THIS IS SUMMARY: The Health Service Executive published the West Area Service Plan 2012 today, 17th February. This West Area Service Plan was prepared in line with the National Service Plan which was approved by the Minister for Health in January. The HSE West plan follows the frameworks, performance targets, policies and standards laid out in the national plan. The service plan can be viewed online at www.hse.ie/news
The funding allocated to HSE West for 2012 is €1.781 billion. The net reduction is 5.2% on the 2011 budget or €104.8m. The staff count for HSE West is set at 24,031 whole time equivalents; a reduction of 3% on 2011 (or 784 whole time equivalents). Our budget and staffing resources will enable us to deliver over 144,000 inpatients, provide emergency department services to more than 320,000 people, deliver almost 16,000 babies, provide more than 3 million home help hours and provide services to 13,800 people with disability.
In 2012, we will focus on a number of key areas in order to improve the effectiveness of services and make it easier for people to access the care or service they need in the most appropriate setting. Despite the reductions in resources, there are a number of new developments taking place in 2012 across the West (see list on page 4). Key principles underpinning the way we deliver services in 2012 will include:
▪ The delivery of a safe and quality service.
▪ Protecting frontline services as much as possible within the current budget
▪ Meeting access improvement targets to ensure patients have rapid and appropriate access to the right service in the most appropriate setting.
▪ Delivering efficient and effective use of resources to ensure best value for money is achieved.
The focus this year will be on reshaping and remodelling health services in line with the ‘Programme for Government’ including the development of hospital networks with new governance structures, and stronger more integrated primary and social care sectors. HSE West is leading the way in this with the two new management structures already underway in the Galway/Roscommon acute hospitals group and the Mid West Hospital acute hospitals group, and further development is on the way in relation to the Northwest Acute Hospitals.
As well as the financial challenge that we face in 2012 we also have a reduction of 683 in staff numbers as the retirement grace period ends in February. Managers across HSE West have been putting contingency plans in place to ensure that essential services are maintained. We will rely on our staff to co-operate with new models of care and to continue to be flexible so that our patients and service users are minimally impacted.
Mr. John Hennessy, Regional Director of Operations said, “Over the last number of years, the reductions in health expenditure have been achieved largely through a combination of price reductions (including drugs, procurement, changes in demand led schemes) as well as increases in charges and reductions in numbers employed. In 2012 the scale of the reductions required will impact increasingly on frontline services. However, the HSE is working to move to new models of care which will allow us to get more from our reduced budget. The new SDU targets and clinical programmes will enable us to achieve more efficiency by seeing the same levels of patients by using our resources more effectively. Notwithstanding this, it is clear that it will be difficult to deliver all services at the same levels as previous years.”
To ensure that we continue to put the patient first in 2012 we will be introducing initiatives such as:
▪ New access targets as laid out by the Special Delivery Unit (SDU) for Acute Hospital Admissions and waiting times for elective surgery.
▪ Introduction of the clinical programmes including the Acute Medicine Programme across acute hospitals.
▪ A range of initiatives to address outpatient waiting lists.
“A full service plan review will be undertaken in March to ensure that the effects of the retirement schemes are fully reflected in the service plan and that contingency arrangements are in place. We have contingency plans to address key gaps through redeployment and reassigning staff. We will be monitoring on a daily basis the effects of the retirements on the system and I am satisfied that that critical services will be maintained.”
Challenges
The HSE West goal this year is to maintain service levels and deliver the highest quality services within the budget allocated; however there are important factors to be highlighted:
§ The financial constraints in 2012 and the continuing recruitment moratorium will challenge our ability to recruit certain categories of staff – significant flexibility in relation to reconfiguration and redeployment will therefore be needed in order to maintain frontline services.
§ The continuing NCHD recruitment difficulties in many of our hospitals will pose challenges in the delivery of acute services.
§ The 2011 deficits carried forward will add to the financial challenges.
§ Delivery on the cost reduction and service restructuring programmes is crucial for 2012 in order to maintain services at current levels with reduced resources.
In 2012 we will provide:
| 144,007 inpatient discharges | Provide 2,238 home care packages |
| 170,210 daycase discharges | Prioritise suicide prevention programmes |
| 320,500 ED attendances | Strengthen Child and Adolescent Mental Health teams |
| 107,200 emergency admissions | Provide foster care to 1,342 children |
| 710,139 Outpatient attendances | Provide 3.11m home help hours |
| 15,968 births | Provide disability services to 13,800 people |
** Some examples of New Developments (full listing in Service Plan)
Community Services
§ Implement National Home Help Guidelines which will introduce a standardised and consistent approach to the delivery of home help services
§ New Primary Care Centres
§ Abbey, Limerick City
§ Athenry, Co. Galway
§ Monksland, Co. Roscommon
§ Castlerea, Co. Roscommon
§ Glenties, Co. Donegal
§ Open the Child and Adolescent Unit (Merlin Park) to full capacity
Acute Hospitals
§ Open Acute Medical Assessment Unit in University Hospital Galway in Q1 2012 and transfer acute medicine from Merlin Park University Hospital to UHG. Appoint three Acute Medicine Physicians
§ Open a Medical Assessment Unit in Portiuncula, Ballinasloe as part of the Acute Medicine Programme
§ Refurbish the Neo Natal Intensive Care unit GUH
§ Upgrade endoscopy facilities in Roscommon County Hospital
§ Open Acute Medical Assessment Unit in Mid Western Regional Hospital Limerick and appoint three Acute Medicine Physicians
§ Upgrade ward facility in Ennis Hospital
§ Appointment of a Consultant Geriatrician, Neurologist and Dermatologist in Sligo General Hospital
§ Upgrade radiology equipment in Sligo General Hospital
§ A new Emergency Department is scheduled to open in Letterkenny General Hospital along with the appointment of a new Emergency Medicine Consultant.
§ Enhancement of Neurology, Rheumatology and Dermatology Services as part of the Outpatient service improvement
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