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Agenda

Agenda. Introduction Purpose of Service Plan Underlying Assumptions Care Group Profiles Questions. 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

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Agenda

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  1. Agenda • Introduction • Purpose of Service Plan • Underlying Assumptions • Care Group Profiles • Questions

  2. 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

  3. 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

  4. FinanceDublin North East Budget Allocation

  5. Service Plan 2010 Presentation Regional Health Forum – Dublin North East22 February 2010

  6. 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

  7. 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

  8. Dublin North East Staffing – Dec 2009

  9. Dublin North East Staff Breakdown - Dec 2009

  10. Quality & Clinical Care • Quality & Clinical Care Directorate • Established late 2009 • Role • Further Strengthen Clinical Leadership • Improve Clinical Performance • Programmatic Approach to • Improving Care • Reducing Costs • Key Result Areas 2009 • Respiratory Diseases • Cardiovascular Diseases • Diabetes • ED Functionality

  11. 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

  12. Primary Care • Key Issues, Activity & Challenges - Dublin North East • Primary Care Teams • 59 New Teams will be put in place in Dublin North East • Projected Teams at 31 Dec 2010 – 84 Teams • Immunisations – 95% Target of Children in DNE • Out of Hours GP Service • 145,200 Contacts in Dublin North East • Delivering Primary Care Infrastructure • 6 Centres in Dublin North East

  13. 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

  14. Community (Demand Led) Schemes • Key Issues, Activity & Challenges - Dublin North East • Centralisation of Medical Cards • PCRS • National Activity Levels 2010 • Budget – Community DLS - €2.8 billion • GP Visit Cards Issued – 114,436 • Persons Covered by Medical Card – 1,622,560 • GMS Prescriptions – 18.4 million • Drug Payment Claims – 5 million • Long Term Illness Claims – 1 million

  15. Mental Health • Span all Life Stages & Covers Primary/Community & Specialist Services • Strategic Objectives • Vision for Change, 2006 • Executive Clinical Directorates • Re-configuration of Long-stay Units • Continued Shift to Community Based Services

  16. Mental Health • Key Issues, Activity & Challenges - Dublin North East • Infrastructure • Implementing Mental Health Capital Plan • Community Focus • Key Activity in Dublin North East • Acute In-patient Admissions – 2,990 • Re-admissions as % of Total –66% Target • Child & Adolescent Teams - 11

  17. Disability Services • Services to Adults & Children to Enable the to Reach their Full Potential • Interdisciplinary Supports • Rehabilitative Training • Day Services, Home Support, PAs • Residential • National Disability Strategy, 2004 • Disability Databases/Demographic Pressures 2010

  18. Disability Services • Key Issues, Activity & Challenges - Dublin North East • 60 Bed Streetscape – Knockamann, Portrane • Legislative / Quality Requirements • Reconfiguration of Service Delivery • Key Activity in Dublin North East • Persons in Rehabilitative Training – 505 • Residential / Respite Places – 1,464 • Emergency Residential Services – 31 • Assessments Completed within timelines – 100%

  19. 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 Strategy • National Intercultural Strategy • Conclusion ofTraveller Health Study

  20. Social Inclusion • Key Issues, Activity & Challenges - Dublin North East • Homeless Strategy - Implementation • Ethnic Minorities – Physical & Mental Health • Key Activity in Dublin North East • Clients in Methadone Treatment – 3,020 • Commencing Substance Abuse Treatment – 250 • Homeless Service – Providers Operating HSE Code of Practice – 100%

  21. 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 Scheme • Development Funding - €117 million Nationally • Enhancement of Home Care packages • Development Funding - €10 million Nationally

  22. Older People • Key Issues & Challenges - Dublin North East • NHSS ‘Fair Deal’ • Processing Applications • Hospital Avoidance Measures • Home Help/Home Care Packages • Community Based Services • Geriatrician-led Teams • Infrastructure – CNUs • 4 New Units in Dublin North East

  23. Older People • Key Activity in Dublin North East • Home Help Hours provided – 2.41 million (2.34m – 2009) • Total in Receipt of Home Help – 12,900 (12,731 – 2009) • Increased Home Care Package Funding • Total 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)

  24. 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

  25. 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

  26. Palliative Care • Key Issues, Activity & Challenges - Dublin North East • Implementing Minimum Data Set • Key Activity in Dublin North East • Patients Treated in Specialist Unit – 34 • Patients – Specialist Domiciliary Care – 561 • Patients receiving Day Care - 55

  27. 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

  28. Acute Services & Pre-Hospital Emergency Care • Challenges • Historic Overdependence on Acute System • On-going Demographic Change • Diversity • Increased Births • Increased Emergency Presentations • Higher Patient Acuity • Delayed Discharges • Increased Demand • European Working Time Directive

  29. Acute Services & Pre-Hospital Emergency Care • Dublin North East Infrastructure 2010 • Connolly Hospital • Refurbishment of Surgical Block • Beaumont Hospital • Neurosurgical Upgrade • Cystic Fibrosis Outpatient • Acute Medical Assessment Unit • Mater Hospital • Neurophysiology Outpatients • Second CT Scanner • Cath Lab & Intervention Radiology • Metabolic Services

  30. Acute Services & Pre-Hospital Emergency Care • Dublin North East Infrastructure 2010 • Temple Street • Theatre Upgrade • Our Lady of Lourdes • Emergency Department • Wards over ED

  31. 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 Activity • Increase Day Cases by 6.5% • Reduce In-patient Care by 5.6% • Out-patients • Increasing number of New Attendances • Emergency Presentations/Admissions • 9% Reduction in Emergency Admissions • Quality & Risk Focus – Improvements • Tackling ED Waits • North East Re-configuration • High Birth Rate

  32. Activity Levels – Dublin North East

  33. 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

  34. National Cancer Control Programme • Key Issues, Activity & Challenges - Dublin North East • Colonoscopy • 28 Day Urgent (Priority 1) Appointment • Centralisation of Cancer Services • Pancreatic Cancer Surgery • Rectal Cancer Surgery

  35. Questions?

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