNational Activity Levels 2010
Budget – Community DLS - €2.8 billionGP Visit Cards Issued – 114,436Persons Covered by Medical Card – 1,622,560 GMS Prescriptions – 18.4 millionDrug Payment Claims – 5 millionLong Term Illness Claims – 1 million
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Mental Health
Span all Life Stages & Covers Primary/Community & Specialist Services
Strategic ObjectivesVision for Change, 2006Executive Clinical DirectoratesRe-configuration of Long-stay UnitsContinued Shift to Community Based
Services
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Mental Health
Key Issues, Activity & Challenges - Dublin North EastInfrastructure
Implementing Mental Health Capital PlanCommunity Focus
Key Activity in Dublin North EastAcute In-patient Admissions – 2,990Re-admissions as % of Total –66% Target Child & Adolescent Teams - 11
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Disability Services
Services to Adults & Children to Enable the to Reach their Full PotentialInterdisciplinary SupportsRehabilitative TrainingDay Services, Home Support, PAsResidential
National Disability Strategy, 2004Disability Databases/Demographic
Pressures 2010
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Disability Services
Key Issues, Activity & Challenges - Dublin North East60 Bed Streetscape – Knockamann, PortraneLegislative / Quality RequirementsReconfiguration of Service DeliveryKey Activity in Dublin North East
Persons in Rehabilitative Training – 505Residential / Respite Places – 1,464Emergency Residential Services – 31Assessments Completed within timelines – 100%
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Social Inclusion
Targeted towards Marginalised & at Risk to ensure equitable access to services
2010 Key Focus Integrate Recommendations into Mainstream
Health Services of National Drugs Strategy National Homeless StrategyNational Intercultural Strategy
Conclusion of Traveller Health Study
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Social Inclusion
Key Issues, Activity & Challenges - Dublin North EastHomeless Strategy - ImplementationEthnic Minorities – Physical & Mental HealthKey Activity in Dublin North East
Clients in Methadone Treatment – 3,020Commencing Substance Abuse Treatment – 250Homeless Service – Providers Operating HSE
Code of Practice – 100%
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Older People
Services to Support Older People to Remain at Home in Independence where possible & then in Appropriate Residential Setting
Focus for 2010 – Implementing Nursing Homes Support SchemeDevelopment Funding - €117 million Nationally
Enhancement of Home Care packagesDevelopment Funding - €10 million Nationally
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Older People
Key Issues & Challenges - Dublin North EastNHSS ‘Fair Deal’
Processing ApplicationsHospital Avoidance Measures
Home Help/Home Care PackagesCommunity Based Services
Geriatrician-led TeamsInfrastructure – CNUs
4 New Units in Dublin North East
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Older People
Key Activity in Dublin North EastHome Help Hours provided – 2.41 million (2.34m –
2009)Total in Receipt of Home Help – 12,900 (12,731 –
2009)
Increased Home Care Package FundingTotal in Receipt of Home Care Packages – 3,373
(3,099 – 2009)Number of Home Care Packages – 1,205 (1,088 –
2009)Total new HCP Clients per Month – 1,053 (809 – 2009)Total Beds in Public Residential Facilities – 1,627
(1,513 – 2009)
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Children & Families
Promote & Protect Health & Well Being Particularly those at Risk of Abuse or Neglect
Focus for 2010 Build on work of Task Force on Children Implement Ryan Report, 2009 Implement Agenda for Children’s Services, 2007
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Palliative Care
Active Holistic Care of Patients with Advanced, Progressive Illness
Direct HSE Provision & Voluntary Providers St Francis Hospice, Raheny
2010 Focus Implement Agreed National Priorities for
Specialist Care Continue to roll-out Minimum Data Set
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Palliative Care
Key Issues, Activity & Challenges - Dublin North EastImplementing Minimum Data Set Key Activity in Dublin North East
Patients Treated in Specialist Unit – 34Patients – Specialist Domiciliary Care – 561Patients receiving Day Care - 55
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Acute Services & Pre-Hospital Emergency Care
Services include Assessment, Diagnosis, Treatment & Acute Rehabilitation
2010 Focus – Continue to provide for emergency admissions & priority services while controlling overall level of acute work Managing Elective Workloads Continue Shift to Day Case Activity Improve Performance – Day of Surgery
Admissions/ALOS
Continue on-going Hospital re-configuration
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Acute Services & Pre-Hospital Emergency Care
ChallengesHistoric Overdependence on Acute SystemOn-going Demographic Change
DiversityIncreased Births
Increased Emergency PresentationsHigher Patient AcuityDelayed DischargesIncreased DemandEuropean Working Time Directive
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Acute Services & Pre-Hospital Emergency Care
Dublin North East Infrastructure 2010 Connolly Hospital
Refurbishment of Surgical Block Beaumont Hospital
Neurosurgical UpgradeCystic Fibrosis OutpatientAcute Medical Assessment Unit
Mater HospitalNeurophysiology OutpatientsSecond CT ScannerCath Lab & Intervention RadiologyMetabolic Services
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Acute Services & Pre-Hospital Emergency Care
Dublin North East Infrastructure 2010 Temple Street
Theatre Upgrade Our Lady of Lourdes
Emergency DepartmentWards over ED
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Acute Services & Pre-Hospital Emergency Care
Key Issues, Activity & Challenges - Dublin North East In-patient / Day Case
Continued Shift from In-patient to Day Case ActivityIncrease Day Cases by 6.5%Reduce In-patient Care by 5.6%
Out-patientsIncreasing number of New Attendances
Emergency Presentations/Admissions9% Reduction in Emergency Admissions
Quality & Risk Focus – Improvements Tackling ED Waits North East Re-configuration High Birth Rate
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Activity Levels – Dublin North East
Service Type 2009 Target
2010 Target
In-patient Discharges 116,100 109,800
Day Cases 125,380 139,518
Total In-patient & Day Case 241,480
249,318
Emergency Presentations 242,970 246,086
Emergency Admissions 73,740 66,366
OPD Attendance 784,410 813,326
Births 15,750 15,100
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National Cancer Control Programme
NCCP Established under Strategy for Cancer Control in Ireland 2006
Provide Necessary Governance, integration, Leadership, Operational Framework & Core Support Services for Cancer Control
2010 Programme Includes Additional Oncology Appointments Reduction in Number of Hospitals Carrying Out
Rectal Surgery Centralisation of Upper GI & Gynae. Cancers Continued Implementation - National Plan for
Radiation Oncology
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National Cancer Control Programme
Key Issues, Activity & Challenges - Dublin North EastColonoscopy
28 Day Urgent (Priority 1) AppointmentCentralisation of Cancer Services
Pancreatic Cancer SurgeryRectal Cancer Surgery
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Questions?