Download National Hospital Information Systems Progamme

Agenda
Introduction
Purpose of Service Plan
Underlying Assumptions
Care Group Profiles
Questions
1
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
2
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
3
Finance
Dublin North East Budget Allocation
Service Area
2009
2009
Re-stated
2010
€m
€m
€m
North Dublin Hospitals
791
748
691
North East Hospitals
282
266
242
Community Services
1,071
964
924
Major Voluntary Agencies
184
172
166
Population Health
21
20
20
Corporate Functions
81
74
61
€2,431
€2,244
Total
€2,104
4
Service Plan 2010
Presentation
Regional Health Forum – Dublin North East
22 February 2010
5
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
6
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
7
Dublin North East
Staffing – Dec 2009
Service Area
Hospitals (Inc. Acute Voluntaries)
Ambulance
Staff Number
12,008
170
Major Voluntaries (Non-acute)
3,576
Community Services
7,785
Population Health
217
Corporate
324
Total
24,080
8
Dublin North East
Staff Breakdown - Dec 2009
Staff Category
Hospitals
Ambulance
Major Vols (PCCC)
PCCC
Pop Health
Corporate
Medical /Dental
1,505
0
26
358
7
3
Nursing
4,750
0
990
2,438
2
15
Health & Social Care
1,473
0
808
1,352
120
1
Mgt/Admin
(Includes, medical
Sec., welfare staff,
receptionists and
telephonists, primary
care teams support
etc)
1,969
5
331
1,190
72
248
Gen Support
1,632
41
517
505
11
56
679
124
904
1,942
5
1
12,008
170
3,576
7,785
217
324
Other Patient /Client
Care
Totals
9
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
10
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
11
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
12
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
13
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
14
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
15
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
16
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
17
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%
18
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
of Traveller Health Study
19
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%
20
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
21
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
22
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)
23
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
24
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
25
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
26
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
27
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
28
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
29
Acute Services & Pre-Hospital
Emergency Care
 Dublin North East Infrastructure 2010
 Temple
Street
 Theatre Upgrade
 Our
Lady of Lourdes
 Emergency Department
 Wards over ED
30
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
31
Activity Levels – Dublin North East
Service Type
2009
Target
2010
Target
In-patient Discharges
Day Cases
116,100
125,380
109,800
139,518
Total In-patient & Day Case
241,480
249,318
Emergency Presentations
242,970
246,086
73,740
66,366
784,410
813,326
15,750
15,100
Emergency Admissions
OPD Attendance
Births
32
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
33
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
34
Questions?
35