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Sláintecare•Right Care.Right Place.Right Time.
SláintecareAction Plan 2019
1 Introduction 32 Sláintecare – Context 83 SláintecareImplementationStrategy 104 SláintecareActionPlan2019 105 ProjectImplementationandGovernance 116 PartnershipWorking 147 SláintecareProjectManagementStructure 168 SláintecareImplementationWorkstreams 179 WorkstreamsBreakdownbyProgramme 19 Appendix 54 GlossaryofTerms 56
� Workstream 1: ServiceReDesignand SupportingInfrastructure 21 TermsofReference:2019—2028 23 WorkBreakdown 24 GanttCharts 26� Workstream 2: SafeCare,Co-ordinated GovernanceandValueforMoney 35 TermsofReference:2019—2028 37 WorkBreakdown 38 GanttCharts 39� Workstream 3: TeamsoftheFuture 42 TermsofReference:2019—2028 44 WorkBreakdown 45 GanttCharts 46� Workstream 4: SharingProgress 48 TermsofReference:2019—2028 50 WorkBreakdown 51 GanttCharts 52
Contents
Sláintecare•
Right Care.Right Place.Right Time.
1 IntroductionBackground
There are many aspects of the health and social care service in Ireland that we can be very proud of. Our healthcare staffareroutinelypraisedfortheirhardworkandempathyand,ofthosein-patientssurveyedin2018,84%expressedsatisfactionwiththeservice1.LifeexpectancyincreasedinIrelandby2.4yearsbetween2005and2018andisnowabovethe EU average, and mortality rates have decreased. As Irish peoplewecanexpecttolive,disability-free,forlonger2 and moreofuscanexpecttolivelongerafteracancerdiagnosisthan ever before3. However,inspiteofthesesuccesses,weknowourhealthandsocialcareservicesneedsignificantimprovementinmanyareas,particularlyinrelationtotimelyaccesstoaffordablecare.Furtherpressuresarealreadybeingfeltaswearegrowingasapopulationby60,000peopleeachyear.Intenyears’timetherewillbemorepeopleagedover65thanunder14.Therewillbeonemillionpeopleover65and100,000peopleover80–onethirdmorethannow4. Morepeoplemeansmoredemand,and,aswellasneedingtherightinfrastructure–people,buildingsande-health–todelivertherightservices,wealsoneedtorethinkhowwedelivertheseservices,placingagreateremphasisonpreventionandpopulationhealthinitiativesinordertosupportpeopletoliveindependentlyintheirowncommunityforaslongaspossible.Weneedtodeliverhealthandsocialcareservicesinawaythatisefficient,effectiveandsustainable,meetingtheneedsofallpatients,citizens,familieswithdisabilities,peoplewithmentalhealthneedsandcarers.Thiswillrequireawhole-societyapproachwithnewwaysofthinkingandworkingtogether.
Wealsoknowthereisgeographicvariationincurrentserviceavailability.Dependingonwhereyoulive,someservicesareonlyavailabletomedicalcardholders,noteveryoneiseligibleforthesameservices,andthereislimitedavailabilityofsomeservices.So,weneedtoofferpublicservicesinafairandtransparentway,andcreatemoreservicesforthegrowingpopulation. Sláintecareisaboutdeliveringahealthandsocialcareservicethatmeetstheneedsofourpopulationandattractsandretainstheverybesthealthcareprofessionals,managersandstaff.Overaten-yearperiod,wewilldeliverauniversalhealthservicethatofferstherightcare,intherightplace,attherighttime,withapriorityfocusondevelopingprimaryandcommunityserviceswithinanationalpolicycontext.Withappropriate,well-governedinvestment,wewilldeliveraservicethatisgivenbytherightteamatlowornocharge.Crucially,itwillbeessentialtoengagewithstaff,staffrepresentativebodies,andthewiderstakeholdernetwork,tofindnewwaysofworkingtodeliverexpandedservicesandoptimisethewealthofskillsandknowledgeinherentinourworkforce. WhileSláintecarewilltaketenyearstoimplementinitsentirety,this ActionPlan2019outlineskeyareasoffocusfor2019,thefirstfullyearofSláintecareimplementation.
1NationalPatientExperienceSurvey,2018availableat https://www.patientexperience.ie/survey-results/survey-reports/
2DepartmentofHealth(2019)LifeExpectancy,availableat https://health.gov.ie/publications-research/statistics/statistics-by-topic/life-expectancy/
3DepartmentofHealth(2019)Cancer,availableat https://health.gov.ie/publications-research/statistics/statistics-by-topic/cancer/
4CSO(2018)PopulationandLabourForceProjections2017-2051,availableat https://www.cso.ie/en/releasesandpublications/ep/p-plfp/populationandlabourforceprojections2017-2051/populationprojectionsresults/
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Sláintecare Action Plan 2019
Citizen and Staff Engagementand Empowerment
Clinical and Corporate Goverance
Sláintecare Citizen CareMasterplan Implementation
Programme Delivery
PopulationHealth Planning
ServiceRedesign
Infrastructureand eHealth
Public and PrivateDelivery Partners
Workforce Planningand Capacity Building
Accountability andValue for Money
Entitlementand Eligibilty
Citizen Care MasterplanTheten-yearreformprogrammewillresultinthecreationandimplementationofaCitizenCareMasterplan.TheframeworkfortheimplementationoftheCitizenCareMasterplanisoutlinedintheimagebelow.Theframeworkstepsaresupportedbyacontinuousandcross-cuttingprogrammedeliveryapproach.
Figure 1: Sláintecare Implementation Framework
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Sláintecare Action Plan 2019
1 CitizenandStaffEngagement&Empowerment
Aparticipativeapproachwillunderpinthere-designingofthehealthserviceandsystem.In2019Sláintecarewillengagewithcitizensandhealthcarestaffindefiningandco-designingthekindofhealthserviceweenvisageandneedforourgrowingpopulation. Wewillaskpeoplewhatroletheybelievetheycanplayintheirownhealthandwellbeing,andhowthiscanbeempowered.
2 ClinicalandCorporateGovernance
Enablingasafe,qualityserviceisfundamentaltotheSláintecareprogramme.Itisexpectedthathealthserviceswillbedeliveredatnational,regionalandcommunitylevels,asappropriate,toofferasafe,devolvedandaccountablehealthandwellbeingserviceandsystem.RegionalIntegratedCareOrganisations(RICOs)willbeestablishedtoenablethedeliveryofregionallyplannedcarethatisrightfortheneedsofthatlocalpopulation.TherespectiverolesoftheDepartmentofHealth,theHealthServiceExecutive(HSE),andRICOswillbedefinedduring2019inordertopavethewayforclearanddevolvedclinicalandcorporategovernancewhichcandeliversafeservices.During2019wewillcommencepilotingcommunityhealthcarenetworkstotesthowservicescanbestbedeliveredinanintegratedwayinacommunitycontext.
3 PopulationHealthPlanning
Apopulationhealthplanningapproachisessentialinordertounderstandandplanforthehealthandsocialcareneedsofthepopulationbasedondemographicandgeographicconsiderations. Theresultswillinformandprioritisethehealthandsocialcareservicesthatneedtobedevelopedforeachregion,sothepopulationcangettherightcare,intherightplace,attherighttime,inlinewithresourceavailability.In2019wewillbeginaprogrammeofpopulationhealthplanninganddeviseamethodofregionalbudgetallocationwhichcandistributeresourcesonanequitablebasis.Acomprehensiveapproachtodatagatheringwillbedevised,providingthebasisforevidence-baseddecisionmaking.
4 ServiceRedesign
TheredesignofhealthandsocialcareservicesforthepeopleofIrelandwillbeunderpinnedbythedrivetoimprovethehealthandwellbeingofthepopulation,andtokeeppeoplewellintheirowncommunitiesforaslongaspossible.Basedonthespecificneedsofthepopulationforeachregionasdeterminedbythepopulationhealthplanningprocess,andbasedonknowledgeofcurrentlevelsofservicedeliveryandcurrentconfiguration,wewill,withourpartners,co-designtheservicerequirementsneededforthatregion’spopulation. Wewilldothisinaprioritisedwaylookingatthewholecarepathwayfromprevention,toearlyintervention,detection,diagnosis,treatment,rehabilitationandpalliativecareservices.Certainservicesneedtobeplannedanddeliverednationally,whileotherserviceswillbeplannedanddeliveredinanintegrated,devolvedwayataregionalandlocallevel,takingaccountofnationalstrategiesasappropriate.Therewillbecontinuedfocusondevelopinglonger-termcapacitytotreatpeopleinatimelymannerinaccordancewithSláintecarewaitingtimetargets. During2019wewillpilotinitiativeswhichsupportintegratedcareforolderpeopleandforpeoplelivingwithchronicdisease.Asingleassessmenttoolwillbeprocuredtoidentifythecareneedsofpeoplelivinginthecommunity,whetherinresidentialcareorlivingathome.
5 Infrastructure&eHealth
DeliveringenhancedandmodernisedinfrastructureisacorecomponentofSláintecareandisessentialtosupportdeliveryofanefficient,modernandresponsivehealthsystem.In2019wewill:• Commencemappingtheinfrastructurethatexistsineachregionandplanhowit
canbestsupporttheservicesneededtobedevelopedappropriatelyasquicklyaspossible.
• Decidethelocationfornewelectiveandnewcommunitybedscapacity(asperCapacityReview).
• Investigatehowbesttodeliverenhanceddiagnosticscapacityinthecommunityandhospitals.
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Sláintecare Action Plan 2019
• Deliver14newprimarycarecentres.• DecidethelocationfortheMajorTraumaCentreinDublin.• Rolloutthetake-upoftheIndividualHealthIdentifier(IHI)inordertoprovide
thefoundationsforaPersonalHealthPortalandtheElectronicHealthRecord.• Pilottelehealthsolutions.
6 Public&PrivateDeliveryPartners
Sláintecarestressestheimportanceofpublicmoneybeingspentinthepublicinterest.Wewillworkwithourdeliverypartnerstoagreehowthemanypublic,privateandvoluntaryproviderscaneachplaytheirroleinajoined-upwaytodelivertheserviceneedsofthepopulation.In2019thedeBuitléirReportwillrecommendstepstobetakenontheremovalofprivateworkfromthepublichealthsystem.
7 WorkforcePlanningandCapacityBuilding
TheSláintecarevisionrequiresappropriatestaffinglevels,enabledteams,targetedtrainingandstrongleadership.WewillfinalisecontractualarrangementswithGPsandNursesalignedwiththeSláintecareworkingprinciples.Wewillundertakeworkforceplanning,anticipategapsbasedontheservicesrequiredandbegintoplanthetrainingrequirementsneededforthefuture.Wewillexplorehowbesttoattractandretainhealthcareworkers.Wewilldeviseteamtrainingandinnovationprogrammessowecanscalebestpracticesandmaximisepositiveexperiencesmadetodateatbothlocalandnationallevels.
8 EntitlementandEligibility
Sláintecareisfocusedontheneedtoexpandentitlementandeligibilityaspartofatransitiontowardsuniversalhealthandsocialcareaccess.In2019wewilldevelopanapproachtomodelingvariousentitlementandeligibilityscenariosandexaminecostsandbenefits.Sláintecareproposesprovidinguniversalservicesatnoorlowcosttothepatient/serviceuser.Wewillplanhow,when,andinwhatorderofprioritythiscouldbedoneandmakeproposalstogovernmentforconsideration.
9 AccountabilityandValueforMoney
Wewillbenchmarkthefundingforthepublichealthandsocialcaresystemagainstinternationalcomparators.Wewillestablishabasisonwhichtomovenewand/orexistingfundingandresourcesincreasinglytowardspreventionandself-management.Wewillbegintoplanformulti-annualfundingforthehealthsystem.WewilldevelopabasisforallocatingbudgetsatRICOlevelbasedonpopulationprofileandneed.Wewilldevelopinitiativesthatwillgainefficienciesinthecontextofofferingtherightcare,intherightplace,attherighttime.Sláintecareiscommittedtoensuringthatthereistransparencyandaccountabilitywithregardtohowhealthandsocialcarefundingisproportioned,monitored,andoptimised.
10ProgrammeDelivery
SláintecarewillbedeliveredthroughapartnershipapproachbytheSláintecareProgrammeImplementationOffice(SPIO)locatedintheDepartmentofHealth.TheSPIOwillworkinpartnershipwithcitizens,staffanddeliverypartnersinthepublicandprivatehealthandsocialcaresectors,electedrepresentatives,andwiderstakeholderinterestgroupstodeliverontherangeofactionswithinthereformprogramme. TheSPIOwillreportonprogressanddeviseacommunicationsplantoengagewithstakeholdersandkeeppeopleinformedofprogress.WewillworkwiththeSláintecareImplementationAdvisoryCouncil(SIAC),theHighLevelDeliveryBoardandtheCabinetSub-CommitteeonHealth,aswellasourcolleaguesintheDepartmentofHealthandtheHSE.TheOfficewillmakeeveryefforttocontinuetoachievethevisionaryexamplesetbytheOireachtasCommitteeontheFutureofHealthcare,inlinewithavailableresources.
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Sláintecare Action Plan 2019
Partnership
Staff andDelivery Partners
ElectedRepresentatives
Wider DeterminantsStakeholders
Citizens
ConclusionSláintecarewilltransformourhealthandsocialcareservicesoveraten-yearperiod.Itwilltaketimeandwillbeundertakeninapartnershipapproach.However,tosucceed,Sláintecarewillrequirethelong-termcommitmentoftargetedandprotectedfundingandsupporttoenablethedeliveryofthereformprogramme.Thisfundingwillbeinvestedstrategically,andwillsupporttheoverallvisionforreform,withaconsistentfocusoneffectiveness,efficiencyandvalueformoney.
Figure 2: Our Partnership Approach
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Sláintecare Action Plan 2019
2 Sláintecare–Context TheOireachtasCommitteeontheFutureofHealthcarewasestablished to devise cross-party agreement on a single, long-termvisionforhealthandsocialcareandthedirectionofhealthpolicyinIreland.TheCommittee’sreport‘TheSláintecareReport’wasadoptedbytheGovernmentandpublishedinMay2017andisavailableontheirofficialwebsite.ThisvisionofSláintecareistoachieveauniversalsingle-tierhealthandsocialcaresystemwhereeveryonehasequitableaccesstoservicesbasedonneed,andnotabilitytopay.Overtime,everyonewillhaveentitlementtoacomprehensiverangeofprimary,acuteandsocialcareservices.Ithasaquadrupleaimto:i improvepatient/serviceuserexperienceii improveclinicianexperienceiii lowercostsiv achievebetteroutcomes
TheSláintecareFundamentalPrincipleswereoutlinedintheOireachtasReportandwillunderpintheimplementationapproachoverthetenyearsoftheprogramme. TheeightprinciplesunderpinningtheSláintecarereportareoutlinedbelow.TheyguidedthedevelopmentoftheActionPlan2019andwillcontinuetoactasareferencepointthroughouttheimplementationprocess.
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Sláintecare Action Plan 2019
Figure 3: Sláintecare Fundamental Principles
AccountabilityEffective organisational alignmentand good governance are central tothe organisation and functioning ofthe health system.
EngagementCreate a modern, responsive, integrated public health system, comparable to other European countries. Through building long-term public and political confidence in the delivery and implementation of this plan.
Public Money and InterestPublic money is only spent in the public interest for the public good (ensuring value for money, integra-tion, oversight, accountability and correct incentives).
WorkforceThe health service workforce is appropriate, accountable,flexible, well-resourced, supported and valued.
Prevention and Public HealthPatients accessing care at themost appropriate, cost effectiveservice level with a strong emphasison prevention and public health.
Free at the point of deliveryCare provided free at the point of delivery, based entirely on clinical need.
Patient is ParamountAll care is planned and provided so that the patient/service user is paramount, ensuring appropriatecare pathways and seamless transition backed-up by full patient record and information.
Timely AccessTo all health and social care according to medical need.
SláintecareFundamental
Principles
ACCOUNTABILITY
ENGA
GEM
ENT
PATIENT IS PARAMOUNT
TIMELY ACCESS
PREVEN
TION
& PU
BLIC
HEA
LTH
FREE AT THE POINT OF DELIVERY
WORKFORCE
PUBLIC M
ON
EY & INTEREST
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Sláintecare Action Plan 2019
3 Sláintecare ImplementationStrategy
InresponsetotheSláintecareReport,theGovernmentapprovedtheSláintecareImplementationStrategyon 17thJuly2018.TheStrategyisavailableonthe DepartmentofHealthwebsite.TheSláintecareImplementationStrategyrepresentedthefirstoutputfromtheDepartmentofHealthofthedetailedplanningprocessfortheimplementation oftheSláintecareReport. TheImplementationStrategysetouttheactionstobetakeninthefirstthreeyearsoftheSláintecareimplementationprocess.Therewere106sub-actionsdetailedintheStrategy.WithintheActionPlan2019,wehavereferencedthe sub-actionnumbersfromtheSláintecareImplementationStrategyforeaseof cross-referral.
4 Sláintecare ActionPlan2019TheSláintecareProgrammeImplementationOffice(SPIO)wasestablishedinSeptember2018withtheinitialtaskofreviewingandrefiningtheImplementationStrategyintoamoredetailedActionPlanfor2019.
Athree-stageapproachwastakentoundertakethisreviewasfollows:
DelveStage–September-October2018
ThisfocusedonreviewingtheSláintecareImplementationStrategy sub-actionsandidentifiedwherefurtheractionswererequired.
DiscoverStage–October-November2018
Areadinessassessmentofallthe106Sláintecaresub-actionswasinitiated.Thisexaminedthedegreetowhichtherewereplansbehindthesesub-actionsandwhowasresponsiblefordeliveringthem.
DeliveryStage–November-December2018
Thisstagelookedathowbesttostructureteamsforsuccessfulandeffectivedelivery.ACitizenCareMasterplanFrameworkfortheimplementationoftheSláintecareactionswasdevelopedinordertoestablishaprogrammaticapproachtodelivery. TheSPIOhasnowrefinedtheImplementationStrategywhichcontained106sub-actionsintoaprogrammaticActionPlan2019.TheActionPlanwillbeupdatedannuallyduringtheten-yearimplementationperiod.TheActionPlanhasidentifiedfourmainWorkstreamsasfollows:Workstream1:ServiceRedesign&SupportingInfrastructureWorkstream2:SafeCare,Co-ordinatedGovernance&ValueforMoneyWorkstream3:TeamsoftheFutureWorkstream4:SharingProgress EachofthefourWorkstreamshasfivemainProgrammesandmultipleProjectswithineachProgramme.
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Sláintecare Action Plan 2019
Dedicated reform programmeoffice to act as the engine
for transformation
Deep and sustainedengagement
with stakeholders
Focused work programme with a clear start,middle and end
Targeted and protected funding for the
reform programme
Senior leadershipand decision making
SuccessfulImplementation
5 ProjectImplementation andGovernance
TheSláintecareActionPlanchangeprogrammerequiresacoalitionacrossthewiderhealthandsocialcaresystemtoworktogetheroverthelong-term,sustainingmomentum,andwithaclearfocusonthedesired outcomesofreform.Ourimplementationapproachwillbebuilton thecorecomponentsdetailedbelow:
Figure 4: Core Components for Successful Implementation
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Sláintecare Action Plan 2019
ImplementationandOversightFigure5depictstheSláintecareimplementationandoversightstructures.Themainfeaturesare:• TheMinisterforHealthwillbeaccountabletotheOireachtasforthedeliveryof
Sláintecareandwillreportregularlyonprogress.• TheCabinetCommitteeonHealth,chairedbytheTaoiseach,willgiveoverall
strategicdirectionandwilloverseeimplementation,ensuringleadershipatthehighestlevel.
• TheHighLevelDeliveryBoardandtheSláintecareExecutiveDirectorwill ensureeffectivedeliveryofagreedplansandresourcingoftheSláintecarereformprogramme.
• TheSIACwilladviseandsupporttheSPIOonthechangeprogramme.• TheSPIOwilloverseetheimplementationprocessthroughtheExecutiveTask
Forceandtheworkstreams’deliverystructurecomprisingmultipleProgrammesandProjectsasoutlinedonthefollowingpages.
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Sláintecare Action Plan 2019
Workstreams andWork Programmes
1.1Data, Researchand Evaluation
Programme
1.2Population
based PlanningProgramme
1.3Service ReDesign
FrameworkProgramme
1.4Capital PlanningImplementation
Programme
1.5eHealth
Programme
2.1Geoalignment andRICOs Structure
Programme
2.2Corporate and
Clinical GovernanceProgramme
2.3Public and
Private PartnersProgramme
2.4Eligibilty / Entitlement
Programme
2.5Financing Reform
Programme
3.1Workforce Planning
Programme
3.2Training Pipelineand New Ways of
Training Programme
3.3Culture Change and
New Ways of WorkingProgramme
3.4Innovation /
Capacity BuildingProgramme
3.5Future Intelligence /
InfluencersProgramme
4.1 Citizen and StaffEngagement andEmpowerment
Programme
4.2 Sláintecare Programme
ImplementationOffice and Governance
Programme
4.3 EvaluationFramework and
Reporting ProgressProgramme
4.4 IntegrationFund and SláintecareBudget Management
Programme
4.5 Communicationsand Recognising
Success Programme
Workstream 1Service ReDesign and
Supporting Infrastructure
Workstream 2Safe Care, Co-ordinated
Governance and Value for MoneyWorkstream 3
Teams of the FutureWorkstream 4
Sharing Progress
Implementation
Oversight
PUBLIC ACCOUNTABILITY
SLÁINTECARE — CHANGE FOCUS
DEL
IVER
Y A
ND
ACC
OU
NTA
BILI
TY
SLÁ
INTE
CARE
— S
TRO
NG
CH
AN
GE
CAPA
BILI
TY
SLÁINTECARE — CHANGE FOCUS
SláintecareImplementation
Structures
OireachtasGovernmentMinster for Health
Cabinet Committeeon Health
High LevelDelivery Board
ExecutiveTask Force
SláintecareImplementation
Advisory Council
ExecutiveDirector
Sláintecare ProgrammeImplementation Office
Secretary General
Department of Health
HSE Board
HSE
Health Ecosystem of Partners /Stakeholders
Citizen
Figure 5: How Sláintecare will be overseen and implemented
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Sláintecare Action Plan 2019
6 PartnershipWorking TheSláintecareProgrammeImplementationOffice(SPIO) hasbeenestablishedtosupportanddrivetheimplementationof the Sláintecare vision.
TheSPIOwillworkinpartnershipwithcolleaguesintheDepartmentofHealth,theHSE,otheragenciesandkeystakeholders.
TheSPIOwill:• Lead,manageandmonitorthereformprogramme.• Drivethereformprocessthroughimplementationplanninganddirection.• Establishprogrammemanagementandamonitoring/evaluationculture.• Actasacentralhubforhealthreform.• Supporttheworkstreams,programmesandprojects,intermsofproblem-
solving,identifyingandhelpingmanageinter-dependencies.• Helpescalateissuestogetdecisionswhereneeded.• Providetoolsandsupportwherehelpful(forexample,innovationlabs,
programmemanagementtoolsandcommunicationsupport).ItwillhaveakeyroleinprovidingregularreportingonimplementationprogresstotheMinisterandtotheCabinetCommitteeonHealth,andincommunicatingthereformprogrammeprioritiesandprogresstostakeholdersandthepublic.
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Sláintecare Action Plan 2019
WorkingwiththeHSEAssetoutintheHSE’sNationalServicePlan2019,theHSE’sProgrammeforHealthServiceImprovement(PHSI)resourceandexpertisewillbere-directedtoestablishaHSEStrategicTransformationOfficeundertheremitofStrategicPlanningandTransformation. Thisoffice,workingcollaborativelywiththeSPIO,commissioningteams,andthewiderorganisation,willlead,driveandactivelysupportthedeliveryoftheSláintecarereformsinlinewiththeSláintecareActionPlan.
TheHSEStrategicTransformationOfficewilloverseethechangemanagementbusinessplanningapproachacrosstheHSEorganisationandwillaligntheexistingPHSIframeworktothenewestablishedpriorities.Inspecifictermsitwill:• WorkinpartnershipwiththeSPIOandthroughtheSláintecareExecutive
TaskForceandSláintecaregovernancestructurestoensurethat implementationofreformisdeliveredasplanned.
• DriveandactivelysupportthedeliveryoftheSláintecarereformsand otherkeyprogrammesdeterminedasbeingcriticaltotheoverallHSEtransformationprogramme.
• Overseethechangemanagementbusinessplanningapproachacross theorganisationandaligntheexistingPHSIframeworktothenew establishedpriorities.
• ProvideassurancetothenewHSEBoardonSláintecareimplementationprogress,highlightissuesofconcern,andtakecorrectiveactionsasrequired,toensurethatoveralloutcomesaredeliveredandthatvalueformoneyisachieved.
• Directavailableresourcesandexpertisetowardsthedeliveryof transformationalchangeinaccordancewithprioritisedprojects.
• Buildstrategicchangecapability,enablingteamstosuccessfully deliverandachievethebenefitsoftransformationprogrammes.
• SupportandenablelocalProgrammeManagementOfficestodeliver strategicreformsatfrontlineservicelevelwhereitwillbeexperienced bycommunities,serviceusers,patientsandfamilies.
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Sláintecare Action Plan 2019
7 SláintecareProject Management StructureTheSPIOhasstructuredtheActionPlanintofourWorkstreamsasfollows:• Workstream1:ServiceRedesign&SupportingInfrastructure• Workstream2:SafeCare,Co-ordinatedGovernance&ValueforMoney• Workstream3:TeamsoftheFuture• Workstream4:SharingProgressEachworkstreamhasfivemajorProgrammeswitheachProgrammehavinga numberofspecificProjectsassetoutinthefollowingpages. TheProjectsaregroupedintoProgrammesbasedontheirlinkagesanddependencies.TheProjectswillbedeliveredbyteamscomprisingmembersoftheDepartmentofHealth,HSE,andotheragencies/stakeholdergroupsasappropriate. RepresentativesfromtheProjectTeamswillbefacilitatedbyaSPIOexecutiveataProgrammelevelsoastoprovideinformation,linksandvisibilitybetween andacrosstheProjects.TheExecutiveTaskForcewillbemadeupofrepresentativesfromtheindividualProjectsandProgrammesandwillbechairedbytheExecutiveDirectorofSláintecare. TheSPIOwillpublishrollingplansonanannualbasis.Progressreports willbepublishedonabiannualbasis.
AProjectInitiationDocumentwillbepreparedforpriorityProjectsandProgrammessettingoutclearmilestonedeliverables,timeframes,projectdependencies,projectownersandteam.Theprojectownerwillberesponsibleforthetimelydeliveryoftheprojectmilestonesandeffectivereportingonprojectprogress. ARisk,Actions,IssuesandDependencies(RAID)logwillbeintroducedforeachproject.AnominatedteammemberwillactivelyupdateandmaintaintheRAIDlogby:• Identifyingpotentialrisksandissuesandassigningresponsibleowners• Assessingthepotentialimpact/likelihoodofariskorissue• Establishingplanstomitigateagainstthespecificrisksandissues• Implementingactionplansforriskandissuemitigation. ThefollowingsectiondescribestheSPIOWorkstreamsandWorkProgrammes,andsetsoutthe2019-2028termsofreferenceforeachofthe20WorkProgrammes.Thesetermsofreferenceprovideaten-yearoverviewoftheWorkProgrammes.Theprojectmilestonestobedeliveredin2019arethenoutlined.
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Sláintecare Action Plan 2019
8 SláintecareImplementation Workstreams
ThissectiondescribestheSPIOWorkstreamsandWorkProgrammes andsetsoutthe2019-2028termsofreferenceforeachofthe 20workprogrammes.
ProjectGanttsarealsoincludedshowingthekeydeliverablesfor the20workprogrammesfor2019.
Sláintecare Executive Task ForceChair: Executive Director, Sláintecare
Service ReDesign and Supporting Infrastructure
Workstream 1
Safe Care, Co-ordinatedGovernance and Value for Money
Workstream 2
Teams of the Future
Workstream 3
Sharing Progress
Workstream 4
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Sláintecare Action Plan 2019
This workstream is centred on planning, building and supporting ahealth and social care workforce which can deliver on the Sláintecarereform programme, as well as initiatives which promote innovation,participation and the creation of a supportive work environment.The workforce planning framework will be progressed with a focus onengagement with the education sector and training bodies, to agree new ways of training multidisciplinary teams. The implementation of the recommendations in the Strategic Review of Medical Training and Career Structures will be progressed. Projects which support staff to work to the full scope of their licence to ensure that patients are seen at the lowest level of complexity possible will be identified and implemented.
This workstream is concerned with fostering the support of citizens and stakeholders in the Sláintecare reform process, consulting them
about its delivery and informing them about progress through engagement and open reporting. In 2019 a Citizen and Staff
Engagement and Empowerment Programme will commence which will be sustained throughout the 10-year implementation period. Development of an evaluation and reporting framework will also
commence in 2019. The Sláintecare Integration Fund will be established, all projects supported will be publicised, and progress
and evaluation reports published. A programme for promoting good practice so that successful projects can be recognised and scaled up
will be established.
SláintecareWork Programme
Action Plan
This workstream focuses on providing the right care, in the right place, at the right time, where the patient / service user is paramount and strong emphasis is placed on prevention and public health. Programmes will design integrated services to provide care and support at, or near, home where appropriate and to ensure hospital stays are minimised. This includes planning for bed and diagnostic capacity and ICT infrastructure to support integrated care and patient / service user empowerment. Programmes will focus on commencing and scaling projects to improve the management of chronic disease and older people’s services. The role that technology can play in reducing waiting times will be pursued under this workstream including an integrated ICT waiting list.
A focus will be placed on three areas for development:A PreventionB Integrated CareC National Policies
This workstream involves programmes which will enable a safe, devolved and accountable system to support the delivery of Irish
health and social care services. The aim is to establish a strong system of national and regional governance to drive improved performance
and accountability. In 2019, a new organisational and operational structure for the future reconfigured health service, including
respective roles of the Department of Health, the HSE and regional and community organisations will be defined. Sláintecare proposes
providing universal services at no or low cost to the patient/service user. Various entitlement and eligibility scenarios will be considered to
develop a roadmap and policy proposals for how and when this could be done. In 2019, a HSE Board will be established and key decisions will be made in relation to the establishment of Regional Integrated
Care Organisations. The Patient Safety Bill will be progressed.
Workstream 1Service Redesign and Supporting Infrastructure
Workstream 2Safe Care, Co-ordinated Governance and Value for Money
Workstream 3 Teams of the Future
Workstream 4Sharing Progress
Figure 6: SPIO Four Implementation Workstreams
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Sláintecare Action Plan 2019
9 WorkstreamsBreakdown byProgramme
Workstream 1 ServiceReDesignandSupportingInfrastructure Workstream 2 SafeCare,Co-ordinatedGovernanceandValueforMoney Workstream 3 TeamsoftheFuture Workstream 4 SharingProgress
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Sláintecare Action Plan 2019
Sláintecare Executive Task ForceChair: Executive Director, Sláintecare
Service ReDesign and Supporting Infrastructure
Workstream 1
1.1Data, Researchand Evaluation
Programme
1.2Population
based PlanningProgramme
1.3Service
ReDesignFrameworkProgramme
1.4Capital PlanningImplementation
Programme
1.5eHealth
Programme
Safe Care, Co-ordinatedGovernance and Value for Money
Workstream 2
2.1Geoalignment andRICOs Structure
Programme
2.2Corporate
and ClinicalGovernanceProgramme
2.3Public and
Private PartnersProgramme
2.4Eligibilty /
EntitlementProgramme
2.5FinancingReform
Programme
Teams of the Future
Workstream 3
3.1Workforce
PlanningProgramme
3.2Training Pipelineand New Ways
of TrainingProgramme
3.3Culture Changeand New Ways
of WorkingProgramme
3.4Innovation /
Capacity BuildingProgramme
3.5Future
Intelligence /InfluencersProgramme
Sharing Progress
Workstream 4
4.1Citizen and StaffEngagement andEmpowerment
Programme
4.2 Sláintecare Programme
ImplementationOffice and
GovernanceProgramme
4.3 EvaluationFramework and
Reporting ProgressProgramme
4.4 IntegrationFund and
Sláintecare BudgetManagementProgramme
4.5Communicationsand Recognising
SuccessProgramme
Figure 7: Sláintecare Executive Task Force
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Sláintecare Action Plan 2019
Workstream 1 —
Service ReDesign andSupporting Infrastructure
Sláintecare
Sláintecare Executive Task ForceChair: Executive Director, Sláintecare
Service ReDesign and Supporting Infrastructure
Workstream 1
1.1Data, Researchand Evaluation
Programme
1.2Population
based PlanningProgramme
1.3Service
ReDesignFrameworkProgramme
1.4Capital PlanningImplementation
Programme
1.5eHealth
Programme
Safe Care, Co-ordinatedGovernance and Value for Money
Workstream 2
2.1Geoalignment andRICOs Structure
Programme
2.2Corporate
and ClinicalGovernanceProgramme
2.3Public and
Private PartnersProgramme
2.4Eligibilty /
EntitlementProgramme
2.5FinancingReform
Programme
Teams of the Future
Workstream 3
3.1Workforce
PlanningProgramme
3.2Training Pipelineand New Ways
of TrainingProgramme
3.3Culture Changeand New Ways
of WorkingProgramme
3.4Innovation /
Capacity BuildingProgramme
3.5Future
Intelligence /InfluencersProgramme
Sharing Progress
Workstream 4
4.1Citizen and StaffEngagement andEmpowerment
Programme
4.2 Sláintecare Programme
ImplementationOffice and
GovernanceProgramme
4.3 EvaluationFramework and
Reporting ProgressProgramme
4.4 IntegrationFund and
Sláintecare BudgetManagementProgramme
4.5Communicationsand Recognising
SuccessProgramme
22
Sláintecare Action Plan 2019
Workstream 1 — Service ReDesign and SupportingInfrastructureThisworkstreamiscomposedofthefollowingfiveworkprogrammes:
1.1 Data,ResearchandEvaluationProgramme 1.2 Population-basedPlanningProgramme 1.3 ServiceReDesignFrameworkProgramme 1.4 CapitalPlanningImplementationProgramme 1.5 eHealthProgrammeThedescriptionforeachoftheseworkprogrammesissetoutbelow.
1 Data, Research and EvaluationProgramme
Thisprogrammewillconsolidateexistingdata,collectnewdata,andwillensurethathighqualitynationalandinternationalevidenceisaccessed,synthesisedorgeneratedtoinformdecision-making,therebyoptimisingimpactforpatientoutcomes,thehealthsystemandtheeconomy.
2 Population-based PlanningProgramme
ThisprogrammewilldefinethehealthprofileofourpopulationbyRegionalIntegratedCareOrganisation(RICO),basedondemographicfactors,withtheaimofunderstandingandanticipatingthehealthandsocialneedsfortheregion.
3 Service Redesign FrameworkProgramme
Thisprogrammeisfocussedonthedevelopmentofintegratedcarepathwayswithinanationalpolicycontext,comprisingpreventative,therapeutic,treatment,rehabilitativeandpalliativecareelements.Theaimistoensurethatpeoplegettherightcare,intherightplace,attherighttime.Planningcareatthelowestlevelofcomplexitywhetherathome,nearhome,inhospitalorviaintegratedcarestructureswillunderpinthesepathways.Thefollowingarekeyto thisprogramme:A Developmentofanationalframeworkfor
ModelsofCaredesignB Developmentofanationalclinicalstrategyfor
RegionalPlanningC ImplementingHealthyIrelandD DevelopmentofPrimaryCare,SocialCare
andCommunityServicesE Implementingintegratedcarebetweenprimary,
communityandhospitalservicesF ImplementingtheCapacityPlan
G ImplementingtheTraumaPlanH ImplementinginnovativewaystoaddresswaitinglistsI Decidingonserviceswhichshouldbemovedfromthe
hospitaltoacommunitysetting
4 CapitalPlanning ImplementationProgramme
Thisprogrammewillsupportthere-designedservices.TheNationalDevelopmentPlanprovidesforfundingofover€10.9billiontoenabletheten-yearSláintecarevision.Keyinfrastructureprojectsincludethecommissioningofelectivehospitalinfrastructure;furtherPrimaryCarecentres;additionalhospitalbeds;diagnosticsintherightlocations;communityinfrastructureincludinglong-termandshort-termresidentialbedsincommunitynursinghomesandadditionalfacilitiesforpeoplewithdisabilities.
5 eHealthProgrammeThisprogrammeisfocussedonensuringthattherequisiteICTinfrastructurewillbeputinplacetosupportservicedelivery.TheaimistodevelopacoherentsuiteofeHealthsolutionsfortheIrishhealthcaresystemwhichwillsupporttheoverallvisionforintegrated,patient-centredcare.Thiswillrequiredatatosupportpopulationhealthplanning,aswellassystemstodrivemoreefficient,effectiveandcollaborativecare.Afocusonprovidingcliniciansandmanagerswiththetoolsandinformationneededtosupportdecision-makingisalsocentraltothisprogramme.
TermsofReference: 2019—2028
TheWorkstreamWorkBreakdownandProjectGanttsfordeliveryoftheseProgrammesin2019areasfollows:23
Sláintecare Action Plan 2019
Work Breakdown Workstream 1: 2019Service Redesign and Supporting Infrastructure
Develop a Health Information Policy framework
Establish an R&D forum with key partners to develop
a research strategy 2020-2025
Consolidate and invest indata and R&D infrastructure
and capability
Models of Care (MoC)See next page for breakdown
Access and Waiting ListsSee next page for breakdown
Strategic PoliciesSee next page for breakdown
Project areas outlined indetail on next page
Establish population quantum and profile (age,
deprivation, ability, etc.) by RICO
Develop a geographic population ResourceAllocation Formula
Identify resources and servicesrequired in the community
Invite CHO & HG & Deliverypartners to co-design
integrated services fortheir geo-aligned region
Review utilisation ofPrimary Care Centres
Review diagnostics requirements in a RICO context (community and
hospital settings)
Establish more primary care centres and scope
community-based diagnostics
Prioritise locations for expansion of community and hospital beds
Progress the Project Ireland 2040Capital Plan for Health
Progress procurement of the Electronic Health Record
Commence development of a shared care record
Commence developmentof a national community
based ePrescribing service
Progress providing a digitalworkplace to enable health
service professionals to operate ina modern digitised environment
Progress the development ofclinical ICT systems, to provide therequired infrastructure to support effective clinical decision making
Continue implementing financial / corporate systems to improve
accountability and ensure money can follow patient activity
Identify improved information architecture, including standards,
information and identity to underpin the delivery of integrated care
Identify TelehealthCare solutions
Establish Individual HealthIdentifier office (IHI)
1.3 Service RedesignFramework Programme
1.1 Data Research andEvaluation Programme
1.2 Population-based Planning Programme
1.4 Capital PlanningImplementation Programme
1.5 eHealthProgramme
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Sláintecare Action Plan 2019
1.3 Service Redesign Framework Programme
Health andWellbeing Programme
Integrated Care at RICO level
Programmes at National level
Strategic PoliciesAccess and Waiting ListsModels of Care (MoC)
Prepare PID for Capacity Plan
Establish future needsfor people with disabilities
Publish “A Vision for Change” mental health strategy (no. 2)
Publish and Implement“Housing Options for ourAgeing Population” report
Commence the development ofa revised palliative care policy
Sustain cross-governmentsupport for Healthy Ireland
implementation
Deliver communicationcampaign and activities
in collaborationwith Sláintecare
Deliver 3rd round ofHealthy Ireland fund
Develop Social Care Strategy
Continued implementation of the Healthy and Positive
Ageing Initiative (HaPAI) including publication of
National Indicators Report
Progress Public Health Legislation programme
Develop Integrated Communicable Disease
Control Framework
Implement “Living Well witha Chronic Condition” –
Self-Management Framework
Support the coordination of HSE Healthy Ireland National Priority Programmes covering
the following areas: — Tobacco — Alcohol
— Healthy Eating and Active Living
— Sexual Health— Healthy Childhood
Appoint specialist expertiseto inform service design /
Models of Care
Implement the followingnational programmes:
— National Maternity Strategy including
the Digital Maternity Strategy— National Cancer Strategy
— National Neuro-rehabilitation Strategy
— National Paediatric Model of Care— National Programme for Transplant Services
— Palliative Care Development Framework
— National Dementia Strategy— Progressing Disability Services
— New Direction Day Services— Time to Move On
from Congregated Settings— “First Five Years”
Implement key Mental Healthinitiatives and review
recommendations of theMental Health Act 2001
Develop a best practice nationalframework for the conduct of
a clinical service review
Complete review of specialistcardiac services and report
on best practice
Agree, procure and commenceimplementation of a
single assessment tool
Implement NationalTrauma Strategy
Roll out Lean Capacity Improvement Plan Project
Draft UnscheduledCare Plan
Develop multi-annual Hospitaloperations, procedures andappointments Access plan
Commence implementationof the recommendations of
the Delayed Discharges Report
Carry out a review of ED, MIU,MAU and similar unit utilisation
Implement theRecommendations of the 2018Capacity Review plan including:
— Identify opportunities toopen and invest in additionalhospital and community beds
— Decide criteria for Elective/Ambulatory site selection and
decide on locations
— Progress the development ofcapacity of dedicated elective
& emergency workstreams
Implement theAmbulance Reform Plan
Finalise a National Frameworkfor Models of Care Design
Commence the development of aNational Clinical Strategy to form the
basis of all national and regional planning
Develop Healthy IrelandStrategic Action Plan
2020 – 2022 and progresskey Government approvals
incl. next phase of Sláintecare / Healthy Ireland
Outcomes Framework
Set up integrated co-designteams from CHOs / HGs / GPs /
Pharmacists / Allied Health /Nursing / Other Partners
to develop models oflocal service delivery
Select and develop demonstratorsites to support integrated care
Examine communityintervention and OPAT teams
Implement Integrated CareProgrammes focused on
people with chronicconditions and older people
Develop Pathways of Care
Develop and introduce a newmodel of nursing and
midwifery on a phased basis
Develop HG and CHOstrategic plans in the context
of RICOs
25
Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Conduct populationhealth analysis
Develop an integrated regional resource allocation formula
Establish population quantum and profile(age, deprivation, ability, etc.) by integrated region
Commence developing a methodology for determiningresources and integrated services on a regional basis
4.1.2,NEW
Convene Forum andbegin gap analysis
10.6.1,10.6.2,10.6.3
Agree terms of referencefor R&D Forum
Establish plan to developHealth Information Policy
FrameworkWorkshops and engagement with stakeholders
Develop Target Operating Model for IntegratedInformation Services (IIS) within the HSE
Develop design specification and governancestructures for the consolidation of national and
priority data and information requirements
Invite, setup and mobilise teams from CHO, HG and delivery partners to co-design integrated services
Data, Researchand EvaluationProgramme
Population Based PlanningProgramme
1.1
1.2
Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019
Data, Research and Evaluation Programme
Population Based Planning Programme
Complete draft HealthInformation Policy
Framework
Complete draft R&Dstrategy policy document
and consult
26
Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Fram
ewor
k Finalise principles for National Framework for Models of Care Design
3.3.1,5.2.2
3.2.2,NEW
Hea
lth &
Wel
lbei
ng
Set up governance and initiate development of theNational Clinical Strategy for national and regional
planning (ongoing into 2020)
Support the coordination of HSE Healthy Ireland National Priority Programmes covering the following areas:Tobacco, Alcohol, Healthy Eating and Active Living, Sexual Health, Healthy Childhood
Deliver Healthy Ireland communications campaign and activities in collaboration with Sláintecare
Deliver 3rd round of Healthy Ireland fund
Develop Healthy Ireland StrategicAction Plan 2020-2022
Implement Healthy Ireland cross-sectoral priorities fromStrategic Action Plan (ongoing into 2020)
Agree details of next phase ofSláintecare / Healthy Ireland
Outcomes FrameworkImplement programme for Health and
Wellness Assessment of relevant policy areas
Publish Healthy IrelandSurvey 2019
Complete information gathering andprepare Healthy Ireland Survey report
Commence development of the IntegratedCommunicable Disease Control Framework
Progress Public Health Legislation programme
Implement ‘Living Well with a Chronic Condition’ Framework for self management support
1.3
Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019
Service ReDesign Framework Programme
Models of Care (MoC)
Service ReDesignFrameworkProgramme
27
Sláintecare Action Plan 2019
Service ReDesign Framework Programme
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Models of Care (MoC)
3.3.2,3.4.1,3.4.2,5.4.4,10.3.1a,NEW
3.2.2,NEW
Nati
onal
Identify Telehealth pilotsites for Mental health
Complete stakeholder engagement and develop a best practice national frameworkfor the conduct of a clinical service review
Complete review and report of specialist cardiac services
Commence designationprocess for Major Trauma
& appoint staff to theNational Trauma Office
Develop ambulancebypass protocols
Implement & Review Mental Health Telehealth pilots
Continued implementation of the Healthy and Positive Ageing Initiative (HaPAI)
Publish National Healthy and PositiveAgeing Initiative (HaPAI) Indicators Report
Hea
lth &
Wel
lbei
ng
National Trauma Office to develop &implement detailed project plan
Complete scoping of operating model for Health &Wellbeing in the context of RICOs to accelerateconsistent and measurable implementation ofHealthy Ireland objectives across all services
Evaluate requirements for the Single Assessment Tool (SAT) Progress and procureSAT system
Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019
1.3
Service ReDesignFrameworkProgramme
28
Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Implement the 2019 actions of the National Maternity Strategy including the Digital Maternity Strategy
Implement the 2019 actions of the National Cancer Strategy
Implement the 2019 actions ahead of the National Neurorehabilitation Strategy
Implement the 2019 actions of the National Paediatric Models of Care Strategy
Implement the 2019 actions of the National Programme for Transplant Services Strategy
Implement the 2019 actions of the Palliative Care Development Framework
Implement the Reform Programme for the Disability Sector under:• Transforming Lives; Progressing Disability Services
• New Direction Day Services• Time to Move on from Congregated Settings
4.3.3,5.4.1,5.4.2,5.4.3,NEW
Implement the 2019 actions of the National Dementia Strategy
Implement First 5 Strategy
1.3
Service ReDesignFrameworkProgramme
Service ReDesign Framework Programme
Models of Care (MoC)
Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019
Nati
onal
29
Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Models of Care (MoC)
4.3.2, 4.4.2,4.5.1,5.2.1,9.2.1,NEW
Appoint specialistexpertise for RICOs
Service Design /Models of Care
Set up integrated co-design teamsfrom CHOs / HGs / GPs /
Pharmacists / Allied Health /Nursing / Other Partners to develop
models of local service delivery
Commence detailed development ofregional integrated care models
Develop a new model of community nursing and midwifery on a regional integrated care model basis
Examine Community Intervention Teams and OPAT teams in a regional context
Prepare expansion of Integrated Care Programmes focussed on peoplewith chronic conditions and older people
Develop principles of Models of Care(MoC) for regional integrated care delivery
within a National Framework context
Host 4 workshopsto decide
implementationplans for:
• COPD• Diabetes• Heart Failure• Integrated Care
for Older People
Develop HG and CHO strategic plans in a regional integrated care model context
Rollout regional CHN demonstrator sites androllout integrated fund projects in CHN context
Decide on regionalCHN demonstrator sites
Engage with integratedcare stakeholders
Conduct workshopswith integrated care
stakeholders
Consolidate feedbackfrom integrated care
stakeholders
Review Clinical CareProgrammes anddecide next steps
Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019
1.3
Service ReDesignFrameworkProgramme
Service ReDesign Framework Programme
Models of Care (MoC)RI
CO
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Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
5.1.1, 5.1.2, 5.1.3,NEW Draft multi-annual Hospital operations, procedures
and appointments Access plan
Draft Unscheduled Care Plan
Develop Lean CapacityImprovement Plan Commence roll-out of Lean Capacity Improvement Plan
Establish a Delayed Discharges Oversight Group Draft Delayed Discharge Operational Policy
Procure Lean Expertise forCapacity Improvement Plan
Develop and publishScheduled Care Access
Plan 2019Deliver Scheduled Care Access Plan 2019
Develop Scheduled Care Improvement Plan 2019-2020 Work on implementation of 2019 Improvement Areas
Refine 2020Improvement Plan
Scope a digital solutionto improve patient flow
Publish review ofWinter Plan 2018/2019
Prepare WinterPlan 2019/2020
Review, approve, publishand implement Winter Plan
2019/2020 Plan
Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019
1.3
Service ReDesignFrameworkProgramme
Service ReDesign Framework Programme
Access and Waiting Lists
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Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Roll out of NationalCentralised ValidationUnit and Publication
of Validation scheduleValidation of National Inpatient and Outpatient waiting lists
5.3.2,NEW
Elec
tive
Hos
pita
l Sel
ectio
n
Commence review of best practiceutilisation of ED, MIU and MAU
Workshop and engage with stakeholders toexamine options for optimum utilisation
Conduct population profiling to inform hospitaland community beds planning
Prepare final report onrecommendations foroptimum utilisation
Implement the Ambulance Reform Plan in line with the NSP (multi-annual project)
Draft proposal on hospital and community beds planning
Identify opportunities to open and invest in additional hospital and community beds
Publication of “Open Bed Report” Ongoing publication of “Open Bed Report”
Decide criteria for elective / ambulatory sites
Progress the development of capacity of dedicated elective & emergency workstreamssuch as Nenagh Ophthalmology, Tallaght Day Surgery (2019/2020)
4.2.3,5.1.1,5.1.2,5.1.3,5.1.4,5.1.5,5.2.3,NEW
5.1.5,5.3.1
Continue roll out of Bed Capacity Programme
Provide 75 Acute beds– Winter Plan 2018/2019
Continue commissioning of Beds in Mater,CUH, Drogheda & Tipperary (+78 Beds)
Winter Plan 2019/2020 – Prepare forfurther increase in bed capacity (202 beds
fully operational by Q1 2020)
Build
ing
Capa
city
1.3
Service ReDesignFrameworkProgramme
Service ReDesign Framework Programme
Access and Waiting Lists
Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019
32
Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Conduct international literature review for National Social Care Strategy
Establish Future Needs for People with a Disability
Develop report of existing and potential capacityexpansion of services in Primary Care Centres
Commence adoption ofrecommended diagnostic
capacity expansion
Assess financing options for Capacity Planrecommendations for community and hospital beds
Devise procurement and funding plan for expansionof community and hospital beds
Conduct review of Primary Care Centres’ potentialrole in regional integrated models of care
Review diagnostics requirements in aregional integrated care context
Continue roll out of Primary Care Centres in line with regional population profiling needs
4.2.2,4.2.3,5.3.4,NEW
Progress 2040 Capital Plan for Health
Publish “A Vision for Change” Mental Health Strategy (no. 2)
Commence the development of arevised Palliative Care Policy
NEW
Launch report on HousingOptions for our AgeingPopulation with DHPLG
Convene DHPLGinterdepartmental
implementation groupProgress implementation of Housing Options
for our Ageing Population
1.3
Service ReDesignFrameworkProgramme
1.4
Capital Planning ImplementationProgramme
Service ReDesign Framework Programme
Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019
Develop report of existing andpotential diagnostics capacity &
expansion of services
Capital Planning Implementation Programme
Strategic Policies
33
Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Start procurement
Develop strategy, business case and secure approval for Shared Care Record
Implement HR andPayroll corporatesystems acrossidentified areas
Procure and select strategic implementation partner for National Finance System
Secure Government decision for EHR procurement
Workshop & research existing telehealth solutions Scope new telehealth pilots
Upgrade community site connections and deploy end user devicesas part of Digital Workplace project
1st tranche
Deliver ICT systems to support effective clinical decision making
Identify communitysites for improveddigital connectivity
10.1.1, 10.2.1.a, 10.2.1.b,10.3.1, 10.3.2, 10.3.3, 10.4.1, 10.4.3, 10.5.1,NEW
Establish specification for ePrescribingin community care systems
Consolidatestakeholder feedbackEstablish governance for ePharmacy Programme Conduct Stakeholder
engagement
Establish Individual Health Identifier (IHI) Office
eHealthProgramme
1.5 eHealth Programme
Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019
2nd tranche 3rd tranche
34
Sláintecare Action Plan 2019
Safe Care, Co-ordinated Governance and Value for Money
Sláintecare
Workstream 2 —
Sláintecare Executive Task ForceChair: Executive Director, Sláintecare
Safe Care, Co-ordinatedGovernance and Value for Money
Workstream 2
2.1Geoalignment andRICOs Structure
Programme
2.2Corporate
and ClinicalGovernanceProgramme
2.3Public and
Private PartnersProgramme
2.4Eligibilty /
EntitlementProgramme
2.5FinancingReform
Programme
Service ReDesign and Supporting Infrastructure
Workstream 1
1.1Data, Researchand Evaluation
Programme
1.2Population
based PlanningProgramme
1.3Service
ReDesignFrameworkProgramme
1.4Capital PlanningImplementation
Programme
1.5eHealth
Programme
Teams of the Future
Workstream 3
3.1Workforce
PlanningProgramme
3.2Training Pipelineand New Ways
of TrainingProgramme
3.3Culture Changeand New Ways
of WorkingProgramme
3.4Innovation /
Capacity BuildingProgramme
3.5Future
Intelligence /InfluencersProgramme
Sharing Progress
Workstream 4
4.1Citizen and StaffEngagement andEmpowerment
Programme
4.2 Sláintecare Programme
ImplementationOffice and
GovernanceProgramme
4.3 EvaluationFramework and
Reporting ProgressProgramme
4.4 IntegrationFund and
Sláintecare BudgetManagementProgramme
4.5Communicationsand Recognising
SuccessProgramme
36
Sláintecare Action Plan 2019
TermsofReference: 2019—2028
Workstream 2 — Safe Care, Co-ordinated GovernanceandValue for Money
1 Geoalignmentand RICOsStructureProgramme
ThelackofgeographicalalignmentbetweenHospitalGroups(HGs)andCommunityHealthcareOrganisations(CHOs)createsanimpedimentforthehealthsystemtodeliveronitsintegratedcareobjectives.ThisprogrammewillestablishRegionallyIntegratedCareOrganisations(RICOs),withonebudgetforthepopulationoftheregion,toenablethedeliveryofplannedcarethatisrightfortheneedsofthatlocalpopulation.Thedevelopmentofaneffectiveimplementationstructureforthisreformisanintegralpartofthisprogrammetoensurethatclear,tangiblehealthoutcomesareachievedforthepopulationofeachregion.ThealignmentofCommunityHealthNetworksforlocaldeliverywillbeanimportantpartofthisprogramme.
2 Corporate and Clinical GovernanceProgramme
Thisprogrammewillgiveclaritytotherolesandresponsibilitiesofalltheagentsinvolvedindefining,funding,commissioning,anddeliveringhealthcareservicesinIreland.
3 PublicandPrivatePartnersProgramme
Thisprogrammewillinformourunderstandinganddecision-makingaroundwhowilldeliverservicesatdifferentpointsacrosstheclinicalpathway.This
involvesconsideringhowserviceswillbedeliveredbypublic,privateand/orcommunityandvoluntaryplayers.ItwillalsoconsiderthepublicationoftheIndependentReviewGrouponVoluntaryBodiesReportandthereviewfromTheIndependentReviewGroup,chairedbyDrDonaldeBuitléir,examiningtheremovalofprivatepracticefrompublicacutehospitals.TheprogrammealsoincludestheagreementofaGPcontractwhichwillstreamlineintegratedperson-centredcare,aswellastheroleofthepharmacist,carersandotherprofessionals.Theambitionistoachievefullequityinthedeliveryofhealthandsocialcareservicesinaco-ordinated,safe,appropriate,sustainableandperson-centredway.
4 Eligibility/EntitlementProgrammeThisprogrammewillplanhowtoaddressbarriersand/orinequitiesinaccesstohealthandsocialservicessoastotransitiontowardsauniversalsingletiersystemwherepriceisnotabarriertogettingtimelycare.
5 FinancingReformProgrammeThisprogrammewillsupporttheattainmentofasustainable,accountable,value-for-moneyfinancingsystem,inlinewiththedeliveryofanequitablehealthservice.
TheWorkstreamWorkBreakdownandProjectGanttsfordeliveryoftheseProgrammesin2019areasfollows:
37
Sláintecare Action Plan 2019
Work Breakdown Workstream 2: 2019Safe Care, Co-ordinated
Governance and Value for Money
Consult, finalise and announcedecisions on the geographicalignment of HGs & CHOs
Legislate for new HSE Board
Establish new HSE Board
Introduce modifications toHGs and CHOs to ensure
geographic alignmentDefine and agree new organisational
and operational structures for areconfigured health service,
including respective roles of theDepartment of Health, the HSE
and national and regionalintegrated care organisations
Commence the process for decidingan overarching clinical and corporate
governance framework within thecontext of revised structures
Progress the Patient Safety Bill toencompass clinical audit, reportingof serious events, open disclosureand extension of HIQA’s remit to
the private sector
Implement a patient safety,complaints and advocacy policy
Progress the Implementation of the National Action Planon Antimicrobial Resistance
Progress the development ofa National Adult Safeguarding
Policy for the health sector
Determine and progress priority objectives for GP
contractual reform
Strengthen governance, monitoringand management of privatepractice in public hospitals
Complete and progressrecommendations from the
impact analysis of privatepractice removal from hospitals
Develop role of different healthcare professionals, contractors
and voluntary groups
Progress design of a statutory scheme for homecare
Commence a staged pilot of personalised budgets for people with
a disability over a two-year period
Review current framework anddevelop a policy proposal and
roadmap for universal eligibility
Explore devolving decisionmaking and autonomy to
regional levels
Develop proposals formulti-annual budgeting in the
healthcare and social care system tofacilitate accountability and planningand strengthen financial management
for revenue and capital funding
Develop a plan for the design of asystem of population-based funding
Develop plan to embed andextend the benefits of hospitalactivity-based funding (ABF)
Advance community-based costingfocusing initially on residential
placements and home help services
Benchmark quantum of health andsocial care budget in a
comparative international context
Invest in a multi-annual programmeof work with key health stakeholdersand academic researchers to develop
an activity and cost database for healthand social care in Ireland
Develop financial models to redirect demand to location
of least complexity
Undertake a governance review of the drugs approval
and procurement process
Progress Patient Safety (Licensing)Bill to include clinical governance,
patient safety operating frameworksand licensing of providers by HIQA
2.1 Geoalignment andRICOs Structure Programme
2.2 Corporate and ClinicalGovernance Programme
2.3 Public and PrivatePartners Programme
2.4 Eligibility /Entitlement Programme
2.5 FinancingReform Programme
Review basis for existing hospitaland medical charges
38
Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Announce Geoalignment and RICO structures
1.2.1, 1.2.2, 1.2.3
Research governance of successful regional integrated structuresin other jurisdictions
Develop interim standardised processes for HGs andCHOs on an integrated regional basis
1.1.1, 1.1.2, 1.1.3, 1.1.4, 1.4.1, 1.4.2, 1.4.3, 1.4.4, 1.4.6, 1.4.7, NEW
Develop and approve an overarching clinical and corporate governance framework
Submit Memo toGovernment on neworganisational and
operational structures
International EvidenceReview of Nationaland Regional Health
Structures
Work to progress Patient Safety (Licensing) Bill
Establish new HSE Board
Implement National Action Plan on Antimicrobial Resistance
Develop draft options appraisal for the neworganisational and operational structure for the
future reconfigured health service(DoH, HSE, RICOs)
Complete Patient Safety Bill Legislative Draft
Roll out of patient safety, complaints and advocacy competency framework Patient Safety AdvocacyService in operation
Research approach to legislating revised health structures
Commence development of Adult Safeguarding Policyfor the health sector
Continue stakeholder andservice user engagement
Publish 1st draft of AdultSafeguarding policy
and commence publicconsultation in early 2020
Sláintecare Implementation Timeline: Workstream 2 – Gantts 2019
Geoalignment andRICOs StructureProgramme
2.1
Corporate and Clinical GovernanceProgramme
2.2
Geoalignment and RICOs Structures Programme
Corporate and Clinical Governance Programme
39
Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
6.1.1,6.2.1,6.2.2,6.3.1,7.1.6
Review basis for existing hospitaland medication charges
Develop options for future changes tohospital and medication charges to be
considered in national budgetary process
Develop policy proposal and options forachieving universal eligibility
Progress development of Statutory Scheme for Homecare and draft design of statutory scheme
4.4.1,8.1.1,8.1.2,8.1.3,NEW
Establish ‘basket of services’ forchronic disease management aligned to
the new GP contract agreement
Finalise GP contracts
Consider the implications of therecommendations of the
de Buitléir report
Strengthen governance and operational framework for private practice in public hospitals
Examine the potential for healthcareprofessionals, contractors and voluntary groups
to explore models of care opportunities
Develop role of different healthcare professionals,contractors and voluntary groups
Continue two-year roll-out of staged pilot of personalisedbudgets for people with a disability
Initiate proposals for personalisedbudgets for people with a disability
Establish Interdepartmental Groupon Eligibility / Entitlement
Publish the independent review group (Catherine Day)
report of the role ofvoluntary organisations
Seek Governmentdecision on de Buitléir
recommendations
Sláintecare Implementation Timeline: Workstream 2 – Gantts 2019
Public and PrivatePartners Programme
2.3
Eligibilty / EntitlementProgramme
2.4
Determine and progresspriority objectives for GP
contractual reform
Eligibility /Entitlement Programme
Public and Private Partners Programme
40
Sláintecare Action Plan 2019
Sláintecare Implementation Timeline: Workstream 2 – Gantts 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
7.2.1,7.1.5, 7.1.1, 7.1.2, 7.1.3, 7.1.4, 7.3.1, 7.4.2, 7.4.1, NEW
Develop the “Hospital ABFImplementation Plan 2019-2022” to
embed and extend ABF benefits
Conduct research and benchmark for health and social care budgets incomparable international jurisdictions
Identify areas of healthcare provision that can berelocated from hospitals to community settings
Review programme of work to develop an activity and cost database for health and social care in Ireland
Sign contract for the implementation of an externalsystem to support financial / corporate system objectives
Develop paper to inform the development ofproposals for multi-annual budgeting in the
healthcare system
Research approaches forthe allocation of fundingon a population-based
approach
Complete initial comparison costing report on the commissioningof external disability and mental health residential placements
Set out policy proposal for multi-annual budgetingEstablish interdepartmental (DoH, DPER, HSE)working group to review multi-annual budgeting
Review international best practice forpopulation-based funding
Develop draft budget approach forregional population-based funding
Roll out agreed ABF actions
Undertake governance review of drugs approval andprocurement process
Examine financial models to redirectdemand to location of least complexity
2.5
Financing ReformProgramme
Financing Reform Programme
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Sláintecare Action Plan 2019
Workstream 3 —
Teams of the Future
Sláintecare
Sláintecare Executive Task ForceChair: Executive Director, Sláintecare
Service ReDesign and Supporting Infrastructure
Workstream 1
1.1Data, Researchand Evaluation
Programme
1.2Population
based PlanningProgramme
1.3Service
ReDesignFrameworkProgramme
1.4Capital PlanningImplementation
Programme
1.5eHealth
Programme
Safe Care, Co-ordinatedGovernance and Value for Money
Workstream 2
2.1Geoalignment andRICOs Structure
Programme
2.2Corporate
and ClinicalGovernanceProgramme
2.3Public and
Private PartnersProgramme
2.4Eligibilty /
EntitlementProgramme
2.5FinancingReform
Programme
Teams of the Future
Workstream 3
3.1Workforce
PlanningProgramme
3.2Training Pipelineand New Ways
of TrainingProgramme
3.3Culture Changeand New Ways
of WorkingProgramme
3.4Innovation /
Capacity BuildingProgramme
3.5Future
Intelligence /InfluencersProgramme
Sharing Progress
Workstream 4
4.1Citizen and StaffEngagement andEmpowerment
Programme
4.2 Sláintecare Programme
ImplementationOffice and
GovernanceProgramme
4.3 EvaluationFramework and
Reporting ProgressProgramme
4.4 IntegrationFund and
Sláintecare BudgetManagementProgramme
4.5Communicationsand Recognising
SuccessProgramme
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Sláintecare Action Plan 2019
Workstream 3 — TeamsoftheFuture
1 WorkforcePlanningProgrammeThisprogrammewillensurethattherightteamsareavailable,attherighttime,todeliverontheclinicalandserviceobjectivesoftheSláintecarereform.Effectiveshort,medium,andlong-termworkforceplanningwillbeundertakentoensurethatnewModelsofCareareproperlyplannedinordertodeliverintegratedcare.Targetedrecruitmentandretentioninitiativeswillbescopedandcommenced.
2 TrainingPipelineandNewWays ofTrainingProgramme
ThisprogrammewillplandynamictraininginitiativestosupporttheSláintecarereform.Itwillbeacollaborativerelationshipwitheducatorsandstudentstosupporttheevolutionofinterdisciplinarycaremodelsandteamsovertime.Afocuswillbetodriveskillsoptimisationandteam-basedworking,andleadershipcapabilitieswillbepromotedbythisprogramme.Enhancedconfidence,satisfaction,andcompetenceofstaffwithintheirjobsisakeygoalforthisprogramme,includingtherolewhichtheworkingenvironmentplaysinattractingandretainingstaff.
3 Culture Change and New Ways of WorkingProgramme
Thisprogrammewillencourageandsupportthehealthcareworkforcetobecomeleadersandchampionsinunderstandingandadaptingto thewide-rangingimplicationsoftheSláintecare reforminitiatives.
4 Innovation/CapacityBuildingProgramme
Thisprogrammewillsupportstafftodeveloptheirinnovativeideas,talentandcompetenciesneededtonavigateadynamicandevolvinghealthcaresystem. Afocusonencouragingandbuildingcapacitywithintheworkforcetoadaptprocesses,systems,andways ofworkingwillbecentraltothisprogramme.
5 FutureIntelligence/InfluencersProgramme
Thisprogrammewillhorizon-scanfornewinitiativesandenablerswhichmayhelptheworkforcetodeliverthebestservicetopatients,serviceusersandclientsfortheoptimumvaluetothetaxpayer.
TheWorkstreamWorkBreakdownandProjectGanttsfordeliveryoftheseProgrammesin2019areasfollows:
TermsofReference: 2019—2028
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Sláintecare Action Plan 2019
Work Breakdown Workstream 3: 2019Teams of the Future
Implement Medical Training andCareer Structures recommendations
Implement new contractualarrangements with GPs and Nursing
Enhance leadership through theHealth Service Leadership Academy
Introduce skills developmentprogrammes including lean
improvement projects
Identify good practice in terms ofSláintecare objectives and scale/
promote/disseminatethrough the Integration Fund
Conduct research on potential impactof AI, Robotics etc. on Workforce
Planning, and on services forpatients / service users
Commence development of anIntegrated Workforce Plan (WFP)
Develop a methodology fordetermining the resourcesand services required for
a community service model
Expand capacity in GPand community nursing
to manage chronic disease
Progress developmentof Public Health
Doctors’ role in Ireland
Assess existing health professionals’ contracts in the context of enabling
a shift to significantly enhanced community-based care, including
an examination of scope for extended working hours
3.1 WorkforcePlanning Programme
3.2 Training Pipeline andNew Ways of Training Programme
3.3 Culture Change and NewWays of Working Programme
3.4 Innovation / Capacity Building Programme
3.5 Future Intelligence / Influencers Programme
Publish policy anddevelop the role of Advanced
Nurse Practitioners
Introduce performance managementin areas of public health service
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Sláintecare Action Plan 2019
Sláintecare Implementation Timeline: Workstream 3 – Gantts 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
4.1.1,4.1.2,4.2.1,4.3.1,9.1.1,9.1.2,9.1.3,9.2.3,9.3.1,9.3.2,NEW
9.2.4,9.2.2
Convene cross departmentalWorkforce Planning Forum
Review recommendations
in the MedicalTraining and Career
Structures documentfor implementation
Develop implementation policy andplan to roll out Medical Training &
Career Structures recommendations
Progress development of Public HealthDoctors’ role in Ireland
Publish policy and develop the role of advanced nursing practitioners for operationalisation by the HSE
Expand capacity in GP and community nursing to manage chronic disease
Commence roll-out of Medical Training &Career Structures recommendations
Develop a methodology for determining the resources required for delivering integrated care on a regional basis
Establish a team to lead on detailedstrategic health workforce planning
Commence development of an Integrated WorkforcePlan to include Doctors, Nurses, HSCPs and all staff
Continue development of an Integrated WorkforcePlan to include Doctors, Nurses, HSCPs and all staff
3.1
WorkforcePlanningProgramme
3.2
Training Pipelineand New Ways ofTraining Programme
Workforce Planning Programme
Training Pipeline and New Ways of Training Programme
46
Sláintecare Action Plan 2019
Sláintecare Implementation Timeline: Workstream 3 – Gantts 2019
Culture Change and New Ways of Working Programme
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Innovation /Capacity Building Programme
4.4.3,9.4.2,NEW
HSE to finalise and publishproposals for Performance Management
Systems across the health service
9.4.1,9.5.1,NEW
Scale up good practice for innovation and capacity building across services
Roll-out skills development programme
Agree programme forthe Health Service
Leadership Academy Plan future leadership development initiatives
Agree professional skills development programmesincluding lean improvement projects
NEW Complete research on the potential impact of Artificial Intelligence, Robotics and other technologieson workforce planning, and on services for patients / service users
Assess existing health professionals’ contracts in the context of enablinga shift to significantly enhanced community-based care
Identify good practicein innovative service
delivery projects
Implement new contractual arrangements with GPs and Nurses
3.3
3.4
3.5
Culture Change and New Ways ofWorking Programme
Innovation /Capacity BuildingProgramme
Future Intelligence /InfluencersProgramme
Future Intelligence / Influencers Programme
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Sláintecare Action Plan 2019
Workstream 4 —
Sharing Progress
Sláintecare
Sláintecare Executive Task ForceChair: Executive Director, Sláintecare
Service ReDesign and Supporting Infrastructure
Workstream 1
1.1Data, Researchand Evaluation
Programme
1.2Population
based PlanningProgramme
1.3Service
ReDesignFrameworkProgramme
1.4Capital PlanningImplementation
Programme
1.5eHealth
Programme
Safe Care, Co-ordinatedGovernance and Value for Money
Workstream 2
2.1Geoalignment andRICOs Structure
Programme
2.2Corporate
and ClinicalGovernanceProgramme
2.3Public and
Private PartnersProgramme
2.4Eligibilty /
EntitlementProgramme
2.5FinancingReform
Programme
Teams of the Future
Workstream 3
3.1Workforce
PlanningProgramme
3.2Training Pipelineand New Ways
of TrainingProgramme
3.3Culture Changeand New Ways
of WorkingProgramme
3.4Innovation /
Capacity BuildingProgramme
3.5Future
Intelligence /InfluencersProgramme
Sharing Progress
Workstream 4
4.1Citizen and StaffEngagement andEmpowerment
Programme
4.2 Sláintecare Programme
ImplementationOffice and
GovernanceProgramme
4.3 EvaluationFramework and
Reporting ProgressProgramme
4.4 IntegrationFund and
Sláintecare BudgetManagementProgramme
4.5Communicationsand Recognising
SuccessProgramme
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Sláintecare Action Plan 2019
Workstream 4 — SharingProgress
1 CitizenandStaffEngagementandEmpowermentProgramme
Thisprogrammewillengageandempowercitizensintheirownhealthandwellbeing.Theaimistocreateamodern,responsive,andintegratedpublichealthsystemwhichsecureslong-termpublicandpoliticalconfidenceinthedeliveryandsuccessoftheSláintecarereform.Initiativestoenablehealthliteracywillbeidentifiedandscopedaspartofthisprogramme. Thisprogrammewillalsoinvolvetherolloutofacomprehensiveengagementplanforthehealthworkforce,toensurethatfrontlinestaffareinvolvedin,andfeelownershipof,thedesignanddeliveryoftheSláintecarechangeprogramme.
2 SláintecareProgrammeImplementationOfficeandGovernanceProgramme
ThisprogrammewillbeledbytheSPIOincollaborationwiththeDepartmentofHealth,theHSEandotherstakeholders.TheProgrammewillselecttheSláintecarepriorityprojectsforimplementationandestablishthestructuresandgovernancetoenableearlydeliveryoftheseprojects.Centraltothisprogrammeishavingclearstructuresinplacetosupportriskmanagement,issuesescalation,conflictmanagement,andproblemsolving,astheten-yearreformisplannedanddelivered.
3 EvaluationFrameworkandReportingProgressProgramme
ThisprogrammewilldefineanevaluationframeworkwhichcanbeusedtosupportregularreportingontheSláintecarereform.ItwillbeusedtounderstandhowtheDepartmentofHealth,HSEandotherstakeholdersareprogressingpriorityprojectssoastodemonstrateprogress.ItwillworkwithHealthyIrelandtorefineanddeliveroneOutcomesFrameworkforIreland.
4 IntegrationFundandSláintecareBudgetManagementProgramme
ThisProgrammewillmanagetheSláintecarebudget,includingtheIntegrationFund,bydesigning,establishingandresourcingprojectstotestnewModelsofCare,supportchangeprocesses,andimplementpriorityprogrammes.ItwillpreparedetailedbudgetsforaTransitionFundtosupportSláintecarereform.
5 CommunicationsProgrammeandRecognisingSuccessProgramme
Thisprogrammewillensurethattheappropriatecommunicationprocesses,tools,andschedulesareinplacetoshareprogressonthestatusandadvancementofSláintecareinitiatives.
TheWorkstreamWorkBreakdownandProjectGanttsfordeliveryoftheseProgrammesin2019areasfollows:
TermsofReference: 2019—2028
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Sláintecare Action Plan 2019
Launch and roll out a public andhealth workforce engagement
and empowerment plan
Convene SláintecareImplementation Advisory
Council meetings
Develop a CitizenHealth Portal Prototype
Convene High Level DeliveryBoard Meetings
Develop a Public Health Service Online Directory
Develop and expand patientexperience capture systems
Promote shared valuesamongst HSE staff
Scope initiatives tosupport Health Literacy
Develop an evaluation programmefor the overall Sláintecare reform
Convene Executive Task Force,and Programme Teams
Develop monthly reportsand RAID logs
Roll out Integration Fundfor new Models of Careand integration projects
Develop Communications Plan and tools for Sláintecare
Publish detailed Action Plan andpublish progress reports biannually
Identify Programme torecognise successful delivery
4.1 Citizen and Staff Engagement and Empowerment Programme
4.2 Sláintecare Programme Implementation Office and
Governance Programme
4.3 Evaluation Framework andReporting Progress Programme
4.4 Integration Fund andSláintecare Management
Programme
4.5 Communications Programme and Recognising
Success Programme
Work Breakdown Workstream 4: 2019Sharing Progress
Establish a multi-annualTransition Fund
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Sláintecare Action Plan 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
Prepare for 2020 nationwide Public and Staff Engagementand Empowerment initiatives
Launch Public and Staff Engagementand Empowerment Programme
Develop and expand systems to capture patient/service user experience
Convene and hold High Level Delivery Board Meetings
Hold monthly Executive Task Force and Programme Teams meetings
Sláintecare Programme Implementation Office and Governance Programme
Convene and hold Sláintecare Implementation Advisory Council Quarterly Meetings 2019
Promote sharedvalues amongst thehealth workforce
Support initiatives to promote Health Literacy
Develop monthly progress reports and RAID logs
Confirm all projects have PIDS, Budgets,delivery trajectories and RAID log
Agree meeting andreporting structures,
frequency and methods
Mobilise SPIO team
Continue roll-out of shared values amongst health workforce
Establish monthlyExecutive Task Force
and ProgrammeTeams meetings
Continue roll-out of Citizen and Staff engagement initiatives
Develop roadmap for delivery of the Citizen Health Portal
4.1
Citizen and StaffEngagement andEmpowermentProgramme
4.2
SláintecareProgrammeImplementationOffice and GovernanceProgramme
Sláintecare Implementation Timeline: Workstream 4 – Gantts 2019
2.4.1,2.4.2, 1.4.5,3.1.1, NEW
2.1.2,2.2.2, NEW
Citizen and Staff Engagement and Empowerment Programme
Design and developCitizen Health
Portal prototype
52
Sláintecare Action Plan 2019
Sláintecare Implementation Timeline: Workstream 4 – Gantts 2019
SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019
4.3
4.4
4.5
10.6.4,2.3.1,NEW
Prepare first Sláintecare mid-year report
Communications Programme & Recognising Success Programme
2.5.1,3.3.3
Develop criteriaand governance forIntegration Fund.Launch callout ofIntegration Fund
Prepare bid for Transition Fund based on priorityprevention and early intervention, capacity and value
for money projects Establish and resource multi-annual Transition Fund
2.3.1,2.3.2,NEW
Publish progress reports on a biannual basis
Identify Programme to recognise successful delivery
Develop and roll-out Communications Plansand tools for Sláintecare programme
Integration Fund & SC Budget Management Programme
Provide information and respond to requests on reporting of Sláintecare implementation progress
Publish 2019 Action Plan
Select projects
Conduct ongoing evaluation
Commence evaluationof impact of fund
Rollout Programme to recognise successful delivery
Draft 2019Sláintecare Progress
Report
Prepare 2020 Action Plan
Evaluation Framework &Reporting ProgressProgramme
Integration Fund & SláintecareBudget Management Programme
CommunicationsProgramme &Recognising SuccessProgramme
Evaluation Framework & Reporting Progress Programme
Launch and mobilise projects to testand scale new Models of Care
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Sláintecare Action Plan 2019
AppendixListofAbbreviations
ABF Activitybasedfunding
AHP AdvancedHealthcarePractitioner
ANP AdvancedNursePractitioner
AI ArtificialIntelligence
CHN CommunityHealthcareNetwork
CHO CommunityHealthcareOrganisation
COPD ChronicObstructivePulmonaryDisease
DOH DepartmentofHealth
DPER DepartmentofExpenditureandReform
ED EmergencyDepartment
EHR ElectronicHealthRecord
FOI FreedomofInformation
HaPAI HealthyandPositiveAgeingInitiative
HG HospitalGroups
HI HealthyIreland
54
Sláintecare Action Plan 2019
HIQA HealthInformationandQualityAuthority
HSCP HealthandSocialCareProfessional
HSE HealthServicesExecutive
IHI IndividualHealthIdentifier
IIS IntegratedInformationSystem
MAU MedicalAssessmentUnit
MIU MinorInjuryUnit
MOC ModelofCare
NSP NationalServicePlan
OPAT Outpatientparenteralantimicrobialtherapy
PHSI ProgrammeforHealthServiceImprovement
PID ProjectInitiationDocument
PQ ParliamentaryQuestion
RAID Risks,Actions,IssuesandDependencies
RICO RegionalIntegratedCareOrganisation
RSSMAC ResidentialSupportServicesMaintenanceandAccommodationContributions
SAT SingleAssessmentTool
SIAC SláintecareImplementationAdvisoryCouncil
SPIO SláintecareProgrammeImplementationOffice
WFP WorkforcePlan
WHO WorldHealthOrganisation
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Sláintecare Action Plan 2019
GlossaryofTerms ActivityBasedFunding(ABF)ABFmeansthathospitalsarepaidfortheactualquantityandqualityofcaretheydelivertopatients,therebyenablingthehospitalstoseeclearlythelinkbetweenmoneyandtheworktheydo.In2016theHSEintroducedABF forhospitalcareforinpatientandday-caseservices.TargetsforhospitalactivityaresetcentrallybytheHSEandpricesaresetbytheHealthcarePricingOffice.
CommunityHealthcareOrganisations(CHO)CommunityHealthcareOrganisations–ReportandRecommendationsoftheIntegratedServiceAreaReviewGroup1,publishedinOctober2014,setsouthowhealthservices,outsideofacutehospitals,arecurrentlyorganisedandmanaged.Knownascommunityhealthcareservices,theseservicesincludeprimarycare,socialcare(servicesforolderpeopleandforpersonswithadisability),mentalhealthandhealth&wellbeing.
HospitalGroups2
ThehospitalsinIrelandhavebeenorganisedintosevenHospitalGroupssince20133.Theservicesdeliveredincludeinpatientscheduledcare,unscheduled/emergencycare,maternityservices,outpatientanddiagnosticservices.TheGroupChiefExecutiveofeachHospitalGroupreportstotheNationalDirectorforAcuteServicesandisaccountablefortheirHospitalGroupsplanningandperformanceundertheHSEAccountabilityFramework(2015).
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Sláintecare Action Plan 2019
MedicalAssessmentUnit(MAU)AMAUisafacilitywithbedsseparatefromEDwhoseprimaryfunctionistheimmediateandearlyspecialistmanagementofacutelyunwelladultpatientswhopresentto,orarereferredfromwithin,ahospitalrequiringurgentmedicalcare.MAUsenableappropriatestreamingofpatientsawayfromEDtoimproveclinicalcareandthepatientexperience.MAUshavethepotentialtoprovidemoreintegratedcareforpatientswithurgentmedicalneed,deliveredinamoreappropriatesetting,bystaffwiththecorrectskillsmixandexpertise.
Model of CareAmodelofcaredefinesthewayhealthservicesaredeliveredanddescribesbestpracticecareandservicesforaperson,populationgrouporpatientcohortastheyprogressthroughthestagesofacondition,injuryorevent4.
1https://www.hse.ie/eng/services/publications/corporate/choreport.html2https://www.hse.ie/eng/services/list/3/acutehospitals/hospitalgroups.html3TheEstablishmentofHospitalGroupsasatransitiontoIndependentHospitalTrusts4NSWAgencyforClinicalInnovation(2013)Understandingtheprocesstodevelopamodelofcare– AnACIframework,availableathttps://www.aci.health.nsw.gov.au/_data/assets/pdf_file/0009/181935/HS13-034_Framework-DevelopMoC_D7.pdf
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Sláintecare Action Plan 2019
Sláintecare•Right Care.Right Place.Right Time.