sláintecare...sláintecare is focused on the need to expand entitlement and eligibility as part of...

Sláintecare•Right Care.Right Place.Right Time.

SláintecareAction Plan 2019

1 Introduction 32 Sláintecare – Context 83 SláintecareImplementationStrategy 104 SláintecareActionPlan2019 105 ProjectImplementationandGovernance 116 PartnershipWorking 147 SláintecareProjectManagementStructure 168 SláintecareImplementationWorkstreams 179 WorkstreamsBreakdownbyProgramme 19 Appendix 54 GlossaryofTerms 56

� Workstream 1: ServiceReDesignand SupportingInfrastructure 21 TermsofReference:2019—2028 23 WorkBreakdown 24 GanttCharts 26� Workstream 2: SafeCare,Co-ordinated GovernanceandValueforMoney 35 TermsofReference:2019—2028 37 WorkBreakdown 38 GanttCharts 39� Workstream 3: TeamsoftheFuture 42 TermsofReference:2019—2028 44 WorkBreakdown 45 GanttCharts 46� Workstream 4: SharingProgress 48 TermsofReference:2019—2028 50 WorkBreakdown 51 GanttCharts 52

Contents

Sláintecare•

Right Care.Right Place.Right Time.

1 IntroductionBackground

There are many aspects of the health and social care service in Ireland that we can be very proud of. Our healthcare staffareroutinelypraisedfortheirhardworkandempathyand,ofthosein-patientssurveyedin2018,84%expressedsatisfactionwiththeservice1.LifeexpectancyincreasedinIrelandby2.4yearsbetween2005and2018andisnowabovethe EU average, and mortality rates have decreased. As Irish peoplewecanexpecttolive,disability-free,forlonger2 and moreofuscanexpecttolivelongerafteracancerdiagnosisthan ever before3. However,inspiteofthesesuccesses,weknowourhealthandsocialcareservicesneedsignificantimprovementinmanyareas,particularlyinrelationtotimelyaccesstoaffordablecare.Furtherpressuresarealreadybeingfeltaswearegrowingasapopulationby60,000peopleeachyear.Intenyears’timetherewillbemorepeopleagedover65thanunder14.Therewillbeonemillionpeopleover65and100,000peopleover80–onethirdmorethannow4. Morepeoplemeansmoredemand,and,aswellasneedingtherightinfrastructure–people,buildingsande-health–todelivertherightservices,wealsoneedtorethinkhowwedelivertheseservices,placingagreateremphasisonpreventionandpopulationhealthinitiativesinordertosupportpeopletoliveindependentlyintheirowncommunityforaslongaspossible.Weneedtodeliverhealthandsocialcareservicesinawaythatisefficient,effectiveandsustainable,meetingtheneedsofallpatients,citizens,familieswithdisabilities,peoplewithmentalhealthneedsandcarers.Thiswillrequireawhole-societyapproachwithnewwaysofthinkingandworkingtogether.

Wealsoknowthereisgeographicvariationincurrentserviceavailability.Dependingonwhereyoulive,someservicesareonlyavailabletomedicalcardholders,noteveryoneiseligibleforthesameservices,andthereislimitedavailabilityofsomeservices.So,weneedtoofferpublicservicesinafairandtransparentway,andcreatemoreservicesforthegrowingpopulation. Sláintecareisaboutdeliveringahealthandsocialcareservicethatmeetstheneedsofourpopulationandattractsandretainstheverybesthealthcareprofessionals,managersandstaff.Overaten-yearperiod,wewilldeliverauniversalhealthservicethatofferstherightcare,intherightplace,attherighttime,withapriorityfocusondevelopingprimaryandcommunityserviceswithinanationalpolicycontext.Withappropriate,well-governedinvestment,wewilldeliveraservicethatisgivenbytherightteamatlowornocharge.Crucially,itwillbeessentialtoengagewithstaff,staffrepresentativebodies,andthewiderstakeholdernetwork,tofindnewwaysofworkingtodeliverexpandedservicesandoptimisethewealthofskillsandknowledgeinherentinourworkforce. WhileSláintecarewilltaketenyearstoimplementinitsentirety,this ActionPlan2019outlineskeyareasoffocusfor2019,thefirstfullyearofSláintecareimplementation.

1NationalPatientExperienceSurvey,2018availableat https://www.patientexperience.ie/survey-results/survey-reports/

2DepartmentofHealth(2019)LifeExpectancy,availableat https://health.gov.ie/publications-research/statistics/statistics-by-topic/life-expectancy/

3DepartmentofHealth(2019)Cancer,availableat https://health.gov.ie/publications-research/statistics/statistics-by-topic/cancer/

4CSO(2018)PopulationandLabourForceProjections2017-2051,availableat https://www.cso.ie/en/releasesandpublications/ep/p-plfp/populationandlabourforceprojections2017-2051/populationprojectionsresults/

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Sláintecare Action Plan 2019

Citizen and Staff Engagementand Empowerment

Clinical and Corporate Goverance

Sláintecare Citizen CareMasterplan Implementation

Programme Delivery

PopulationHealth Planning

ServiceRedesign

Infrastructureand eHealth

Public and PrivateDelivery Partners

Workforce Planningand Capacity Building

Accountability andValue for Money

Entitlementand Eligibilty

Citizen Care MasterplanTheten-yearreformprogrammewillresultinthecreationandimplementationofaCitizenCareMasterplan.TheframeworkfortheimplementationoftheCitizenCareMasterplanisoutlinedintheimagebelow.Theframeworkstepsaresupportedbyacontinuousandcross-cuttingprogrammedeliveryapproach.

Figure 1: Sláintecare Implementation Framework

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1 CitizenandStaffEngagement&Empowerment

Aparticipativeapproachwillunderpinthere-designingofthehealthserviceandsystem.In2019Sláintecarewillengagewithcitizensandhealthcarestaffindefiningandco-designingthekindofhealthserviceweenvisageandneedforourgrowingpopulation. Wewillaskpeoplewhatroletheybelievetheycanplayintheirownhealthandwellbeing,andhowthiscanbeempowered.

2 ClinicalandCorporateGovernance

Enablingasafe,qualityserviceisfundamentaltotheSláintecareprogramme.Itisexpectedthathealthserviceswillbedeliveredatnational,regionalandcommunitylevels,asappropriate,toofferasafe,devolvedandaccountablehealthandwellbeingserviceandsystem.RegionalIntegratedCareOrganisations(RICOs)willbeestablishedtoenablethedeliveryofregionallyplannedcarethatisrightfortheneedsofthatlocalpopulation.TherespectiverolesoftheDepartmentofHealth,theHealthServiceExecutive(HSE),andRICOswillbedefinedduring2019inordertopavethewayforclearanddevolvedclinicalandcorporategovernancewhichcandeliversafeservices.During2019wewillcommencepilotingcommunityhealthcarenetworkstotesthowservicescanbestbedeliveredinanintegratedwayinacommunitycontext.

3 PopulationHealthPlanning

Apopulationhealthplanningapproachisessentialinordertounderstandandplanforthehealthandsocialcareneedsofthepopulationbasedondemographicandgeographicconsiderations. Theresultswillinformandprioritisethehealthandsocialcareservicesthatneedtobedevelopedforeachregion,sothepopulationcangettherightcare,intherightplace,attherighttime,inlinewithresourceavailability.In2019wewillbeginaprogrammeofpopulationhealthplanninganddeviseamethodofregionalbudgetallocationwhichcandistributeresourcesonanequitablebasis.Acomprehensiveapproachtodatagatheringwillbedevised,providingthebasisforevidence-baseddecisionmaking.

4 ServiceRedesign

TheredesignofhealthandsocialcareservicesforthepeopleofIrelandwillbeunderpinnedbythedrivetoimprovethehealthandwellbeingofthepopulation,andtokeeppeoplewellintheirowncommunitiesforaslongaspossible.Basedonthespecificneedsofthepopulationforeachregionasdeterminedbythepopulationhealthplanningprocess,andbasedonknowledgeofcurrentlevelsofservicedeliveryandcurrentconfiguration,wewill,withourpartners,co-designtheservicerequirementsneededforthatregion’spopulation. Wewilldothisinaprioritisedwaylookingatthewholecarepathwayfromprevention,toearlyintervention,detection,diagnosis,treatment,rehabilitationandpalliativecareservices.Certainservicesneedtobeplannedanddeliverednationally,whileotherserviceswillbeplannedanddeliveredinanintegrated,devolvedwayataregionalandlocallevel,takingaccountofnationalstrategiesasappropriate.Therewillbecontinuedfocusondevelopinglonger-termcapacitytotreatpeopleinatimelymannerinaccordancewithSláintecarewaitingtimetargets. During2019wewillpilotinitiativeswhichsupportintegratedcareforolderpeopleandforpeoplelivingwithchronicdisease.Asingleassessmenttoolwillbeprocuredtoidentifythecareneedsofpeoplelivinginthecommunity,whetherinresidentialcareorlivingathome.

5 Infrastructure&eHealth

DeliveringenhancedandmodernisedinfrastructureisacorecomponentofSláintecareandisessentialtosupportdeliveryofanefficient,modernandresponsivehealthsystem.In2019wewill:• Commencemappingtheinfrastructurethatexistsineachregionandplanhowit

canbestsupporttheservicesneededtobedevelopedappropriatelyasquicklyaspossible.

• Decidethelocationfornewelectiveandnewcommunitybedscapacity(asperCapacityReview).

• Investigatehowbesttodeliverenhanceddiagnosticscapacityinthecommunityandhospitals.

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• Deliver14newprimarycarecentres.• DecidethelocationfortheMajorTraumaCentreinDublin.• Rolloutthetake-upoftheIndividualHealthIdentifier(IHI)inordertoprovide

thefoundationsforaPersonalHealthPortalandtheElectronicHealthRecord.• Pilottelehealthsolutions.

6 Public&PrivateDeliveryPartners

Sláintecarestressestheimportanceofpublicmoneybeingspentinthepublicinterest.Wewillworkwithourdeliverypartnerstoagreehowthemanypublic,privateandvoluntaryproviderscaneachplaytheirroleinajoined-upwaytodelivertheserviceneedsofthepopulation.In2019thedeBuitléirReportwillrecommendstepstobetakenontheremovalofprivateworkfromthepublichealthsystem.

7 WorkforcePlanningandCapacityBuilding

TheSláintecarevisionrequiresappropriatestaffinglevels,enabledteams,targetedtrainingandstrongleadership.WewillfinalisecontractualarrangementswithGPsandNursesalignedwiththeSláintecareworkingprinciples.Wewillundertakeworkforceplanning,anticipategapsbasedontheservicesrequiredandbegintoplanthetrainingrequirementsneededforthefuture.Wewillexplorehowbesttoattractandretainhealthcareworkers.Wewilldeviseteamtrainingandinnovationprogrammessowecanscalebestpracticesandmaximisepositiveexperiencesmadetodateatbothlocalandnationallevels.

8 EntitlementandEligibility

Sláintecareisfocusedontheneedtoexpandentitlementandeligibilityaspartofatransitiontowardsuniversalhealthandsocialcareaccess.In2019wewilldevelopanapproachtomodelingvariousentitlementandeligibilityscenariosandexaminecostsandbenefits.Sláintecareproposesprovidinguniversalservicesatnoorlowcosttothepatient/serviceuser.Wewillplanhow,when,andinwhatorderofprioritythiscouldbedoneandmakeproposalstogovernmentforconsideration.

9 AccountabilityandValueforMoney

Wewillbenchmarkthefundingforthepublichealthandsocialcaresystemagainstinternationalcomparators.Wewillestablishabasisonwhichtomovenewand/orexistingfundingandresourcesincreasinglytowardspreventionandself-management.Wewillbegintoplanformulti-annualfundingforthehealthsystem.WewilldevelopabasisforallocatingbudgetsatRICOlevelbasedonpopulationprofileandneed.Wewilldevelopinitiativesthatwillgainefficienciesinthecontextofofferingtherightcare,intherightplace,attherighttime.Sláintecareiscommittedtoensuringthatthereistransparencyandaccountabilitywithregardtohowhealthandsocialcarefundingisproportioned,monitored,andoptimised.

10ProgrammeDelivery

SláintecarewillbedeliveredthroughapartnershipapproachbytheSláintecareProgrammeImplementationOffice(SPIO)locatedintheDepartmentofHealth.TheSPIOwillworkinpartnershipwithcitizens,staffanddeliverypartnersinthepublicandprivatehealthandsocialcaresectors,electedrepresentatives,andwiderstakeholderinterestgroupstodeliverontherangeofactionswithinthereformprogramme. TheSPIOwillreportonprogressanddeviseacommunicationsplantoengagewithstakeholdersandkeeppeopleinformedofprogress.WewillworkwiththeSláintecareImplementationAdvisoryCouncil(SIAC),theHighLevelDeliveryBoardandtheCabinetSub-CommitteeonHealth,aswellasourcolleaguesintheDepartmentofHealthandtheHSE.TheOfficewillmakeeveryefforttocontinuetoachievethevisionaryexamplesetbytheOireachtasCommitteeontheFutureofHealthcare,inlinewithavailableresources.

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Partnership

Staff andDelivery Partners

ElectedRepresentatives

Wider DeterminantsStakeholders

Citizens

ConclusionSláintecarewilltransformourhealthandsocialcareservicesoveraten-yearperiod.Itwilltaketimeandwillbeundertakeninapartnershipapproach.However,tosucceed,Sláintecarewillrequirethelong-termcommitmentoftargetedandprotectedfundingandsupporttoenablethedeliveryofthereformprogramme.Thisfundingwillbeinvestedstrategically,andwillsupporttheoverallvisionforreform,withaconsistentfocusoneffectiveness,efficiencyandvalueformoney.

Figure 2: Our Partnership Approach

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2 Sláintecare–Context TheOireachtasCommitteeontheFutureofHealthcarewasestablished to devise cross-party agreement on a single, long-termvisionforhealthandsocialcareandthedirectionofhealthpolicyinIreland.TheCommittee’sreport‘TheSláintecareReport’wasadoptedbytheGovernmentandpublishedinMay2017andisavailableontheirofficialwebsite.ThisvisionofSláintecareistoachieveauniversalsingle-tierhealthandsocialcaresystemwhereeveryonehasequitableaccesstoservicesbasedonneed,andnotabilitytopay.Overtime,everyonewillhaveentitlementtoacomprehensiverangeofprimary,acuteandsocialcareservices.Ithasaquadrupleaimto:i improvepatient/serviceuserexperienceii improveclinicianexperienceiii lowercostsiv achievebetteroutcomes

TheSláintecareFundamentalPrincipleswereoutlinedintheOireachtasReportandwillunderpintheimplementationapproachoverthetenyearsoftheprogramme. TheeightprinciplesunderpinningtheSláintecarereportareoutlinedbelow.TheyguidedthedevelopmentoftheActionPlan2019andwillcontinuetoactasareferencepointthroughouttheimplementationprocess.

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Figure 3: Sláintecare Fundamental Principles

AccountabilityEffective organisational alignmentand good governance are central tothe organisation and functioning ofthe health system.

EngagementCreate a modern, responsive, integrated public health system, comparable to other European countries. Through building long-term public and political confidence in the delivery and implementation of this plan.

Public Money and InterestPublic money is only spent in the public interest for the public good (ensuring value for money, integra-tion, oversight, accountability and correct incentives).

WorkforceThe health service workforce is appropriate, accountable,flexible, well-resourced, supported and valued.

Prevention and Public HealthPatients accessing care at themost appropriate, cost effectiveservice level with a strong emphasison prevention and public health.

Free at the point of deliveryCare provided free at the point of delivery, based entirely on clinical need.

Patient is ParamountAll care is planned and provided so that the patient/service user is paramount, ensuring appropriatecare pathways and seamless transition backed-up by full patient record and information.

Timely AccessTo all health and social care according to medical need.

SláintecareFundamental

Principles

ACCOUNTABILITY

ENGA

GEM

ENT

PATIENT IS PARAMOUNT

TIMELY ACCESS

PREVEN

TION

& PU

BLIC

HEA

LTH

FREE AT THE POINT OF DELIVERY

WORKFORCE

PUBLIC M

ON

EY & INTEREST

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3 Sláintecare ImplementationStrategy

InresponsetotheSláintecareReport,theGovernmentapprovedtheSláintecareImplementationStrategyon 17thJuly2018.TheStrategyisavailableonthe DepartmentofHealthwebsite.TheSláintecareImplementationStrategyrepresentedthefirstoutputfromtheDepartmentofHealthofthedetailedplanningprocessfortheimplementation oftheSláintecareReport. TheImplementationStrategysetouttheactionstobetakeninthefirstthreeyearsoftheSláintecareimplementationprocess.Therewere106sub-actionsdetailedintheStrategy.WithintheActionPlan2019,wehavereferencedthe sub-actionnumbersfromtheSláintecareImplementationStrategyforeaseof cross-referral.

4 Sláintecare ActionPlan2019TheSláintecareProgrammeImplementationOffice(SPIO)wasestablishedinSeptember2018withtheinitialtaskofreviewingandrefiningtheImplementationStrategyintoamoredetailedActionPlanfor2019.

Athree-stageapproachwastakentoundertakethisreviewasfollows:

DelveStage–September-October2018

ThisfocusedonreviewingtheSláintecareImplementationStrategy sub-actionsandidentifiedwherefurtheractionswererequired.

DiscoverStage–October-November2018

Areadinessassessmentofallthe106Sláintecaresub-actionswasinitiated.Thisexaminedthedegreetowhichtherewereplansbehindthesesub-actionsandwhowasresponsiblefordeliveringthem.

DeliveryStage–November-December2018

Thisstagelookedathowbesttostructureteamsforsuccessfulandeffectivedelivery.ACitizenCareMasterplanFrameworkfortheimplementationoftheSláintecareactionswasdevelopedinordertoestablishaprogrammaticapproachtodelivery. TheSPIOhasnowrefinedtheImplementationStrategywhichcontained106sub-actionsintoaprogrammaticActionPlan2019.TheActionPlanwillbeupdatedannuallyduringtheten-yearimplementationperiod.TheActionPlanhasidentifiedfourmainWorkstreamsasfollows:Workstream1:ServiceRedesign&SupportingInfrastructureWorkstream2:SafeCare,Co-ordinatedGovernance&ValueforMoneyWorkstream3:TeamsoftheFutureWorkstream4:SharingProgress EachofthefourWorkstreamshasfivemainProgrammesandmultipleProjectswithineachProgramme.

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Dedicated reform programmeoffice to act as the engine

for transformation

Deep and sustainedengagement

with stakeholders

Focused work programme with a clear start,middle and end

Targeted and protected funding for the

reform programme

Senior leadershipand decision making

SuccessfulImplementation

5 ProjectImplementation andGovernance

TheSláintecareActionPlanchangeprogrammerequiresacoalitionacrossthewiderhealthandsocialcaresystemtoworktogetheroverthelong-term,sustainingmomentum,andwithaclearfocusonthedesired outcomesofreform.Ourimplementationapproachwillbebuilton thecorecomponentsdetailedbelow:

Figure 4: Core Components for Successful Implementation

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ImplementationandOversightFigure5depictstheSláintecareimplementationandoversightstructures.Themainfeaturesare:• TheMinisterforHealthwillbeaccountabletotheOireachtasforthedeliveryof

Sláintecareandwillreportregularlyonprogress.• TheCabinetCommitteeonHealth,chairedbytheTaoiseach,willgiveoverall

strategicdirectionandwilloverseeimplementation,ensuringleadershipatthehighestlevel.

• TheHighLevelDeliveryBoardandtheSláintecareExecutiveDirectorwill ensureeffectivedeliveryofagreedplansandresourcingoftheSláintecarereformprogramme.

• TheSIACwilladviseandsupporttheSPIOonthechangeprogramme.• TheSPIOwilloverseetheimplementationprocessthroughtheExecutiveTask

Forceandtheworkstreams’deliverystructurecomprisingmultipleProgrammesandProjectsasoutlinedonthefollowingpages.

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Workstreams andWork Programmes

1.1Data, Researchand Evaluation

Programme

1.2Population

based PlanningProgramme

1.3Service ReDesign

FrameworkProgramme

1.4Capital PlanningImplementation

Programme

1.5eHealth

Programme

2.1Geoalignment andRICOs Structure

Programme

2.2Corporate and

Clinical GovernanceProgramme

2.3Public and

Private PartnersProgramme

2.4Eligibilty / Entitlement

Programme

2.5Financing Reform

Programme

3.1Workforce Planning

Programme

3.2Training Pipelineand New Ways of

Training Programme

3.3Culture Change and

New Ways of WorkingProgramme

3.4Innovation /

Capacity BuildingProgramme

3.5Future Intelligence /

InfluencersProgramme

4.1 Citizen and StaffEngagement andEmpowerment

Programme

4.2 Sláintecare Programme

ImplementationOffice and Governance

Programme

4.3 EvaluationFramework and

Reporting ProgressProgramme

4.4 IntegrationFund and SláintecareBudget Management

Programme

4.5 Communicationsand Recognising

Success Programme

Workstream 1Service ReDesign and

Supporting Infrastructure

Workstream 2Safe Care, Co-ordinated

Governance and Value for MoneyWorkstream 3

Teams of the FutureWorkstream 4

Sharing Progress

Implementation

Oversight

PUBLIC ACCOUNTABILITY

SLÁINTECARE — CHANGE FOCUS

DEL

IVER

Y A

ND

ACC

OU

NTA

BILI

TY

SLÁ

INTE

CARE

— S

TRO

NG

CH

AN

GE

CAPA

BILI

TY

SLÁINTECARE — CHANGE FOCUS

SláintecareImplementation

Structures

OireachtasGovernmentMinster for Health

Cabinet Committeeon Health

High LevelDelivery Board

ExecutiveTask Force

SláintecareImplementation

Advisory Council

ExecutiveDirector

Sláintecare ProgrammeImplementation Office

Secretary General

Department of Health

HSE Board

HSE

Health Ecosystem of Partners /Stakeholders

Citizen

Figure 5: How Sláintecare will be overseen and implemented

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6 PartnershipWorking TheSláintecareProgrammeImplementationOffice(SPIO) hasbeenestablishedtosupportanddrivetheimplementationof the Sláintecare vision.

TheSPIOwillworkinpartnershipwithcolleaguesintheDepartmentofHealth,theHSE,otheragenciesandkeystakeholders.

TheSPIOwill:• Lead,manageandmonitorthereformprogramme.• Drivethereformprocessthroughimplementationplanninganddirection.• Establishprogrammemanagementandamonitoring/evaluationculture.• Actasacentralhubforhealthreform.• Supporttheworkstreams,programmesandprojects,intermsofproblem-

solving,identifyingandhelpingmanageinter-dependencies.• Helpescalateissuestogetdecisionswhereneeded.• Providetoolsandsupportwherehelpful(forexample,innovationlabs,

programmemanagementtoolsandcommunicationsupport).ItwillhaveakeyroleinprovidingregularreportingonimplementationprogresstotheMinisterandtotheCabinetCommitteeonHealth,andincommunicatingthereformprogrammeprioritiesandprogresstostakeholdersandthepublic.

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WorkingwiththeHSEAssetoutintheHSE’sNationalServicePlan2019,theHSE’sProgrammeforHealthServiceImprovement(PHSI)resourceandexpertisewillbere-directedtoestablishaHSEStrategicTransformationOfficeundertheremitofStrategicPlanningandTransformation. Thisoffice,workingcollaborativelywiththeSPIO,commissioningteams,andthewiderorganisation,willlead,driveandactivelysupportthedeliveryoftheSláintecarereformsinlinewiththeSláintecareActionPlan.

TheHSEStrategicTransformationOfficewilloverseethechangemanagementbusinessplanningapproachacrosstheHSEorganisationandwillaligntheexistingPHSIframeworktothenewestablishedpriorities.Inspecifictermsitwill:• WorkinpartnershipwiththeSPIOandthroughtheSláintecareExecutive

TaskForceandSláintecaregovernancestructurestoensurethat implementationofreformisdeliveredasplanned.

• DriveandactivelysupportthedeliveryoftheSláintecarereformsand otherkeyprogrammesdeterminedasbeingcriticaltotheoverallHSEtransformationprogramme.

• Overseethechangemanagementbusinessplanningapproachacross theorganisationandaligntheexistingPHSIframeworktothenew establishedpriorities.

• ProvideassurancetothenewHSEBoardonSláintecareimplementationprogress,highlightissuesofconcern,andtakecorrectiveactionsasrequired,toensurethatoveralloutcomesaredeliveredandthatvalueformoneyisachieved.

• Directavailableresourcesandexpertisetowardsthedeliveryof transformationalchangeinaccordancewithprioritisedprojects.

• Buildstrategicchangecapability,enablingteamstosuccessfully deliverandachievethebenefitsoftransformationprogrammes.

• SupportandenablelocalProgrammeManagementOfficestodeliver strategicreformsatfrontlineservicelevelwhereitwillbeexperienced bycommunities,serviceusers,patientsandfamilies.

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7 SláintecareProject Management StructureTheSPIOhasstructuredtheActionPlanintofourWorkstreamsasfollows:• Workstream1:ServiceRedesign&SupportingInfrastructure• Workstream2:SafeCare,Co-ordinatedGovernance&ValueforMoney• Workstream3:TeamsoftheFuture• Workstream4:SharingProgressEachworkstreamhasfivemajorProgrammeswitheachProgrammehavinga numberofspecificProjectsassetoutinthefollowingpages. TheProjectsaregroupedintoProgrammesbasedontheirlinkagesanddependencies.TheProjectswillbedeliveredbyteamscomprisingmembersoftheDepartmentofHealth,HSE,andotheragencies/stakeholdergroupsasappropriate. RepresentativesfromtheProjectTeamswillbefacilitatedbyaSPIOexecutiveataProgrammelevelsoastoprovideinformation,linksandvisibilitybetween andacrosstheProjects.TheExecutiveTaskForcewillbemadeupofrepresentativesfromtheindividualProjectsandProgrammesandwillbechairedbytheExecutiveDirectorofSláintecare. TheSPIOwillpublishrollingplansonanannualbasis.Progressreports willbepublishedonabiannualbasis.

AProjectInitiationDocumentwillbepreparedforpriorityProjectsandProgrammessettingoutclearmilestonedeliverables,timeframes,projectdependencies,projectownersandteam.Theprojectownerwillberesponsibleforthetimelydeliveryoftheprojectmilestonesandeffectivereportingonprojectprogress. ARisk,Actions,IssuesandDependencies(RAID)logwillbeintroducedforeachproject.AnominatedteammemberwillactivelyupdateandmaintaintheRAIDlogby:• Identifyingpotentialrisksandissuesandassigningresponsibleowners• Assessingthepotentialimpact/likelihoodofariskorissue• Establishingplanstomitigateagainstthespecificrisksandissues• Implementingactionplansforriskandissuemitigation. ThefollowingsectiondescribestheSPIOWorkstreamsandWorkProgrammes,andsetsoutthe2019-2028termsofreferenceforeachofthe20WorkProgrammes.Thesetermsofreferenceprovideaten-yearoverviewoftheWorkProgrammes.Theprojectmilestonestobedeliveredin2019arethenoutlined.

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8 SláintecareImplementation Workstreams

ThissectiondescribestheSPIOWorkstreamsandWorkProgrammes andsetsoutthe2019-2028termsofreferenceforeachofthe 20workprogrammes.

ProjectGanttsarealsoincludedshowingthekeydeliverablesfor the20workprogrammesfor2019.

Sláintecare Executive Task ForceChair: Executive Director, Sláintecare

Service ReDesign and Supporting Infrastructure

Workstream 1

Safe Care, Co-ordinatedGovernance and Value for Money

Workstream 2

Teams of the Future

Workstream 3

Sharing Progress

Workstream 4

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This workstream is centred on planning, building and supporting ahealth and social care workforce which can deliver on the Sláintecarereform programme, as well as initiatives which promote innovation,participation and the creation of a supportive work environment.The workforce planning framework will be progressed with a focus onengagement with the education sector and training bodies, to agree new ways of training multidisciplinary teams. The implementation of the recommendations in the Strategic Review of Medical Training and Career Structures will be progressed. Projects which support staff to work to the full scope of their licence to ensure that patients are seen at the lowest level of complexity possible will be identified and implemented.

This workstream is concerned with fostering the support of citizens and stakeholders in the Sláintecare reform process, consulting them

about its delivery and informing them about progress through engagement and open reporting. In 2019 a Citizen and Staff

Engagement and Empowerment Programme will commence which will be sustained throughout the 10-year implementation period. Development of an evaluation and reporting framework will also

commence in 2019. The Sláintecare Integration Fund will be established, all projects supported will be publicised, and progress

and evaluation reports published. A programme for promoting good practice so that successful projects can be recognised and scaled up

will be established.

SláintecareWork Programme

Action Plan

This workstream focuses on providing the right care, in the right place, at the right time, where the patient / service user is paramount and strong emphasis is placed on prevention and public health. Programmes will design integrated services to provide care and support at, or near, home where appropriate and to ensure hospital stays are minimised. This includes planning for bed and diagnostic capacity and ICT infrastructure to support integrated care and patient / service user empowerment. Programmes will focus on commencing and scaling projects to improve the management of chronic disease and older people’s services. The role that technology can play in reducing waiting times will be pursued under this workstream including an integrated ICT waiting list.

A focus will be placed on three areas for development:A PreventionB Integrated CareC National Policies

This workstream involves programmes which will enable a safe, devolved and accountable system to support the delivery of Irish

health and social care services. The aim is to establish a strong system of national and regional governance to drive improved performance

and accountability. In 2019, a new organisational and operational structure for the future reconfigured health service, including

respective roles of the Department of Health, the HSE and regional and community organisations will be defined. Sláintecare proposes

providing universal services at no or low cost to the patient/service user. Various entitlement and eligibility scenarios will be considered to

develop a roadmap and policy proposals for how and when this could be done. In 2019, a HSE Board will be established and key decisions will be made in relation to the establishment of Regional Integrated

Care Organisations. The Patient Safety Bill will be progressed.

Workstream 1Service Redesign and Supporting Infrastructure

Workstream 2Safe Care, Co-ordinated Governance and Value for Money

Workstream 3 Teams of the Future

Workstream 4Sharing Progress

Figure 6: SPIO Four Implementation Workstreams

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9 WorkstreamsBreakdown byProgramme

Workstream 1 ServiceReDesignandSupportingInfrastructure Workstream 2 SafeCare,Co-ordinatedGovernanceandValueforMoney Workstream 3 TeamsoftheFuture Workstream 4 SharingProgress

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Workstream 1


Programme

1.2Population


1.3Service

ReDesignFrameworkProgramme


Programme

1.5eHealth

Programme


Workstream 2


Programme

2.2Corporate

and ClinicalGovernanceProgramme

2.3Public and


2.4Eligibilty /

EntitlementProgramme

2.5FinancingReform

Programme

Teams of the Future

Workstream 3

3.1Workforce

PlanningProgramme

3.2Training Pipelineand New Ways

of TrainingProgramme

3.3Culture Changeand New Ways

of WorkingProgramme

3.4Innovation /


3.5Future

Intelligence /InfluencersProgramme

Sharing Progress

Workstream 4

4.1Citizen and StaffEngagement andEmpowerment

Programme


ImplementationOffice and

GovernanceProgramme



4.4 IntegrationFund and

Sláintecare BudgetManagementProgramme

4.5Communicationsand Recognising

SuccessProgramme

Figure 7: Sláintecare Executive Task Force

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Workstream 1 —

Service ReDesign andSupporting Infrastructure

Sláintecare



Workstream 1


Programme

1.2Population


1.3Service



Programme

1.5eHealth

Programme


Workstream 2


Programme

2.2Corporate


2.3Public and


2.4Eligibilty /


2.5FinancingReform

Programme

Teams of the Future

Workstream 3

3.1Workforce

PlanningProgramme




of WorkingProgramme

3.4Innovation /


3.5Future


Sharing Progress

Workstream 4


Programme



GovernanceProgramme






SuccessProgramme

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Workstream 1 — Service ReDesign and SupportingInfrastructureThisworkstreamiscomposedofthefollowingfiveworkprogrammes:

1.1 Data,ResearchandEvaluationProgramme 1.2 Population-basedPlanningProgramme 1.3 ServiceReDesignFrameworkProgramme 1.4 CapitalPlanningImplementationProgramme 1.5 eHealthProgrammeThedescriptionforeachoftheseworkprogrammesissetoutbelow.

1 Data, Research and EvaluationProgramme

Thisprogrammewillconsolidateexistingdata,collectnewdata,andwillensurethathighqualitynationalandinternationalevidenceisaccessed,synthesisedorgeneratedtoinformdecision-making,therebyoptimisingimpactforpatientoutcomes,thehealthsystemandtheeconomy.

2 Population-based PlanningProgramme

ThisprogrammewilldefinethehealthprofileofourpopulationbyRegionalIntegratedCareOrganisation(RICO),basedondemographicfactors,withtheaimofunderstandingandanticipatingthehealthandsocialneedsfortheregion.

3 Service Redesign FrameworkProgramme

Thisprogrammeisfocussedonthedevelopmentofintegratedcarepathwayswithinanationalpolicycontext,comprisingpreventative,therapeutic,treatment,rehabilitativeandpalliativecareelements.Theaimistoensurethatpeoplegettherightcare,intherightplace,attherighttime.Planningcareatthelowestlevelofcomplexitywhetherathome,nearhome,inhospitalorviaintegratedcarestructureswillunderpinthesepathways.Thefollowingarekeyto thisprogramme:A Developmentofanationalframeworkfor

ModelsofCaredesignB Developmentofanationalclinicalstrategyfor

RegionalPlanningC ImplementingHealthyIrelandD DevelopmentofPrimaryCare,SocialCare

andCommunityServicesE Implementingintegratedcarebetweenprimary,

communityandhospitalservicesF ImplementingtheCapacityPlan

G ImplementingtheTraumaPlanH ImplementinginnovativewaystoaddresswaitinglistsI Decidingonserviceswhichshouldbemovedfromthe

hospitaltoacommunitysetting

4 CapitalPlanning ImplementationProgramme

Thisprogrammewillsupportthere-designedservices.TheNationalDevelopmentPlanprovidesforfundingofover€10.9billiontoenabletheten-yearSláintecarevision.Keyinfrastructureprojectsincludethecommissioningofelectivehospitalinfrastructure;furtherPrimaryCarecentres;additionalhospitalbeds;diagnosticsintherightlocations;communityinfrastructureincludinglong-termandshort-termresidentialbedsincommunitynursinghomesandadditionalfacilitiesforpeoplewithdisabilities.

5 eHealthProgrammeThisprogrammeisfocussedonensuringthattherequisiteICTinfrastructurewillbeputinplacetosupportservicedelivery.TheaimistodevelopacoherentsuiteofeHealthsolutionsfortheIrishhealthcaresystemwhichwillsupporttheoverallvisionforintegrated,patient-centredcare.Thiswillrequiredatatosupportpopulationhealthplanning,aswellassystemstodrivemoreefficient,effectiveandcollaborativecare.Afocusonprovidingcliniciansandmanagerswiththetoolsandinformationneededtosupportdecision-makingisalsocentraltothisprogramme.

TermsofReference: 2019—2028

TheWorkstreamWorkBreakdownandProjectGanttsfordeliveryoftheseProgrammesin2019areasfollows:23


Work Breakdown Workstream 1: 2019Service Redesign and Supporting Infrastructure

Develop a Health Information Policy framework

Establish an R&D forum with key partners to develop

a research strategy 2020-2025

Consolidate and invest indata and R&D infrastructure

and capability

Models of Care (MoC)See next page for breakdown

Access and Waiting ListsSee next page for breakdown

Strategic PoliciesSee next page for breakdown

Project areas outlined indetail on next page

Establish population quantum and profile (age,

deprivation, ability, etc.) by RICO

Develop a geographic population ResourceAllocation Formula

Identify resources and servicesrequired in the community

Invite CHO & HG & Deliverypartners to co-design

integrated services fortheir geo-aligned region

Review utilisation ofPrimary Care Centres

Review diagnostics requirements in a RICO context (community and

hospital settings)

Establish more primary care centres and scope

community-based diagnostics

Prioritise locations for expansion of community and hospital beds

Progress the Project Ireland 2040Capital Plan for Health

Progress procurement of the Electronic Health Record

Commence development of a shared care record

Commence developmentof a national community

based ePrescribing service

Progress providing a digitalworkplace to enable health

service professionals to operate ina modern digitised environment

Progress the development ofclinical ICT systems, to provide therequired infrastructure to support effective clinical decision making

Continue implementing financial / corporate systems to improve

accountability and ensure money can follow patient activity

Identify improved information architecture, including standards,

information and identity to underpin the delivery of integrated care

Identify TelehealthCare solutions

Establish Individual HealthIdentifier office (IHI)

1.3 Service RedesignFramework Programme

1.1 Data Research andEvaluation Programme

1.2 Population-based Planning Programme

1.4 Capital PlanningImplementation Programme

1.5 eHealthProgramme

24


1.3 Service Redesign Framework Programme

Health andWellbeing Programme

Integrated Care at RICO level

Programmes at National level

Strategic PoliciesAccess and Waiting ListsModels of Care (MoC)

Prepare PID for Capacity Plan

Establish future needsfor people with disabilities

Publish “A Vision for Change” mental health strategy (no. 2)

Publish and Implement“Housing Options for ourAgeing Population” report

Commence the development ofa revised palliative care policy

Sustain cross-governmentsupport for Healthy Ireland

implementation

Deliver communicationcampaign and activities

in collaborationwith Sláintecare

Deliver 3rd round ofHealthy Ireland fund

Develop Social Care Strategy

Continued implementation of the Healthy and Positive

Ageing Initiative (HaPAI) including publication of

National Indicators Report

Progress Public Health Legislation programme

Develop Integrated Communicable Disease

Control Framework

Implement “Living Well witha Chronic Condition” –

Self-Management Framework

Support the coordination of HSE Healthy Ireland National Priority Programmes covering

the following areas: — Tobacco — Alcohol

— Healthy Eating and Active Living

— Sexual Health— Healthy Childhood

Appoint specialist expertiseto inform service design /

Models of Care

Implement the followingnational programmes:

— National Maternity Strategy including

the Digital Maternity Strategy— National Cancer Strategy

— National Neuro-rehabilitation Strategy

— National Paediatric Model of Care— National Programme for Transplant Services

— Palliative Care Development Framework

— National Dementia Strategy— Progressing Disability Services

— New Direction Day Services— Time to Move On

from Congregated Settings— “First Five Years”

Implement key Mental Healthinitiatives and review

recommendations of theMental Health Act 2001

Develop a best practice nationalframework for the conduct of

a clinical service review

Complete review of specialistcardiac services and report

on best practice

Agree, procure and commenceimplementation of a

single assessment tool

Implement NationalTrauma Strategy

Roll out Lean Capacity Improvement Plan Project

Draft UnscheduledCare Plan

Develop multi-annual Hospitaloperations, procedures andappointments Access plan

Commence implementationof the recommendations of

the Delayed Discharges Report

Carry out a review of ED, MIU,MAU and similar unit utilisation

Implement theRecommendations of the 2018Capacity Review plan including:

— Identify opportunities toopen and invest in additionalhospital and community beds

— Decide criteria for Elective/Ambulatory site selection and

decide on locations

— Progress the development ofcapacity of dedicated elective

& emergency workstreams

Implement theAmbulance Reform Plan

Finalise a National Frameworkfor Models of Care Design

Commence the development of aNational Clinical Strategy to form the

basis of all national and regional planning

Develop Healthy IrelandStrategic Action Plan

2020 – 2022 and progresskey Government approvals

incl. next phase of Sláintecare / Healthy Ireland

Outcomes Framework

Set up integrated co-designteams from CHOs / HGs / GPs /

Pharmacists / Allied Health /Nursing / Other Partners

to develop models oflocal service delivery

Select and develop demonstratorsites to support integrated care

Examine communityintervention and OPAT teams

Implement Integrated CareProgrammes focused on

people with chronicconditions and older people

Develop Pathways of Care

Develop and introduce a newmodel of nursing and

midwifery on a phased basis

Develop HG and CHOstrategic plans in the context

of RICOs

25


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

Conduct populationhealth analysis

Develop an integrated regional resource allocation formula

Establish population quantum and profile(age, deprivation, ability, etc.) by integrated region

Commence developing a methodology for determiningresources and integrated services on a regional basis

4.1.2,NEW

Convene Forum andbegin gap analysis

10.6.1,10.6.2,10.6.3

Agree terms of referencefor R&D Forum

Establish plan to developHealth Information Policy

FrameworkWorkshops and engagement with stakeholders

Develop Target Operating Model for IntegratedInformation Services (IIS) within the HSE

Develop design specification and governancestructures for the consolidation of national and

priority data and information requirements

Invite, setup and mobilise teams from CHO, HG and delivery partners to co-design integrated services

Data, Researchand EvaluationProgramme

Population Based PlanningProgramme

1.1

1.2

Sláintecare Implementation Timeline: Workstream 1 – Gantts 2019

Data, Research and Evaluation Programme

Population Based Planning Programme

Complete draft HealthInformation Policy

Framework

Complete draft R&Dstrategy policy document

and consult

26


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

Fram

ewor

k Finalise principles for National Framework for Models of Care Design

3.3.1,5.2.2

3.2.2,NEW

Hea

lth &

Wel

lbei

ng

Set up governance and initiate development of theNational Clinical Strategy for national and regional

planning (ongoing into 2020)

Support the coordination of HSE Healthy Ireland National Priority Programmes covering the following areas:Tobacco, Alcohol, Healthy Eating and Active Living, Sexual Health, Healthy Childhood

Deliver Healthy Ireland communications campaign and activities in collaboration with Sláintecare

Deliver 3rd round of Healthy Ireland fund

Develop Healthy Ireland StrategicAction Plan 2020-2022

Implement Healthy Ireland cross-sectoral priorities fromStrategic Action Plan (ongoing into 2020)

Agree details of next phase ofSláintecare / Healthy Ireland

Outcomes FrameworkImplement programme for Health and

Wellness Assessment of relevant policy areas

Publish Healthy IrelandSurvey 2019

Complete information gathering andprepare Healthy Ireland Survey report

Commence development of the IntegratedCommunicable Disease Control Framework

Progress Public Health Legislation programme

Implement ‘Living Well with a Chronic Condition’ Framework for self management support

1.3


Service ReDesign Framework Programme

Models of Care (MoC)

Service ReDesignFrameworkProgramme

27



SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019


3.3.2,3.4.1,3.4.2,5.4.4,10.3.1a,NEW

3.2.2,NEW

Nati

onal

Identify Telehealth pilotsites for Mental health

Complete stakeholder engagement and develop a best practice national frameworkfor the conduct of a clinical service review

Complete review and report of specialist cardiac services

Commence designationprocess for Major Trauma

& appoint staff to theNational Trauma Office

Develop ambulancebypass protocols

Implement & Review Mental Health Telehealth pilots

Continued implementation of the Healthy and Positive Ageing Initiative (HaPAI)

Publish National Healthy and PositiveAgeing Initiative (HaPAI) Indicators Report

Hea

lth &

Wel

lbei

ng

National Trauma Office to develop &implement detailed project plan

Complete scoping of operating model for Health &Wellbeing in the context of RICOs to accelerateconsistent and measurable implementation ofHealthy Ireland objectives across all services

Evaluate requirements for the Single Assessment Tool (SAT) Progress and procureSAT system


1.3


28


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

Implement the 2019 actions of the National Maternity Strategy including the Digital Maternity Strategy

Implement the 2019 actions of the National Cancer Strategy

Implement the 2019 actions ahead of the National Neurorehabilitation Strategy

Implement the 2019 actions of the National Paediatric Models of Care Strategy

Implement the 2019 actions of the National Programme for Transplant Services Strategy

Implement the 2019 actions of the Palliative Care Development Framework

Implement the Reform Programme for the Disability Sector under:• Transforming Lives; Progressing Disability Services

• New Direction Day Services• Time to Move on from Congregated Settings

4.3.3,5.4.1,5.4.2,5.4.3,NEW

Implement the 2019 actions of the National Dementia Strategy

Implement First 5 Strategy

1.3





Nati

onal

29


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019


4.3.2, 4.4.2,4.5.1,5.2.1,9.2.1,NEW

Appoint specialistexpertise for RICOs

Service Design /Models of Care

Set up integrated co-design teamsfrom CHOs / HGs / GPs /

Pharmacists / Allied Health /Nursing / Other Partners to develop

models of local service delivery

Commence detailed development ofregional integrated care models

Develop a new model of community nursing and midwifery on a regional integrated care model basis

Examine Community Intervention Teams and OPAT teams in a regional context

Prepare expansion of Integrated Care Programmes focussed on peoplewith chronic conditions and older people

Develop principles of Models of Care(MoC) for regional integrated care delivery

within a National Framework context

Host 4 workshopsto decide

implementationplans for:

• COPD• Diabetes• Heart Failure• Integrated Care

for Older People

Develop HG and CHO strategic plans in a regional integrated care model context

Rollout regional CHN demonstrator sites androllout integrated fund projects in CHN context

Decide on regionalCHN demonstrator sites

Engage with integratedcare stakeholders

Conduct workshopswith integrated care

stakeholders

Consolidate feedbackfrom integrated care

stakeholders

Review Clinical CareProgrammes anddecide next steps


1.3



Models of Care (MoC)RI

CO

30


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

5.1.1, 5.1.2, 5.1.3,NEW Draft multi-annual Hospital operations, procedures

and appointments Access plan

Draft Unscheduled Care Plan

Develop Lean CapacityImprovement Plan Commence roll-out of Lean Capacity Improvement Plan

Establish a Delayed Discharges Oversight Group Draft Delayed Discharge Operational Policy

Procure Lean Expertise forCapacity Improvement Plan

Develop and publishScheduled Care Access

Plan 2019Deliver Scheduled Care Access Plan 2019

Develop Scheduled Care Improvement Plan 2019-2020 Work on implementation of 2019 Improvement Areas

Refine 2020Improvement Plan

Scope a digital solutionto improve patient flow

Publish review ofWinter Plan 2018/2019

Prepare WinterPlan 2019/2020

Review, approve, publishand implement Winter Plan

2019/2020 Plan


1.3



Access and Waiting Lists

31


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

Roll out of NationalCentralised ValidationUnit and Publication

of Validation scheduleValidation of National Inpatient and Outpatient waiting lists

5.3.2,NEW

Elec

tive

Hos

pita

l Sel

ectio

n

Commence review of best practiceutilisation of ED, MIU and MAU

Workshop and engage with stakeholders toexamine options for optimum utilisation

Conduct population profiling to inform hospitaland community beds planning

Prepare final report onrecommendations foroptimum utilisation

Implement the Ambulance Reform Plan in line with the NSP (multi-annual project)

Draft proposal on hospital and community beds planning

Identify opportunities to open and invest in additional hospital and community beds

Publication of “Open Bed Report” Ongoing publication of “Open Bed Report”

Decide criteria for elective / ambulatory sites

Progress the development of capacity of dedicated elective & emergency workstreamssuch as Nenagh Ophthalmology, Tallaght Day Surgery (2019/2020)

4.2.3,5.1.1,5.1.2,5.1.3,5.1.4,5.1.5,5.2.3,NEW

5.1.5,5.3.1

Continue roll out of Bed Capacity Programme

Provide 75 Acute beds– Winter Plan 2018/2019

Continue commissioning of Beds in Mater,CUH, Drogheda & Tipperary (+78 Beds)

Winter Plan 2019/2020 – Prepare forfurther increase in bed capacity (202 beds

fully operational by Q1 2020)

Build

ing

Capa

city

1.3



Access and Waiting Lists


32


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

Conduct international literature review for National Social Care Strategy

Establish Future Needs for People with a Disability

Develop report of existing and potential capacityexpansion of services in Primary Care Centres

Commence adoption ofrecommended diagnostic

capacity expansion

Assess financing options for Capacity Planrecommendations for community and hospital beds

Devise procurement and funding plan for expansionof community and hospital beds

Conduct review of Primary Care Centres’ potentialrole in regional integrated models of care

Review diagnostics requirements in aregional integrated care context

Continue roll out of Primary Care Centres in line with regional population profiling needs

4.2.2,4.2.3,5.3.4,NEW

Progress 2040 Capital Plan for Health

Publish “A Vision for Change” Mental Health Strategy (no. 2)

Commence the development of arevised Palliative Care Policy

NEW

Launch report on HousingOptions for our AgeingPopulation with DHPLG

Convene DHPLGinterdepartmental

implementation groupProgress implementation of Housing Options

for our Ageing Population

1.3


1.4

Capital Planning ImplementationProgramme



Develop report of existing andpotential diagnostics capacity &

expansion of services

Capital Planning Implementation Programme

Strategic Policies

33


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

Start procurement

Develop strategy, business case and secure approval for Shared Care Record

Implement HR andPayroll corporatesystems acrossidentified areas

Procure and select strategic implementation partner for National Finance System

Secure Government decision for EHR procurement

Workshop & research existing telehealth solutions Scope new telehealth pilots

Upgrade community site connections and deploy end user devicesas part of Digital Workplace project

1st tranche

Deliver ICT systems to support effective clinical decision making

Identify communitysites for improveddigital connectivity

10.1.1, 10.2.1.a, 10.2.1.b,10.3.1, 10.3.2, 10.3.3, 10.4.1, 10.4.3, 10.5.1,NEW

Establish specification for ePrescribingin community care systems

Consolidatestakeholder feedbackEstablish governance for ePharmacy Programme Conduct Stakeholder

engagement

Establish Individual Health Identifier (IHI) Office

eHealthProgramme

1.5 eHealth Programme


2nd tranche 3rd tranche

34


Safe Care, Co-ordinated Governance and Value for Money

Sláintecare

Workstream 2 —



Workstream 2


Programme

2.2Corporate


2.3Public and


2.4Eligibilty /


2.5FinancingReform

Programme


Workstream 1


Programme

1.2Population


1.3Service



Programme

1.5eHealth

Programme

Teams of the Future

Workstream 3

3.1Workforce

PlanningProgramme




of WorkingProgramme

3.4Innovation /


3.5Future


Sharing Progress

Workstream 4


Programme



GovernanceProgramme






SuccessProgramme

36



Workstream 2 — Safe Care, Co-ordinated GovernanceandValue for Money

1 Geoalignmentand RICOsStructureProgramme

ThelackofgeographicalalignmentbetweenHospitalGroups(HGs)andCommunityHealthcareOrganisations(CHOs)createsanimpedimentforthehealthsystemtodeliveronitsintegratedcareobjectives.ThisprogrammewillestablishRegionallyIntegratedCareOrganisations(RICOs),withonebudgetforthepopulationoftheregion,toenablethedeliveryofplannedcarethatisrightfortheneedsofthatlocalpopulation.Thedevelopmentofaneffectiveimplementationstructureforthisreformisanintegralpartofthisprogrammetoensurethatclear,tangiblehealthoutcomesareachievedforthepopulationofeachregion.ThealignmentofCommunityHealthNetworksforlocaldeliverywillbeanimportantpartofthisprogramme.

2 Corporate and Clinical GovernanceProgramme

Thisprogrammewillgiveclaritytotherolesandresponsibilitiesofalltheagentsinvolvedindefining,funding,commissioning,anddeliveringhealthcareservicesinIreland.

3 PublicandPrivatePartnersProgramme

Thisprogrammewillinformourunderstandinganddecision-makingaroundwhowilldeliverservicesatdifferentpointsacrosstheclinicalpathway.This

involvesconsideringhowserviceswillbedeliveredbypublic,privateand/orcommunityandvoluntaryplayers.ItwillalsoconsiderthepublicationoftheIndependentReviewGrouponVoluntaryBodiesReportandthereviewfromTheIndependentReviewGroup,chairedbyDrDonaldeBuitléir,examiningtheremovalofprivatepracticefrompublicacutehospitals.TheprogrammealsoincludestheagreementofaGPcontractwhichwillstreamlineintegratedperson-centredcare,aswellastheroleofthepharmacist,carersandotherprofessionals.Theambitionistoachievefullequityinthedeliveryofhealthandsocialcareservicesinaco-ordinated,safe,appropriate,sustainableandperson-centredway.

4 Eligibility/EntitlementProgrammeThisprogrammewillplanhowtoaddressbarriersand/orinequitiesinaccesstohealthandsocialservicessoastotransitiontowardsauniversalsingletiersystemwherepriceisnotabarriertogettingtimelycare.

5 FinancingReformProgrammeThisprogrammewillsupporttheattainmentofasustainable,accountable,value-for-moneyfinancingsystem,inlinewiththedeliveryofanequitablehealthservice.

TheWorkstreamWorkBreakdownandProjectGanttsfordeliveryoftheseProgrammesin2019areasfollows:

37


Work Breakdown Workstream 2: 2019Safe Care, Co-ordinated

Governance and Value for Money

Consult, finalise and announcedecisions on the geographicalignment of HGs & CHOs

Legislate for new HSE Board

Establish new HSE Board

Introduce modifications toHGs and CHOs to ensure

geographic alignmentDefine and agree new organisational

and operational structures for areconfigured health service,

including respective roles of theDepartment of Health, the HSE

and national and regionalintegrated care organisations

Commence the process for decidingan overarching clinical and corporate

governance framework within thecontext of revised structures

Progress the Patient Safety Bill toencompass clinical audit, reportingof serious events, open disclosureand extension of HIQA’s remit to

the private sector

Implement a patient safety,complaints and advocacy policy

Progress the Implementation of the National Action Planon Antimicrobial Resistance

Progress the development ofa National Adult Safeguarding

Policy for the health sector

Determine and progress priority objectives for GP

contractual reform

Strengthen governance, monitoringand management of privatepractice in public hospitals

Complete and progressrecommendations from the

impact analysis of privatepractice removal from hospitals

Develop role of different healthcare professionals, contractors

and voluntary groups

Progress design of a statutory scheme for homecare

Commence a staged pilot of personalised budgets for people with

a disability over a two-year period

Review current framework anddevelop a policy proposal and

roadmap for universal eligibility

Explore devolving decisionmaking and autonomy to

regional levels

Develop proposals formulti-annual budgeting in the

healthcare and social care system tofacilitate accountability and planningand strengthen financial management

for revenue and capital funding

Develop a plan for the design of asystem of population-based funding

Develop plan to embed andextend the benefits of hospitalactivity-based funding (ABF)

Advance community-based costingfocusing initially on residential

placements and home help services

Benchmark quantum of health andsocial care budget in a

comparative international context

Invest in a multi-annual programmeof work with key health stakeholdersand academic researchers to develop

an activity and cost database for healthand social care in Ireland

Develop financial models to redirect demand to location

of least complexity

Undertake a governance review of the drugs approval

and procurement process

Progress Patient Safety (Licensing)Bill to include clinical governance,

patient safety operating frameworksand licensing of providers by HIQA

2.1 Geoalignment andRICOs Structure Programme

2.2 Corporate and ClinicalGovernance Programme

2.3 Public and PrivatePartners Programme

2.4 Eligibility /Entitlement Programme

2.5 FinancingReform Programme

Review basis for existing hospitaland medical charges

38


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

Announce Geoalignment and RICO structures

1.2.1, 1.2.2, 1.2.3

Research governance of successful regional integrated structuresin other jurisdictions

Develop interim standardised processes for HGs andCHOs on an integrated regional basis

1.1.1, 1.1.2, 1.1.3, 1.1.4, 1.4.1, 1.4.2, 1.4.3, 1.4.4, 1.4.6, 1.4.7, NEW

Develop and approve an overarching clinical and corporate governance framework

Submit Memo toGovernment on neworganisational and

operational structures

International EvidenceReview of Nationaland Regional Health

Structures

Work to progress Patient Safety (Licensing) Bill

Establish new HSE Board

Implement National Action Plan on Antimicrobial Resistance

Develop draft options appraisal for the neworganisational and operational structure for the

future reconfigured health service(DoH, HSE, RICOs)

Complete Patient Safety Bill Legislative Draft

Roll out of patient safety, complaints and advocacy competency framework Patient Safety AdvocacyService in operation

Research approach to legislating revised health structures

Commence development of Adult Safeguarding Policyfor the health sector

Continue stakeholder andservice user engagement

Publish 1st draft of AdultSafeguarding policy

and commence publicconsultation in early 2020


Geoalignment andRICOs StructureProgramme

2.1

Corporate and Clinical GovernanceProgramme

2.2

Geoalignment and RICOs Structures Programme

Corporate and Clinical Governance Programme

39


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

6.1.1,6.2.1,6.2.2,6.3.1,7.1.6

Review basis for existing hospitaland medication charges

Develop options for future changes tohospital and medication charges to be

considered in national budgetary process

Develop policy proposal and options forachieving universal eligibility

Progress development of Statutory Scheme for Homecare and draft design of statutory scheme

4.4.1,8.1.1,8.1.2,8.1.3,NEW

Establish ‘basket of services’ forchronic disease management aligned to

the new GP contract agreement

Finalise GP contracts

Consider the implications of therecommendations of the

de Buitléir report

Strengthen governance and operational framework for private practice in public hospitals

Examine the potential for healthcareprofessionals, contractors and voluntary groups

to explore models of care opportunities

Develop role of different healthcare professionals,contractors and voluntary groups

Continue two-year roll-out of staged pilot of personalisedbudgets for people with a disability

Initiate proposals for personalisedbudgets for people with a disability

Establish Interdepartmental Groupon Eligibility / Entitlement

Publish the independent review group (Catherine Day)

report of the role ofvoluntary organisations

Seek Governmentdecision on de Buitléir

recommendations


Public and PrivatePartners Programme

2.3

Eligibilty / EntitlementProgramme

2.4

Determine and progresspriority objectives for GP

contractual reform

Eligibility /Entitlement Programme

Public and Private Partners Programme

40



SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

7.2.1,7.1.5, 7.1.1, 7.1.2, 7.1.3, 7.1.4, 7.3.1, 7.4.2, 7.4.1, NEW

Develop the “Hospital ABFImplementation Plan 2019-2022” to

embed and extend ABF benefits

Conduct research and benchmark for health and social care budgets incomparable international jurisdictions

Identify areas of healthcare provision that can berelocated from hospitals to community settings

Review programme of work to develop an activity and cost database for health and social care in Ireland

Sign contract for the implementation of an externalsystem to support financial / corporate system objectives

Develop paper to inform the development ofproposals for multi-annual budgeting in the

healthcare system

Research approaches forthe allocation of fundingon a population-based

approach

Complete initial comparison costing report on the commissioningof external disability and mental health residential placements

Set out policy proposal for multi-annual budgetingEstablish interdepartmental (DoH, DPER, HSE)working group to review multi-annual budgeting

Review international best practice forpopulation-based funding

Develop draft budget approach forregional population-based funding

Roll out agreed ABF actions

Undertake governance review of drugs approval andprocurement process

Examine financial models to redirectdemand to location of least complexity

2.5

Financing ReformProgramme

Financing Reform Programme

41


Workstream 3 —

Teams of the Future

Sláintecare



Workstream 1


Programme

1.2Population


1.3Service



Programme

1.5eHealth

Programme


Workstream 2


Programme

2.2Corporate


2.3Public and


2.4Eligibilty /


2.5FinancingReform

Programme

Teams of the Future

Workstream 3

3.1Workforce

PlanningProgramme




of WorkingProgramme

3.4Innovation /


3.5Future


Sharing Progress

Workstream 4


Programme



GovernanceProgramme






SuccessProgramme

43


Workstream 3 — TeamsoftheFuture

1 WorkforcePlanningProgrammeThisprogrammewillensurethattherightteamsareavailable,attherighttime,todeliverontheclinicalandserviceobjectivesoftheSláintecarereform.Effectiveshort,medium,andlong-termworkforceplanningwillbeundertakentoensurethatnewModelsofCareareproperlyplannedinordertodeliverintegratedcare.Targetedrecruitmentandretentioninitiativeswillbescopedandcommenced.

2 TrainingPipelineandNewWays ofTrainingProgramme

ThisprogrammewillplandynamictraininginitiativestosupporttheSláintecarereform.Itwillbeacollaborativerelationshipwitheducatorsandstudentstosupporttheevolutionofinterdisciplinarycaremodelsandteamsovertime.Afocuswillbetodriveskillsoptimisationandteam-basedworking,andleadershipcapabilitieswillbepromotedbythisprogramme.Enhancedconfidence,satisfaction,andcompetenceofstaffwithintheirjobsisakeygoalforthisprogramme,includingtherolewhichtheworkingenvironmentplaysinattractingandretainingstaff.

3 Culture Change and New Ways of WorkingProgramme

Thisprogrammewillencourageandsupportthehealthcareworkforcetobecomeleadersandchampionsinunderstandingandadaptingto thewide-rangingimplicationsoftheSláintecare reforminitiatives.

4 Innovation/CapacityBuildingProgramme

Thisprogrammewillsupportstafftodeveloptheirinnovativeideas,talentandcompetenciesneededtonavigateadynamicandevolvinghealthcaresystem. Afocusonencouragingandbuildingcapacitywithintheworkforcetoadaptprocesses,systems,andways ofworkingwillbecentraltothisprogramme.

5 FutureIntelligence/InfluencersProgramme

Thisprogrammewillhorizon-scanfornewinitiativesandenablerswhichmayhelptheworkforcetodeliverthebestservicetopatients,serviceusersandclientsfortheoptimumvaluetothetaxpayer.



44


Work Breakdown Workstream 3: 2019Teams of the Future

Implement Medical Training andCareer Structures recommendations

Implement new contractualarrangements with GPs and Nursing

Enhance leadership through theHealth Service Leadership Academy

Introduce skills developmentprogrammes including lean

improvement projects

Identify good practice in terms ofSláintecare objectives and scale/

promote/disseminatethrough the Integration Fund

Conduct research on potential impactof AI, Robotics etc. on Workforce

Planning, and on services forpatients / service users

Commence development of anIntegrated Workforce Plan (WFP)

Develop a methodology fordetermining the resourcesand services required for

a community service model

Expand capacity in GPand community nursing

to manage chronic disease

Progress developmentof Public Health

Doctors’ role in Ireland

Assess existing health professionals’ contracts in the context of enabling

a shift to significantly enhanced community-based care, including

an examination of scope for extended working hours

3.1 WorkforcePlanning Programme

3.2 Training Pipeline andNew Ways of Training Programme

3.3 Culture Change and NewWays of Working Programme

3.4 Innovation / Capacity Building Programme

3.5 Future Intelligence / Influencers Programme

Publish policy anddevelop the role of Advanced

Nurse Practitioners

Introduce performance managementin areas of public health service

45



SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

4.1.1,4.1.2,4.2.1,4.3.1,9.1.1,9.1.2,9.1.3,9.2.3,9.3.1,9.3.2,NEW

9.2.4,9.2.2

Convene cross departmentalWorkforce Planning Forum

Review recommendations

in the MedicalTraining and Career

Structures documentfor implementation

Develop implementation policy andplan to roll out Medical Training &

Career Structures recommendations

Progress development of Public HealthDoctors’ role in Ireland

Publish policy and develop the role of advanced nursing practitioners for operationalisation by the HSE

Expand capacity in GP and community nursing to manage chronic disease

Commence roll-out of Medical Training &Career Structures recommendations

Develop a methodology for determining the resources required for delivering integrated care on a regional basis

Establish a team to lead on detailedstrategic health workforce planning

Commence development of an Integrated WorkforcePlan to include Doctors, Nurses, HSCPs and all staff

Continue development of an Integrated WorkforcePlan to include Doctors, Nurses, HSCPs and all staff

3.1

WorkforcePlanningProgramme

3.2

Training Pipelineand New Ways ofTraining Programme

Workforce Planning Programme

Training Pipeline and New Ways of Training Programme

46



Culture Change and New Ways of Working Programme

SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

Innovation /Capacity Building Programme

4.4.3,9.4.2,NEW

HSE to finalise and publishproposals for Performance Management

Systems across the health service

9.4.1,9.5.1,NEW

Scale up good practice for innovation and capacity building across services

Roll-out skills development programme

Agree programme forthe Health Service

Leadership Academy Plan future leadership development initiatives

Agree professional skills development programmesincluding lean improvement projects

NEW Complete research on the potential impact of Artificial Intelligence, Robotics and other technologieson workforce planning, and on services for patients / service users

Assess existing health professionals’ contracts in the context of enablinga shift to significantly enhanced community-based care

Identify good practicein innovative service

delivery projects

Implement new contractual arrangements with GPs and Nurses

3.3

3.4

3.5

Culture Change and New Ways ofWorking Programme

Innovation /Capacity BuildingProgramme

Future Intelligence /InfluencersProgramme

Future Intelligence / Influencers Programme

47


Workstream 4 —

Sharing Progress

Sláintecare



Workstream 1


Programme

1.2Population


1.3Service



Programme

1.5eHealth

Programme


Workstream 2


Programme

2.2Corporate


2.3Public and


2.4Eligibilty /


2.5FinancingReform

Programme

Teams of the Future

Workstream 3

3.1Workforce

PlanningProgramme




of WorkingProgramme

3.4Innovation /


3.5Future


Sharing Progress

Workstream 4


Programme



GovernanceProgramme






SuccessProgramme

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Workstream 4 — SharingProgress

1 CitizenandStaffEngagementandEmpowermentProgramme

Thisprogrammewillengageandempowercitizensintheirownhealthandwellbeing.Theaimistocreateamodern,responsive,andintegratedpublichealthsystemwhichsecureslong-termpublicandpoliticalconfidenceinthedeliveryandsuccessoftheSláintecarereform.Initiativestoenablehealthliteracywillbeidentifiedandscopedaspartofthisprogramme. Thisprogrammewillalsoinvolvetherolloutofacomprehensiveengagementplanforthehealthworkforce,toensurethatfrontlinestaffareinvolvedin,andfeelownershipof,thedesignanddeliveryoftheSláintecarechangeprogramme.

2 SláintecareProgrammeImplementationOfficeandGovernanceProgramme

ThisprogrammewillbeledbytheSPIOincollaborationwiththeDepartmentofHealth,theHSEandotherstakeholders.TheProgrammewillselecttheSláintecarepriorityprojectsforimplementationandestablishthestructuresandgovernancetoenableearlydeliveryoftheseprojects.Centraltothisprogrammeishavingclearstructuresinplacetosupportriskmanagement,issuesescalation,conflictmanagement,andproblemsolving,astheten-yearreformisplannedanddelivered.

3 EvaluationFrameworkandReportingProgressProgramme

ThisprogrammewilldefineanevaluationframeworkwhichcanbeusedtosupportregularreportingontheSláintecarereform.ItwillbeusedtounderstandhowtheDepartmentofHealth,HSEandotherstakeholdersareprogressingpriorityprojectssoastodemonstrateprogress.ItwillworkwithHealthyIrelandtorefineanddeliveroneOutcomesFrameworkforIreland.

4 IntegrationFundandSláintecareBudgetManagementProgramme

ThisProgrammewillmanagetheSláintecarebudget,includingtheIntegrationFund,bydesigning,establishingandresourcingprojectstotestnewModelsofCare,supportchangeprocesses,andimplementpriorityprogrammes.ItwillpreparedetailedbudgetsforaTransitionFundtosupportSláintecarereform.

5 CommunicationsProgrammeandRecognisingSuccessProgramme

Thisprogrammewillensurethattheappropriatecommunicationprocesses,tools,andschedulesareinplacetoshareprogressonthestatusandadvancementofSláintecareinitiatives.



50


Launch and roll out a public andhealth workforce engagement

and empowerment plan

Convene SláintecareImplementation Advisory

Council meetings

Develop a CitizenHealth Portal Prototype

Convene High Level DeliveryBoard Meetings

Develop a Public Health Service Online Directory

Develop and expand patientexperience capture systems

Promote shared valuesamongst HSE staff

Scope initiatives tosupport Health Literacy

Develop an evaluation programmefor the overall Sláintecare reform

Convene Executive Task Force,and Programme Teams

Develop monthly reportsand RAID logs

Roll out Integration Fundfor new Models of Careand integration projects

Develop Communications Plan and tools for Sláintecare

Publish detailed Action Plan andpublish progress reports biannually

Identify Programme torecognise successful delivery

4.1 Citizen and Staff Engagement and Empowerment Programme

4.2 Sláintecare Programme Implementation Office and

Governance Programme

4.3 Evaluation Framework andReporting Progress Programme

4.4 Integration Fund andSláintecare Management

Programme

4.5 Communications Programme and Recognising

Success Programme

Work Breakdown Workstream 4: 2019Sharing Progress

Establish a multi-annualTransition Fund

51


SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

Prepare for 2020 nationwide Public and Staff Engagementand Empowerment initiatives

Launch Public and Staff Engagementand Empowerment Programme

Develop and expand systems to capture patient/service user experience

Convene and hold High Level Delivery Board Meetings

Hold monthly Executive Task Force and Programme Teams meetings

Sláintecare Programme Implementation Office and Governance Programme

Convene and hold Sláintecare Implementation Advisory Council Quarterly Meetings 2019

Promote sharedvalues amongst thehealth workforce

Support initiatives to promote Health Literacy

Develop monthly progress reports and RAID logs

Confirm all projects have PIDS, Budgets,delivery trajectories and RAID log

Agree meeting andreporting structures,

frequency and methods

Mobilise SPIO team

Continue roll-out of shared values amongst health workforce

Establish monthlyExecutive Task Force

and ProgrammeTeams meetings

Continue roll-out of Citizen and Staff engagement initiatives

Develop roadmap for delivery of the Citizen Health Portal

4.1

Citizen and StaffEngagement andEmpowermentProgramme

4.2

SláintecareProgrammeImplementationOffice and GovernanceProgramme


2.4.1,2.4.2, 1.4.5,3.1.1, NEW

2.1.2,2.2.2, NEW

Citizen and Staff Engagement and Empowerment Programme

Design and developCitizen Health

Portal prototype

52



SC no. Q1 2019 Q2 2019 Q3 2019 Q4 2019

4.3

4.4

4.5

10.6.4,2.3.1,NEW

Prepare first Sláintecare mid-year report

Communications Programme & Recognising Success Programme

2.5.1,3.3.3

Develop criteriaand governance forIntegration Fund.Launch callout ofIntegration Fund

Prepare bid for Transition Fund based on priorityprevention and early intervention, capacity and value

for money projects Establish and resource multi-annual Transition Fund

2.3.1,2.3.2,NEW

Publish progress reports on a biannual basis

Identify Programme to recognise successful delivery

Develop and roll-out Communications Plansand tools for Sláintecare programme

Integration Fund & SC Budget Management Programme

Provide information and respond to requests on reporting of Sláintecare implementation progress

Publish 2019 Action Plan

Select projects

Conduct ongoing evaluation

Commence evaluationof impact of fund

Rollout Programme to recognise successful delivery

Draft 2019Sláintecare Progress

Report

Prepare 2020 Action Plan

Evaluation Framework &Reporting ProgressProgramme

Integration Fund & SláintecareBudget Management Programme

CommunicationsProgramme &Recognising SuccessProgramme

Evaluation Framework & Reporting Progress Programme

Launch and mobilise projects to testand scale new Models of Care

53


AppendixListofAbbreviations

ABF Activitybasedfunding

AHP AdvancedHealthcarePractitioner

ANP AdvancedNursePractitioner

AI ArtificialIntelligence

CHN CommunityHealthcareNetwork

CHO CommunityHealthcareOrganisation

COPD ChronicObstructivePulmonaryDisease

DOH DepartmentofHealth

DPER DepartmentofExpenditureandReform

ED EmergencyDepartment

EHR ElectronicHealthRecord

FOI FreedomofInformation

HaPAI HealthyandPositiveAgeingInitiative

HG HospitalGroups

HI HealthyIreland

54


HIQA HealthInformationandQualityAuthority

HSCP HealthandSocialCareProfessional

HSE HealthServicesExecutive

IHI IndividualHealthIdentifier

IIS IntegratedInformationSystem

MAU MedicalAssessmentUnit

MIU MinorInjuryUnit

MOC ModelofCare

NSP NationalServicePlan

OPAT Outpatientparenteralantimicrobialtherapy

PHSI ProgrammeforHealthServiceImprovement

PID ProjectInitiationDocument

PQ ParliamentaryQuestion

RAID Risks,Actions,IssuesandDependencies

RICO RegionalIntegratedCareOrganisation

RSSMAC ResidentialSupportServicesMaintenanceandAccommodationContributions

SAT SingleAssessmentTool

SIAC SláintecareImplementationAdvisoryCouncil

SPIO SláintecareProgrammeImplementationOffice

WFP WorkforcePlan

WHO WorldHealthOrganisation

55


GlossaryofTerms ActivityBasedFunding(ABF)ABFmeansthathospitalsarepaidfortheactualquantityandqualityofcaretheydelivertopatients,therebyenablingthehospitalstoseeclearlythelinkbetweenmoneyandtheworktheydo.In2016theHSEintroducedABF forhospitalcareforinpatientandday-caseservices.TargetsforhospitalactivityaresetcentrallybytheHSEandpricesaresetbytheHealthcarePricingOffice.

CommunityHealthcareOrganisations(CHO)CommunityHealthcareOrganisations–ReportandRecommendationsoftheIntegratedServiceAreaReviewGroup1,publishedinOctober2014,setsouthowhealthservices,outsideofacutehospitals,arecurrentlyorganisedandmanaged.Knownascommunityhealthcareservices,theseservicesincludeprimarycare,socialcare(servicesforolderpeopleandforpersonswithadisability),mentalhealthandhealth&wellbeing.

HospitalGroups2

ThehospitalsinIrelandhavebeenorganisedintosevenHospitalGroupssince20133.Theservicesdeliveredincludeinpatientscheduledcare,unscheduled/emergencycare,maternityservices,outpatientanddiagnosticservices.TheGroupChiefExecutiveofeachHospitalGroupreportstotheNationalDirectorforAcuteServicesandisaccountablefortheirHospitalGroupsplanningandperformanceundertheHSEAccountabilityFramework(2015).

56


MedicalAssessmentUnit(MAU)AMAUisafacilitywithbedsseparatefromEDwhoseprimaryfunctionistheimmediateandearlyspecialistmanagementofacutelyunwelladultpatientswhopresentto,orarereferredfromwithin,ahospitalrequiringurgentmedicalcare.MAUsenableappropriatestreamingofpatientsawayfromEDtoimproveclinicalcareandthepatientexperience.MAUshavethepotentialtoprovidemoreintegratedcareforpatientswithurgentmedicalneed,deliveredinamoreappropriatesetting,bystaffwiththecorrectskillsmixandexpertise.

Model of CareAmodelofcaredefinesthewayhealthservicesaredeliveredanddescribesbestpracticecareandservicesforaperson,populationgrouporpatientcohortastheyprogressthroughthestagesofacondition,injuryorevent4.

1https://www.hse.ie/eng/services/publications/corporate/choreport.html2https://www.hse.ie/eng/services/list/3/acutehospitals/hospitalgroups.html3TheEstablishmentofHospitalGroupsasatransitiontoIndependentHospitalTrusts4NSWAgencyforClinicalInnovation(2013)Understandingtheprocesstodevelopamodelofcare– AnACIframework,availableathttps://www.aci.health.nsw.gov.au/_data/assets/pdf_file/0009/181935/HS13-034_Framework-DevelopMoC_D7.pdf

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Sláintecare•Right Care.Right Place.Right Time.

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