The HSE is planning a “structured review” of consultant recruitment and retention “challenges” in model 3 hospitals, according to the HSE National Service Plan 2022.
The plan, published today by the Executive, states that a report will be produced on foot of the review with recommendations for implementation.
Additionally, the HSE intends to publish a review of the consultant workforce and “an in-depth medical workforce plan” for the specialties of anaesthesiology (including paediatric anaesthesiology) and ear, nose and throat, as well as projections to “meet the unmet demand for pathology”.
In regard to general practice, the plan commits to building capacity “through the continued implementation of the GP Agreement 2019”. The Executive will also “allocate funding in 2022 to implement a new model of support to general practice in areas of deprivation – tested in 2021”.
Among the “key” priorities in the plan, as directed by the Minister for Health, are implementation of the public consultant contract in consultation with representative bodies; full rollout of the GP agreement to develop and expand community care through the modified chronic disease management programme; and implementation of the Enhanced Community Care Programme, including the operationalisation of community healthcare networks in line with advancement of regional health areas.
Meanwhile, in a section detailing areas “beyond the normal level of financial risk that is managed in any given year”, the plan lists a cost of €60 million for “1 July 2021 FEMPI unwind provisions re twilight premia and overtime”.
This cost is not provided for in the service plan and the Executive queries the feasibility of restoring these payments in 2022.
“The HSE is likely to be able to accommodate the impact of this change in the current year; however, in a largely 24×7/frontline service context, it is not feasible to do so for 2022,” states the report. “€23m of this relates to restoration of twilight premia which is earned by certain grades for hours worked after 6pm with the balance relating to overtime premia, much of it being structural in nature, ie, worked as part of normal/ European Working Time Directive (EWTD) compliant hours for certain grades, including nursing and medical staff.
“…It is suggested that the issue be revisited in the context of the final DoH and DPER decision on the 2020 end year surplus and any potential 2021 surplus, once known. A permanent solution will be pursued thereafter within the 2023 estimates process.”