HSE Dublin North East Publishes Regional Service Plan 2013

The HSE Dublin North East today, (Thursday, 28th February), published its Regional Service Plan 2013. The Service Plan sets out the type and volume of services the Health Service Executive (HSE) will provide directly, and through a range of funded agencies, in the region during 2013. These health and social care services must be delivered within an allocated regional budget of €1.842 billion by Government and within the stipulated employment levels.

HSE DNE Exclusions The budget for HSE DNE in 2013 amounts to *€1,505 m. The draft whole time equivalent (WTE) ceiling target is 17,368.

The key priorities outlined in the DNE Regional Service Plan for 2013 are as follows:

  • Ensure the delivery of high quality and safe services.
  • Maintain the overall level of services provided in 2012 to greatest extent practical.
  • Implement the national clinical change programmes and specified new service developments with a particular emphasis on our primary, community, mental health and social care services.
  • Implement the new structures as outlined by the Minister for Health under the ‘Future Health; A Strategy Framework for Reform of the Health Service 2012-2015’ · Work with the Special Delivery Unit to reform the delivery of emergency services and achieve the access targets for 2013.
  • Deliver the waste and cost reduction and restructuring programmes to maintain these service levels within budget.

Stephen Mulvany, Regional Director of Operations, DNE said: “Our goal this year is to maintain service levels and deliver the highest quality of services and improved access within the budget allocated subject to the financial constraints in 2013 and the public sector moratorium which will continue to restrict recruitment of staff. Flexibility in relation to reconfiguration and redeployment will continue to be needed in order to maintain frontline services”.

“The focus for the coming year continues to be on safely eliminating waste to reduce costs while maintaining services.” 2012 proved to be a very challenging year in terms of bringing expenditure in line with budgets. This was particularly evident in the acute sector. There was an acknowledgement going into 2013 that setting unrealistic budgets, particularly acute budgets, only ‘set us up to fail’, and so a different approach has been adopted this year for budget setting. The intention is to give the hospitals a challenging, but achievable, target for 2013 and offer them a reasonable chance of achieving breakeven. Because a significant effort has been put into rebalancing hospital budgets it is expected that any projected deficits will be dealt with in the planning process. In other words, no hospital can plan for a deficit”.

In broad terms, hospital budgets have been rebalanced -DNE hospitals have been given budget that equates to their 2012 outturn less their share of 2013 budget cuts and they have to deal with 2013 cost pressures identified. In gross terms this has meant DNE acutes receiving €108.71m rebalancing funds in 2013 – 40% of the available national rebalancing fund of €270m. The cost containment challenges vary from 3.0% to 3.9% of their 2012 outturn position.

It is important to note that while the HSE Employment Control Framework for 2013 is not yet finalised, in order for DNE to reach the draft end of 2013 ceiling target it will be necessary to achieve a gross reduction of 750 posts in 2013. The year end position is estimated to be 19, 241.68 WTEs.

There will continue to be tight control of the use of agency staffing and overtime working. There will be a particular focus in the acute hospital service on the achievement of compliance with the European Working Time Directive amongst the non-consultant hospital doctor (NCHD) workforce. In DNE we will also continue to address staff absenteeism and implement revised new sick leave arrangements.

In line with HSE National Service Plan ambitious targets have been set out for all areas of the health services in 2013.

In relation to hospitals these include:

  • No adult will wait more than 8 months for an elective
  • procedure (either inpatient or day case)
  • No child will wait more than 20 weeks for an elective
  • No person will wait longer than 52 weeks for an OPD
  • appointment (at the end of November 2012 approx 115,000 people or 30%
  • No person will wait more than four weeks for an urgent
  • colonoscopy and no person will wait more than 13 weeks following a referral for routine colonoscopy or OGD
  • 95% of all attendees at Emergency Departments will be
  • discharged or admitted within 6 hours of registration

Additional targets for 2013 in the DNE Region include:

  • Mental Health Service
  • Open new 44 bedded psychiatric unit at Beaumont – Mental Health
  • Provide additional resources for development and strengthening of the General Adult, CAMHS, MHID and POA Community Mental Health Team (CMHT) capacity as part of NSP 2013 Mental Health €35m allocation
  • New community accommodation / transfer 22 patients from St Itas.
  • New Phoenix Care centre – transfer from St Brendans.
  • Refurbishment Navan Road / transfer Castleknock CAMHS to DNC governance.
  • Contract awarded for Drogheda acute unit.

Disability Services:

  •  Progress the development of a 10 bedded regional neuro-rehabilitation facility at St. Mary’s Hospital in line with recommendations of the National Policy and Strategy for Neuro-rehabilitation Services in Ireland
  • PA hours / home support – no reduction 2013 (data validation)
  • Respite services, Intellectual Disability –843 clients /32,420 hours (same as 2012)
  • Physical and sensory – 238 clients / 5,781 residential respite bed nights – (same as 2012)
  • Residential services – 1664 Intellectual Disability clients /120 Physical & Sensory clients (similar to 2012)
  • Day services – minimum 3,771 recipients – (same as 2012.)

Social inclusion:

  • 895 emergency places for homeless services in Dublin North City

Primary Care:

  • Tackle core primary care staffing gaps – needs basis
  • National Primary Care Clinical Programmes – Chronic Disease
  • Roll out of National Diabetes Integrated Care Package
  • Roll out of universal new born hearing screening
  • Manage access to other care group secondary services / complex care
  • Primary Care Centres – Progress planning for centres at – Finglas Monaghan Town; Grangegorman Summerhill-North Inner City; Corduff Ashtown / Navan road; Coolock
  • Open new primary care centre at Grove Court, Cavan Town and Ashbourne
  • Orthodontics expected 2050 clients in receipt of active treatment during 2013 same as planned level 2012

Acute Hospital Services:

  • Establish hospital groups and associated governance and management arrangements
  • Further implement the clinical care programmes
  • Implement the ‘money follows the patient’ system of funding provided on a ‘per patient’ basis
  • Strict adherence to chronological order once urgent and urgent cancer cases dealt with.
  • New build in Mater Hospital
  • MRI facilities to be commissioned by Connolly Hospital
  • Beaumont – open Acute Mental Health admission unit
  • Colorectal screening; commence Connolly 2013 progressing Cavan General 2013

Palliative Care:

  • Provide a 12-bed palliative care inpatient unit at Our Lady of Lourdes Hospital, Drogheda

Older People:

  • Provide for 3,545 people to receive a HCP – Home Care Packages same as 2012 – no cut – more via Frail Elderly
  • Provide 1.66m Home Help Hours for all care group (excluding the provision of hours from HCPs) Provide for 9,486 people to receive Home Help Hours. Home Help reductions Qtr 4/2012 reversed – no reductions in 2013
  • Continuation Frail Elderly initiative €9.5m 2013.
  • 21 public units 2012 – same as 2013 – no closures
  • 55 less public beds by end 2013 but funding to replace in private system. – Dignity and proper accommodation for clients (HIQA engagement)
  • 42 rehab beds Frail Elderly Cappagh 2012 / early 2013.
  • DNE Major refurbishment public units – €10m over 4 years 2012 – 2015 DNE.
  • Capital projects: (Public Units)