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  • 1. 10th National Health Summit Choices for our Health Service Mr. Tony OBrien Director General of the Health Service Wednesday 19th February 2014 1
  • 2. 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
  • 3. 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 4
  • 5. Service Developments 2014 5
  • 6. Risks to Delivery of Service Plan 6
  • 7. Patient Safety & Quality
  • 8. Open Disclosure
  • 9. 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)
  • 10. 3. Equal Care Reformed Health Service 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 11
  • 12. Transformation from Industrial Age Healthcare to Information Age Healthcare Industrial Age Healthcare Information Age Healthcare Individual Self-care Person Transformation Through Cost-Effective Use of Information & Communication Technologies Community Primary Secondary Tertiary Friends & Family Community Networks Professionals as Facilitators Professionals as Partners Professionals as Authorities Source: Adapted from Malaysian Telemedicine Blueprint 12
  • 13. Challenges for Healthcare Cost vs Quality 13
  • 14. Changing Role of Patients Patient ePatient Passive Role Active (engaged role Role Information given Seek out information (Internet) Top down delivery Partner in delivery Paternalistic Medicine 14 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 15
  • 16. Medicines Management & Generic Prescribing Statins: SIMVASTATIN PPI: LANSOPRAZOLE ACE inhibitor: RAMIPRIL ARB: CANDESARTAN
  • 17. New Scorecard QUALITY Quality, Access & Resources (to include Finance): The basis of the new balanced scorecard ACCESS Safe, high quality, patient centred services RESOURCES 17
  • 18. Ultimately: Outcomes for All Faster Fairer Access to Hospitals Free Access to GP Care Affordability Improved Health and Well being Improved Quality and Safety More People Cared for in their Homes Better Management of Chronic Illness 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 19