Agenda

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

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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 - PowerPoint PPT Presentation

Transcript of Agenda

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Agenda

IntroductionPurpose of Service PlanUnderlying AssumptionsCare Group ProfilesQuestions

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Purpose of Service Plan

Details Type & Volume of service provided Directly by HSE Through Voluntary Agencies

Service Plan has a backdrop of New Challenges for 2010 Establishing Integrated Service Areas

Overarches Lower Level Plans Regional Performance Contract Dublin North East Level 1 Business Plan Local Service Plans

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Issues & Risks for 2010 Plan

Deliver on Vote Increasing Economic Constraint / Reduced

Income Impact of Recruitment Moratorium Introduction of Integrated Services Programme Continuation of Transformation Programme Increasing Population Trends in Community Demand Led Schemes Changing Health Technology Capital & ICT Plans

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FinanceDublin North East Budget

AllocationService Area 2009 2009

Re-stated

2010

€m €m €mNorth Dublin Hospitals

791 748 691

North East Hospitals

282 266 242

Community Services

1,071 964 924

Major Voluntary Agencies

184 172 166

Population Health 21 20 20Corporate Functions

81 74 61

Total €2,431 €2,244 €2,104

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Service Plan 2010Presentation

Regional Health Forum – Dublin North

East

22 February 2010

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Key National Service Developments 2010

Pandemic Vaccination - €55 million Ryan Report Implementation - €14 m / 200 WTEs Demand Led Schemes - €230 million Disability – Additional Day Services – 400 places NHSS – ‘Fair Deal’ - €117 million Home Care Packages - €10 million Cancer Services - €20 million / 79 WTEs* Innovation Funding €17m / 80 WTE’s * Demographic Funding - €70m / 410 WTE*

* To be confirmed

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Value for Money

Considerable success over last 3 years €500m efficiencies in 2008/2009

Target for 2010 €106m Nationally €22m Dublin North East

€12m Hospitals€9m Community€1m Corporate

Delivered from Non-pay Costs Not Intended to Impact on Service Provision

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Dublin North East Staffing – Dec 2009

Service Area Staff NumberHospitals (Inc. Acute Voluntaries)

12,008

Ambulance 170Major Voluntaries (Non-acute)

3,576

Community Services 7,785Population Health 217Corporate 324Total 24,080

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Staff Category Hospitals

Ambulance

Major Vols (PCCC)

PCCC Pop Health

Corporate

Medical /Dental 1,505 0 26 358 7 3Nursing 4,750 0 990 2,438 2 15Health & Social Care

1,473 0 808 1,352 120 1

Mgt/Admin(Includes, medical Sec., welfare staff, receptionists and telephonists, primary care teams support etc)

1,969 5 331 1,190 72 248

Gen Support 1,632 41 517 505 11 56

Other Patient /Client Care

679 124 904 1,942 5 1

Totals 12,008 170 3,576 7,785 217 324

Dublin North East Staff Breakdown - Dec 2009

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Quality & Clinical Care

Quality & Clinical Care Directorate Established late 2009

Role Further Strengthen Clinical Leadership Improve Clinical Performance Programmatic Approach to

Improving CareReducing Costs

Key Result Areas 2009 Respiratory Diseases Cardiovascular Diseases Diabetes ED Functionality

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Primary Care

Support & Promote Health & Wellbeing Locally Based Services

In 2010 Continue to Support Standardisation Across All PCTs Chronic Disease Management Direct Linkages with Mental Health Hospital Integration & Avoidance Health Promotion / Immunisation

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Primary Care

Key Issues, Activity & Challenges - Dublin North EastPrimary Care Teams

59 New Teams will be put in place in Dublin North East

Projected Teams at 31 Dec 2010 – 84 TeamsImmunisations – 95% Target of Children in DNEOut of Hours GP Service

145,200 Contacts in Dublin North EastDelivering Primary Care Infrastructure

6 Centres in Dublin North East

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Community (Demand Led) Schemes

Government Funded GP, Pharmacy, Dental, Ophthalmic, Addiction & Special Payments GMS – Medical / GP Visit Cards Community Drugs – LTI, High Tech etc. Primary Care Schemes – Maternity & Infant

Recent Trends Unprecedented Increase in Uptake

Medical Cards – 200,000 Increase Nationally since 2005

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Community (Demand Led) Schemes

Key Issues, Activity & Challenges - Dublin North EastCentralisation of Medical Cards

PCRSNational Activity Levels 2010

Budget – Community DLS - €2.8 billionGP Visit Cards Issued – 114,436Persons Covered by Medical Card – 1,622,560 GMS Prescriptions – 18.4 millionDrug Payment Claims – 5 millionLong Term Illness Claims – 1 million

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Mental Health

Span all Life Stages & Covers Primary/Community & Specialist Services

Strategic ObjectivesVision for Change, 2006Executive Clinical DirectoratesRe-configuration of Long-stay UnitsContinued Shift to Community Based

Services

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Mental Health

Key Issues, Activity & Challenges - Dublin North EastInfrastructure

Implementing Mental Health Capital PlanCommunity Focus

Key Activity in Dublin North EastAcute In-patient Admissions – 2,990Re-admissions as % of Total –66% Target Child & Adolescent Teams - 11

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Disability Services

Services to Adults & Children to Enable the to Reach their Full PotentialInterdisciplinary SupportsRehabilitative TrainingDay Services, Home Support, PAsResidential

National Disability Strategy, 2004Disability Databases/Demographic

Pressures 2010

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Disability Services

Key Issues, Activity & Challenges - Dublin North East60 Bed Streetscape – Knockamann, PortraneLegislative / Quality RequirementsReconfiguration of Service DeliveryKey Activity in Dublin North East

Persons in Rehabilitative Training – 505Residential / Respite Places – 1,464Emergency Residential Services – 31Assessments Completed within timelines – 100%

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Social Inclusion

Targeted towards Marginalised & at Risk to ensure equitable access to services

2010 Key Focus Integrate Recommendations into Mainstream

Health Services of National Drugs Strategy National Homeless StrategyNational Intercultural Strategy

Conclusion of Traveller Health Study

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Social Inclusion

Key Issues, Activity & Challenges - Dublin North EastHomeless Strategy - ImplementationEthnic Minorities – Physical & Mental HealthKey Activity in Dublin North East

Clients in Methadone Treatment – 3,020Commencing Substance Abuse Treatment – 250Homeless Service – Providers Operating HSE

Code of Practice – 100%

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Older People

Services to Support Older People to Remain at Home in Independence where possible & then in Appropriate Residential Setting

Focus for 2010 – Implementing Nursing Homes Support SchemeDevelopment Funding - €117 million Nationally

Enhancement of Home Care packagesDevelopment Funding - €10 million Nationally

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Older People

Key Issues & Challenges - Dublin North EastNHSS ‘Fair Deal’

Processing ApplicationsHospital Avoidance Measures

Home Help/Home Care PackagesCommunity Based Services

Geriatrician-led TeamsInfrastructure – CNUs

4 New Units in Dublin North East

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Older People

Key Activity in Dublin North EastHome Help Hours provided – 2.41 million (2.34m –

2009)Total in Receipt of Home Help – 12,900 (12,731 – 2009)Increased Home Care Package FundingTotal in Receipt of Home Care Packages – 3,373

(3,099 – 2009)Number of Home Care Packages – 1,205 (1,088 – 2009)Total new HCP Clients per Month – 1,053 (809 – 2009)Total Beds in Public Residential Facilities – 1,627

(1,513 – 2009)

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Children & Families

Promote & Protect Health & Well Being Particularly those at Risk of Abuse or Neglect

Focus for 2010 Build on work of Task Force on Children Implement Ryan Report, 2009 Implement Agenda for Children’s Services, 2007

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Palliative Care

Active Holistic Care of Patients with Advanced, Progressive Illness

Direct HSE Provision & Voluntary Providers St Francis Hospice, Raheny

2010 Focus Implement Agreed National Priorities for

Specialist Care Continue to roll-out Minimum Data Set

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Palliative Care

Key Issues, Activity & Challenges - Dublin North EastImplementing Minimum Data Set Key Activity in Dublin North East

Patients Treated in Specialist Unit – 34Patients – Specialist Domiciliary Care – 561Patients receiving Day Care - 55

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Acute Services & Pre-Hospital Emergency Care

Services include Assessment, Diagnosis, Treatment & Acute Rehabilitation

2010 Focus – Continue to provide for emergency admissions & priority services while controlling overall level of acute work Managing Elective Workloads Continue Shift to Day Case Activity Improve Performance – Day of Surgery

Admissions/ALOS Continue on-going Hospital re-configuration

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Acute Services & Pre-Hospital Emergency Care

ChallengesHistoric Overdependence on Acute SystemOn-going Demographic Change

DiversityIncreased Births

Increased Emergency PresentationsHigher Patient AcuityDelayed DischargesIncreased DemandEuropean Working Time Directive

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Acute Services & Pre-Hospital Emergency Care

Dublin North East Infrastructure 2010 Connolly Hospital

Refurbishment of Surgical Block Beaumont Hospital

Neurosurgical UpgradeCystic Fibrosis OutpatientAcute Medical Assessment Unit

Mater HospitalNeurophysiology OutpatientsSecond CT ScannerCath Lab & Intervention RadiologyMetabolic Services

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Acute Services & Pre-Hospital Emergency Care

Dublin North East Infrastructure 2010 Temple Street

Theatre Upgrade Our Lady of Lourdes

Emergency DepartmentWards over ED

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Acute Services & Pre-Hospital Emergency Care

Key Issues, Activity & Challenges - Dublin North East In-patient / Day Case

Continued Shift from In-patient to Day Case ActivityIncrease Day Cases by 6.5%Reduce In-patient Care by 5.6%

Out-patientsIncreasing number of New Attendances

Emergency Presentations/Admissions9% Reduction in Emergency Admissions

Quality & Risk Focus – Improvements Tackling ED Waits North East Re-configuration High Birth Rate

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Activity Levels – Dublin North East

Service Type 2009 Target

2010 Target

In-patient Discharges 116,100 109,800Day Cases 125,380 139,518Total In-patient & Day Case 241,48

0249,31

8Emergency Presentations 242,970 246,086Emergency Admissions 73,740 66,366OPD Attendance 784,410 813,326Births 15,750 15,100

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National Cancer Control Programme

NCCP Established under Strategy for Cancer Control in Ireland 2006

Provide Necessary Governance, integration, Leadership, Operational Framework & Core Support Services for Cancer Control

2010 Programme Includes Additional Oncology Appointments Reduction in Number of Hospitals Carrying Out Rectal

Surgery Centralisation of Upper GI & Gynae. Cancers Continued Implementation - National Plan for Radiation

Oncology

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National Cancer Control Programme

Key Issues, Activity & Challenges - Dublin North EastColonoscopy

28 Day Urgent (Priority 1) AppointmentCentralisation of Cancer Services

Pancreatic Cancer SurgeryRectal Cancer Surgery

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Questions?