This year, the HSE will spend a total of €21.6 billion on providing services, deliver additional acute and critical care beds, aim to achieve maximum waiting times of 15 months for outpatient appointments and nine months for inpatient/day case treatment and GI scopes and hire 16,500 staff, according to its 2023 National Service Plan.
It will complete the implementation of national chimeric antigen receptor T-cell therapy (CAR-T), peptide receptor radionuclide therapy (PRRT) and stem cell therapy (SCT) specialised services, establish a dedicated funded Helicopter Emergency Medical Service in the South West and provide additional services for older persons and those with disabilities.
HSE CEO, Bernard Gloster said the HSE’s €21.6 billion revenue budget was by any definition an enormous investment by the State and a reflection of the increasing emphasis Government had placed on improving health and personal social services. “The shared agenda of pursuing universal healthcare is and must remain central to all of our plans. Over the last two years, the Government has invested €1.4bn to permanently strengthen our health and social care services and this rises to circa €1.7bn, when we consider the 2023 investment outlined in this plan. This is in addition to funding to maintain the existing level of services and once-off funding to deal with COVID-19.
“In 2023, we aim to increase the size of our workforce by a further 6,000 staff which will represent one of the largest ever annual increases in our staffing. This additional 6,000 is only counted after we have recruited some 10,500 staff to replace those that will retire or leave during the year.”
RHAs
The HSE will progress the recruitment and establishment of the six RHA leadership team and clarify the corporate and clinical governance arrangements needed to deliver integrated services based on a population-based approach to health and social care delivery, according to its National Service Plan.
It will also progress the transition to an integrated service delivery model for RHAs this year, in line with agreed accountabilities at RHA level and associated changes required within the Department of Health and HSE Centre. The RHAs are due to be established in 2024.
Acute Services
The HSE plans to deliver an additional 184 general acute beds and 26 critical care beds and improve capability to meet patient needs and establish an inclusive trauma system and deliver trauma-related clinical expertise through two regional Trauma Networks where facilities and services co-ordinate the care of injured patients along standardised pathway.
It will progress implementation of systemic anti-cancer therapy (SACT) model of care recommendations and developments of associated KPIs f)M complete the implementation of national chimeric antigen receptor T-cell therapy (CAR-T), peptide receptor radionuclide therapy (PRRT) and stem cell therapy (SCT) specialised services.
The HSE will also establish a dedicated funded Helicopter Emergency Medical Service in the South West.
Waiting Lists
For 2023, an additional €175m has been allocated to address waiting lists and waiting times. Of this, €85.2m allocated to the HSE and further €89.8m is held within the Department of Health to facilitate the procurement of additional scheduled care capacity to alleviate waiting lists.
Wait Time Targets
“Delivering upon the 2023 maximum wait time targets and making progress towards the longer-term Sláintecare targets will require strategic and targeted investment, improved chronological management and reform of service delivery. “
The HSE says it will seek to build upon the progress made in 2022 and aim to achieve maximum waiting times of 15 months for outpatient appointments and nine months for inpatient/day case treatment and GI scopes.
The HSE plans to progress national implementation of the strategy to reduce ‘Did Not Attends’ (DNAs), continue to build strategic partnerships with the Private Hospitals Association and the NTPF organisation, continue implementation of the prioritised modernised care pathways, progress the development of Elective Care Centres in Cork, Dublin and Galway through the Public Spending Code approvals process
In 2023, it will continue to take forward the implementation of the Health Performance Visualisation Platform, building data and information capability and insights at local, regional and national levels, continue to progress implementation of patient-centred booking arrangements and develop a national implementation plan, Delivering Universal Healthcare – Strategic Reform and Innovation National Service Plan 2023.”
CHNs
In 2023, the HSE says it will complete operationalisation of 96 CHNs, each servicing a population of circa 50,000 led by a network manager with a GP Lead, nurse lead and multi-disciplinary team. It will also complete operationalisation of 30 community specialist teams for older people and 30 community specialist teams for chronic disease, including roll-out of heart failure virtual clinics nationally, together with diabetes initiatives around gestational diabetes mellitus patients in the chronic disease management (CDM) prevention programme. Reform of Older Persons’ Service
Older People
Where older people are concerned it says it will finalise the new operational model and implementation plan for publically funded residential community care. It will continue its preparation for the Statutory Home Support Scheme including the development of a national eligibility infrastructure, process and new integrated model of home support within available resources It will continue to support older people to live in their own homes and communities through delivering integrated care pathways that increase access to care and reduce the number of older people receiving acute and residential care, publish the Dementia Model of Care and develop an implementation plan.
Mental Health Services
The HSE says it will continue to develop and deliver crisis resolution services, with a focus on the implementation, monitoring and evaluation of pilot sites and the development of key performance indicators and outcome measurement tools. It will progress the development of the CAMHS hubs initiative, with a focus on the implementation, monitoring and evaluation of the pilot sites to ensure fidelity to the Model of Care. It plans to roll out the agreed capital development plan to enhance facilities and infrastructure for service users and staff to address regulatory compliance and initiate an analysis of capital requirements to inform future service planning.
Disability Services
In 2023, the HSE plans to work to decrease reliance upon residential services by providing enhanced support, including a range of respite supports, within the community and supporting large-scale organisational change focusing on supports in the community settings, supported by building capacity through education and training. It says it will further develop residential service capacity in response to emerging needs Delivering Universal Healthcare – Strategic Reform and Innovation National Service Plan 2023. It further says it will increase the number of people with disabilities playing an active role in directing their own health and social care support responses. It will also progress the development of community neuro-rehabilitation teams as part of the national demonstrator pilot, continue implementing changes in line with the New Directions policy by providing new day services placements for school leavers and rehabilitative training graduates. It will continue to deliver the national personalised budgets demonstrator project to 180 participants and commence an evaluation and undertake a review of rehabilitative training.
Recruitment
The HSE plans to address consultant recruitment and retention challenges in Model 3 hospitals by implementing the recommended actions following the publication of the report of the expert steering group, strengthen medical education training by providing appropriate educational supports at site level by piloting a Clinical Educator network responsible for overseeing onsite training and development of NCHDs and support the implementation of the DoH NCHD Taskforce recommendation. In order to expand the overall consultant workforce, the HSE will market internationally the benefits of the new Consultant Contract together with continuing to implement process improvements to streamline hiring timeframes and the overall candidate experience
Costs
The HSE says a detailed review of consultancy expenditure will be re-prioritised to ensure that any ongoing or future consultancy costs are only utilised in the context of their contribution to strategic decision-making or policy direction. These costs will be monitored regularly and clear guidance will be provided to HSE budget holders to ensure that consultancy firms are only engaged for pre-approved and appropriate projects. “This is a process that had commenced prior to COVID-19 and which is now re-instated as a priority.”
