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Acute hospitals are currently operating ahead of approved employment levels and will need to “reduce pay costs in order to manage within the available resources for 2020”, according to the HSE National Service Plan for next year.
“The service impact of the necessary adjustments will be closely monitored,” states the plan, which has been published this afternoon.
It says addressing unscheduled care “access challenges” continues to be a key priority.
“As the population grows and people live longer, the prevalence of chronic diseases and frailty increases and with this comes increased need for health services. Evidence shows that managing chronic diseases appropriately in primary care reduces hospital emergency department (ED) presentations, hospital admissions and outpatient attendances.
“A substantial focus is on facilitating this re-orientation of the health services towards more care in community settings and reducing the current reliance on acute hospitals for the care of patients with chronic conditions and older patients. Integrating acute and community services in the care of older people will help to reduce admissions and length of hospital stay.”
The HSE will work with the Sláintecare Programme Implementation Office on service redesign programmes to facilitate and advance this reorientation of care. “Containing activity in acute hospitals to funded levels during this period of transition and reform is a significant challenge.”
The Executive is developing specialist hubs linked to acute hospital services which are designed to address the needs of older people and those with chronic disease. These specialist hubs are targeted at reducing ED visits and inpatient hospitalisations.
Primary and community services are to be “significantly enhanced” via a €10 million investment (growing to €60 million in 2021), according to the plan. Developments will include the roll-out of the community health networks (CHNs) with a GP lead role and participation by GPs in care planning.
Specific service development measures include:
• A community-based GP-led Chronic Disease Management Programme – a structured programme targeted in 2020 at GMS clients aged over 75 years with specific chronic diseases (diabetes, asthma, chronic obstructive pulmonary disorder (COPD) and cardiovascular disease) will be rolled out to over 45,000 service users across the country and will benefit over 430,000 GMS clients on full roll-out in 2023. This contract will enable patients with chronic disease to receive their routine chronic disease care in the community
• New supports are being provided for community therapeutic haemochromatosis, involuntary admissions in mental health and virtual clinics.
In partnership with GPs “an ambitious eHealth agenda” has been set for the next three years focused on bringing improved population wellbeing, health service efficiencies and economic opportunity through the use of technology enabled solutions, according to the plan.
• The design and developmental phase of the summary and shared care records
• Roll-out of MedLIS in Beaumont Hospital and Cavan General Hospital in 2020 are foundations for the delivery of co-ordinated and integrated care to service users.