Download - Tony o'brien 1
1
Mr. Tony O’Brien Director General of the Health Service
Wednesday 19th February 2014
Choices for our Health Service
10th National Health Summit
Irish Health Services
• Health & social services for 4.6m people
• €13.6bn gross spend (includes Child & Family)
• Almost 100,000 employees (largest employer in country)
• 550,000+ inpatient cases & 750,000 day cases
• 10m + home help hours
• 15m + GP consultations
• €600+m planned savings in 2014
allthingsd.com
Upward Pressure on Demand and Costs
Overall Affordability of Healthcare?
4
National Service Plan 2014
• Key areas are: – Service Delivery
– Quality and Patient Safety
– Service Reforms
– Financial Outlook and Challenges
• Financial Challenge include: – From 2008, total reduction to HSE gross budget is €3.92bn (26%) includes savings of 619m
– Expenditure reduction targets 2014
5
Service Developments 2014
Patient Safety & Quality
Open Disclosure
Aim of Reform To help people remain healthy and to provide effective safe high quality
healthcare and personal social services to the people of Ireland
(Future Health, Nov 2012)
Reformed
Health
Service
3. Equal Care
A Single Tier UHI System
2. Higher Quality Care
Clinically Lead, Rigorous Performance Management
1. A New Model of Care
Treatment at the Lowest Level of Complexity that is Safe,
Timely, Efficient and as Close to Home As Possible
11
Reforming Healthcare Services • Structural, financial, service and health & wellbeing reform
• Develop an integrated portfolio of reform programmes
• New Directorate established – July 2013
• Sustained emphasis on quality and patient safety − New Patient Safety Agency
• Integration of health and wellbeing
• Integrated models of care
• Performance assurance
• Strategic human resource management
• eHealth and Information and Communication Technology Strategy
• Establishment of Child and Family Agency – 1st Jan 2014
Transformation from Industrial Age Healthcare to Information Age Healthcare
Person Community Primary Secondary Tertiary
Individual Self-care
Friends & Family
Community Networks
Professionals as Facilitators Professionals as Partners
Professionals as Authorities
Transformation Through Cost-Effective Use of Information & Communication
Technologies
Industrial Age Healthcare Information Age Healthcare
Source: Adapted from Malaysian Telemedicine Blueprint
12
Challenges for Healthcare
Cost vs Quality
13
14
Changing Role of Patients
Patient
Passive Role
Information given
Top down delivery Paternalistic Medicine
ePatient Active (engaged role Role
Seek out information (Internet)
Partner in delivery
Participatory Medicine
15
Public Service Agreement Haddington Road Agreement 2013-16
A central pillar to the overall economic strategy of Government, with a focus on productivity, cost extraction and reform
• Key Opportunities: − Workforce restructuring − Reviews of rosters, skill mix, productivity & staffing levels − Reductions in overtime/allowances/agency staff spend − Nursing/Midwifery Graduate Programme − Support Staff Intern Scheme − Grade rationalisation − Increased use of redeployment − Strengthening Performance Management − Assurance Group established
Statins: SIMVASTATIN
PPI: LANSOPRAZOLE
ACE inhibitor: RAMIPRIL
ARB: CANDESARTAN
Medicines Management & Generic Prescribing
17
New Scorecard
Quality, Access & Resources (to
include Finance):
The basis of the new balanced scorecard
Safe,
high quality,
patient centred
services
QUALITY
ACCESS RESOURCES
18
Ultimately: Outcomes for All
Improved Health and Well being
Faster Fairer
Access to Hospitals
Free Access to GP Care
Better Management
of Chronic Illness More
People Cared for in their Homes
Improved Quality
and Safety
Affordability
18
19
Conclusion • Dual challenge of reducing costs while improving patient
outcomes • Continued demographic pressures and increasing
demand • Patient safety is paramount and a central theme of Health
Reform − Although care costs, poor quality care costs more
• We will continue to establish:
– Integrated models of care across all services/care groups – Workforce modernisation within the context of the Public
Service Agreements – Reformed services to provide effective, safe high quality
health and personal social services to the population of Ireland
