National Service Plan 2017 Overview

The National Service Plan for 2017 outlines key priorities, achievements, and budget allocation in the healthcare sector. It covers population changes, service delivery statistics, strategic objectives, and budget details for improving healthcare services and the well-being of the population.

• Healthcare
• National Service Plan
• 2017
• Budget
• Population

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1. 2017 National Service Plan Tony O Brien, Director General

2. 2017 Welcome National Service Plan

3. 2017 Population Changes Population is set to increase by 0.7% between 2016 and 2017 and is projected to increase by 4% by 2022 Between 2016 and 2017 3.7% increase in those aged 85 years and over National Service Plan

4. 2016 What We Have Delivered 2017 National Service Plan 1.7m Hospital Discharges 478,500 GP Visit Cards OPD attendances 3.34m People with a medical card Ambulance Emergency Responses 1.7m No. of CIT contacts 27,000 No. of patients seen for therapy in primary care 309,500 1.5m 23,100 Older people in residential settings 10.57m Home Help Hours delivered to 49,000 older people People with disabilities provided with a residential place 8,170 PA hours provided to adults with a physical and / or sensory disability 1.5m Adults seen by the mental health services 28,875 Children seen by CAMHs services 17,790

5. 2017 2017 Priorities National Service Plan Improving the quality and safety of our services Improving the health and wellbeing of the population Providing care in a more integrated way Programme for Health Service Improvement Developing a performing and accountable health service Developing our business supports and infrastructure Implementing eHealth Ireland Implementing the Health Services People Strategy 2015-2018, Leaders in People Services

6. Health Service Reform Integrated Care Continue to implement integrated care programmes for chronic disease prevention and management, older people, children, and patient flow Continue to work with service users, medical colleges and nursing and therapy leads to develop and implement processes that will improve the way in which care is provided Health Service Improvement Support the decisive shift of service to primary care Support local service improvement programmes Develop programme offices in each of the service delivery organisations Continue the development of the new Children s Hospital Continue to develop the way in which our corporate centre relates to Hospital Groups, CHOs and NAS

7. 2017 Budget 2017 National Service Plan Total revenue budget available in 2017 is 13,948.5m Increase on revised budget 2016 of 458.6m (3.4%) Full year effects of 2016 developments - 72.9m Pay rate funding to support existing level of staff - 118.1m Non-pay and demographics costs - 186.3m Expanding existing & developing new services - 81.3m Within the 13,948.5m, 36.5m is being held by the DoH to fund specific initiatives Separately, a provision of 439m in capital funding will be made available to the HSE in 2017, comprising 384m for building, equipping and furnishing of health facilities and 55m for ICT.

8. 2017 Approach to Financial Risk National Service Plan Governance budgetary control, enhanced Accountability Framework Pay integrated strategy on recruitment, agency conversion and workforce planning Non-pay targeted cost containment programmes Income sustain and improve income generation Activity ABF model within hospitals and the progression of a community costing framework

9. 2017 Expanding and Developing Services - 81.3m National Service Plan Acute Division - 9m NAS and Emergency Management - 1m Primary Care- 12m Social Inclusion- 1.5m Mental Health- 15m Disability Services - 11.8m Services for Older People- 10m PCRS - 20m National Services - 1m

10. 2017 Funding Held National Service Plan Department of Health 2017 - 36.5m Primary Care: 18.5m for service developments including reduced prescription charges for > 70s Mental Health: 15m to initiate new developments in 2017 with a recurring full year value of up to 35m Social Inclusion: 3m to invest in services relating to addiction

11. 2017 National Service Plan Quality and Safety

12. Quality and Safety 13.1m We will establish a 3 year patient safety programme to: Develop the capacity of Hospital Groups, CHOs and NAS to manage safety and risk and improve quality Plan, oversee and ensure clinical leadership for targeted safety initiatives including Healthcare Associated Infections Implement the new National Standards for the Conduct of Reviews and Patient Safety Incidents Implement the revised Integrated Risk Management Policy Strengthen accountability for safety, risk and quality by building capacity for gathering and analysing safety information and audit, including clinical audit

13. 2017 National Service Plan Health and Wellbeing

14. Health and Wellbeing 233m Budget 2017: 233.3m for Health and Wellbeing (increase of 4.2%) Expected activity includes: 155,000 women having a complete Breastcheck mammogram 242,000 women having one or more smear tests 106,875 satisfactory BowelScreen FIT tests 87,000 screenings for Diabetic RetinaScreen clients 13,000 smokers receiving intensive cessation support 2,440 people having completed a structured patient education programme for diabetes 33,000 official food control planned, and planned surveillance, inspections

15. Health and Wellbeing Improve research capability and continue to assess the health needs of the population as part of designing services to promote good physical and mental health Integrate illness prevention, early detection and self-management into our services through initiatives such as Making Every Contact Count and Self Management Support Implement programmes to reduce the burden of chronic disease across the policy priority areas of Tobacco, Alcohol, Healthy Eating Active Living, Healthy Childhood, Sexual Health, Positive Ageing and Mental Health Deliver Healthy Ireland actions through the development and implementation of Hospital Group and CHO Healthy Ireland plans Population health protection and capacity building for prevention, surveillance and management of HCAIs Cross-sectoral partnerships to improve health outcomes and address health inequalities

16. 2017 National Service Plan Primary Care

17. Primary Care 3.6bn Budget 2017: 808m for Primary Care Services (increase of 4%) 2.6bn for PCRS (increase of 0.2%) 133m for Social Inclusion (increase of 2.6%) 76.5m for Palliative Care (increase of 1.2%) 21.5m DoH held funding for service developments including reduced prescription charges for >70s and addiction services Expected activity includes: 32,861 CIT Patient Referrals 1.5m therapy treatments in Primary Care 9,700 opioid substitution treatments (outside prisons) 3,620 patients receiving specialist palliative care treatment in their normal place of residence 1.7m medical card holders covered

18. Primary Care Improve quality, safety, access and responsiveness of primary care services to support the decisive shift of services to primary care Improve health outcomes for the most vulnerable in society including those with addiction issues, the homeless, refugees, asylum seekers, Traveller and Roma communities Improve access, quality and efficiency of palliative care services Reimburse contractors in line with health policy, regulations and within service level arrangements governing administration of health schemes Process applications for eligibility (under PCRS) within agreed timelines Strengthen accountability and compliance across all services and review contractor arrangements

19. 2017 National Service Plan Mental Health

20. Mental Health 853m Budget 2017: 853m for Mental Health (increase of 3% on 2016 closing budget) Above includes :- 15m DoH held funding for additional spending in 2017 for enhanced services up to 35m on a full year basis; 9.4m to stabilise growing pay cost to provide existing level of service. National Forensic Service : Significant Capital Investment in 2017 with Contact to be signed in Q1 Expected Activity (Examples): 18,496 children attending CAMHs 74 CAMHs inpatient beds 335 admissions to CAMHs acute inpatient beds 39,321 adult referrals seen by mental health services 13,104 admissions to adult acute inpatient units 10,013 psychiatry of old age referrals seen by mental health services

21. Mental Health Promote the mental health of the population in collaboration with other services and agencies including reducing the loss of life by suicide Designintegrated, evidence-based and recovery focused mental health services Delivertimely, clinically effective and standardised safe mental health services in adherence to statutory requirements Ensure that the views of service users, family members and carers are central to the design and delivery of mental health services Enable the provision of mental health services by highly trained and engaged staff and fit for purpose infrastructure

22. 2017 National Service Plan Social Care

23. 1.7bn Older People Budget 2017: 765m for Services for Older People (increase of 3.6%) 940m for Nursing Homes Support Scheme (NHSS) Expected activity includes: Provide additional 496 places under NHSS(Fair Deal) to over 23,603 people Maintain 2016 outturn of 10.57m home help hours Provide an additional 300 Home Care Packages increasing the number of recipients to 16,750 people through the Winter Initiative Maintain 190 Intensive HCPs included 60 funded by Atlantic Philanthropies Provide 152 approvals per week for transitional care and 167 in January and February 2017

24. Older People Continue to implement a reform and improvement programme in home care and short stay residential care Provide each CHO with an audit and quality team to support home care reform Continue to rollout SAT and share learning's of the Integrated Care Teams as part of the ICP OP Continue to implement the National Dementia Strategy and the overall investment programme of 27.5m

25. 1.7bn Disability Services Budget 2017: 1.69bn for Disability Services (increase of 96.3m or 6%) Expected activity includes: Emergency Cases ( 16.2m supporting 395 people) New Residential Emergency places 185 New Home support/in home respite for emergency cases 210 Home Support PA Hours ( 5.5m to maintain ELS in mainstream services) 5.5m additional budget to maintain ELS - 250,000 hours over 2016 target. Emergency Cases funding stream will support remaining 250,000 hours over target as part of new person centred initiative.

26. Disability Services New Directions including School Leavers ( 10m Supporting 1,500 People) Provide day service support for approximately 1,500 people leaving school/rehab training Time to Move on from Congregated Settings ( 100m Capital Programme) 223 People will move to Community Living.... 50 additional homes purchased Service reform fund ( 45m over 3 years) - supporting transition and innovation Commitment to stakeholder consultation and engagement Neuro Rehabilitation Strategy Framework for Neuro rehabilitation Strategy completed & an innovative pilot day service aimed at supporting people with severe acquired brain injury National Policy on Safeguarding Vulnerable Persons at Risk of Abuse

27. 2017 National Service Plan Pre-Hospital Emergency Care

28. National Ambulance Service 155m Budget 2017: 155m for NAS Expected activity includes: 315,000 emergency ambulance calls 5,589 clinical status 1 ECHO calls activated 125,985 clinical status 1 DELTA calls activated 30,503 inter-hospital transfer calls 26,846 intermediate care vehicle transfer calls

29. National Ambulance Service Improve operational performance and outcomes for patients Provide a flexible, safe, responsive and effective service to meet planned alternative models of patient care Enhance clinical competencies and governance arrangements to improve quality of care and patient safety Play an active role in improving the health needs of the population Deploy the most appropriate resources safely, quickly and efficiently

30. 2017 National Service Plan Acute Services

31. Acute Hospital Care 4.4bn Budget 2017: 4.367bn for Acute Services (increase of 2.8%) 78.4m for National Cancer Control Programme (increase of 9.7%) Expected activity includes: 1.7m inpatient and day cases 1.2m new Emergency Department attendances 3.4m new and return outpatient attendances 18,000 patients triaged as urgent presenting to symptomatic breast clinics 3,300 patients attending rapid access lung clinics 2,600 patients attending rapid access prostate clinics

32. Acute Hospital Care Ensure Hospital Groups have clear structures to govern and deliver quality care Monitor and control healthcare associated infections (HCAIs) Increase critical care capacity Improve inpatient flow with continued focus on delayed discharges in partnership with social care services Continue to improve patient experience times in EDs Improve access to urgent and planned care by increasing efficiencies, streamlining processes and maximising capacity in hospitals Implement the National Maternity Strategy 2016 2026 Implement the new cancer strategy

33. 2017 National Service Plan Thank you