Varadkar & Lynch welcome publication of 2015 HSE National Service Plan

Minister for Health Leo Varadkar and Minister for Primary and Social Care Kathleen Lynch have welcomed the publication of the 2015 HSE National Service Plan.

“The Service Plan acknowledges that after many years of significant reductions, there is a modest increase in funding in 2015. It will allow for Programme for Government commitments to be met including extension of BreastCheck and GP Care without fees for the oldest and youngest in society, the under 6s and over 70s,” Minister Varadkar said.

“However, the management of the budget within available resources is going to require an exceptional management focus. That’s why a considerably enhanced governance and accountability framework has been put in place for 2015 and beyond. This states that all managers have a responsibility to deliver on the targets set out in the service plan.

“I think it is important to be upfront and honest about this plan. It is based on maintaining the existing level of service plus some targeted improvements. We do not have sufficient funds or the right systems in place to solve all of our problems or meet all of our priorities. Moreover, any increase in demand for services next year will inevitably impact adversely on waiting lists.”

Minister Lynch said: “The Plan sets out how we intend to address the issue of delayed discharges, to which the Government has allocated €25 million. This will fund a range of community and non-acute supports. I am happy that it has been possible to increase the budget for Fair Deal with an extra €10 million which will provide an additional 300 places and €8 million for 115 additional short stay beds across the Dublin area. This includes 65 beds that will come on stream in 2015 in the former Mount Carmel Hospital, as a dedicated community hospital for Dublin. Some €35 million has also been provided for mental health in 2015 bringing to €125 million the amount of funding prioritised for mental health since 2012.”

Budget 2015 identified specific savings and efficiencies of €130 million. However, both Ministers stressed that savings beyond those announced in the Budget should be pursued, as set out in the Budget. Any further savings secured will go back into the delivery of services, and will not be used to reduce the Exchequer provision.

The Service Plan also contains other specific commitments:

· The extension of the pilot ultrasound access project to additional primary care sites on a prioritised basis. This is the first step in a programme to extend the availability of diagnostics to support the maintenance of patients in general practice;

· Pilot the provision of additional minor surgery services in agreed primary care settings and sites;

· Extend the Stroke Clinical Programme to a national basis, with five hub hospitals providing telemedicine support to 17 other hospitals in this area;

· Increase opening hours of Acute Medical Assessment Units to seven days per week in selected hospitals;

· Specific funding of €2 million set aside for maternity services, including a mix of additional midwifes and consultants. The detail will be spelt out later in the HSE operational plans.

· Funding protected for Local Drug Task Forces;

· Extend the coverage of community intervention teams and improve access to primary diagnostics so that patients can transfer to their homes sooner;

· Improve performance across the Balanced Scoreboard in acute hospitals by encouraging innovative cost saving proposals from clinicians, tapping into the experience and commitment of frontline staff and hospital management.

Further details on the Accountability Framework

Even with the modest budget increase for 2015, there will need to be an exceptional management focus. That’s why a significantly enhanced governance and accountability framework has been put in place for 2015 and beyond. Details of this Accountability Framework were set out in the Service Plan today.

The Framework makes explicit the responsibility of all managers to deliver on the targets set out in the service plan.

Performance of individual managers will be monitored on a monthly basis. If individual managers do not meet targets then mechanisms will be identified to assist them.

A scorecard system will be put in place against which managers will have their performance assessed, on issues like access to services, safety of services, finance, and workforce.

There will be formal performance agreements at a national and local level. Every manager will have explicit management targets.

There will be specific arrangements to address areas where underperformance starts to escalate, which will specify the actions to be taken to address this performance.