The Chairman of the HSE, Mr. Liam Downey, has welcomed the Minister for Health and Children’s approval of the HSE’s National Service Plan which is now available on this website. The Chairman confirmed that “preparation of the HSE Service Plan has involved careful choices and that the primary focus for the HSE during the year will be to continue to transform the effectiveness of the way services are delivered and in so doing, to make it easier for people to access the care they need in the most appropriate setting.” The HSE’s National Service Plan outlines its targets for hospital, community and primary care services and details how the HSE plans to maintain access to appropriate treatments and services for patients and clients during 2010 despite current resource pressures.

Acute hospital activity in 2010 will reflect the continuing shift from inpatient to day case activity with an increase in day cases of 6.5% and a targeted reduction in the level of inpatient care provided of 5.6% over the 2009 targets. This will be achieved through a combination of continued reform in how health services are delivered through measures such as minimising length of stay in hospital, more day case procedures and providing alternatives for people who at present have to be admitted to hospital though Emergency Departments for very short hospital stays through the provision of more services within communities. The emphasis is on a continued move towards treatment on a day case basis where this is clinically safe and in line with international best practice. 

While the number of people who visit an Emergency Department (ED) in 2010 is expected to remain constant, the HSE intends to reduce the numbers who are admitted through EDs by 33,313. This will be achieved by increasing access to the specialist skills and senior clinical decision making available in EDs and in current and planned Medical Assessment Units, which will mean that people do not need to be admitted to hospital unnecessarily. In addition, by increasing access to diagnostics for the 10,000 people who are admitted to hospital annually solely for this purpose the reduction in admissions can be achieved in 2010.

Speaking about the Service Plan today, Professor Brendan Drumm, CEO of the HSE, said; “Our challenge this year is to keep on enhancing the quality of the services we provide which can only be achieved by improving our effectiveness and in so doing, reducing costs.

“From a service point of view we will continue to reorient services away from bringing people into hospital for care they should get on a day case basis and in community facilities.  A high hospital admission rate is not a logical measure of the effectiveness of a modern health service. Given the worry and inconvenience hospitalisation can create for patients and their families, we need to continue to lower admission rates and we should only admit patients when there is no better clinical alternative. This is the standard of care we would all want for ourselves.

“A significant number of people who visit EDs do so for treatment associated with their chronic illness which requires interventions such as intravenous antibiotics or simply monitoring and observation. With more active chronic illness management at primary care level, supported by fast track and direct access to a consultant opinion when it is needed, these ED visits, which often lead to admission, can be avoided.

“I am particularly pleased that during the year we will be completing the development of 1,200 very high quality residential beds for older people and new Primary Care Centres for 47Primary Care Teams. These developments will greatly support our shift to the community. We plan to have almost 400 Primary Care Teams in place by year end”, Professor Drumm concluded.

The HSE Service Plan is the framework which outlines how in 2010 the HSE will deliver acute hospital, community and related social services within its budget of €14,070bn. Other than the changes to the delivery of hospital based care as outlined above, the same level of service as 2009 will be maintained in 2010 within the context of health service reform, a rapidly changing economic environment and a climate of reducing resources.

The 2010 budget allocation includes an additional €230 million for Demand Led Schemessuch as Medical Cards, €117 million (€20 million in respect of 2009 funding) for A Fair Deal, €10 million for Home Care Packages for Older People and €20 million for the National Cancer Control Programme. The Service Plan also includes a Value for Money target of €106 million for the HSE and a dependency on income collection which is €745m higher than in 2009. The HSE’s budget allocation for 2010 also includes a reduction of over €500 million in respect of pay in line with Government pay policy as outlined in the Budget.

The National Plan for Radiation Oncology (NPRO) which forms part of the National Cancer Control Programme will continue with the development of radiation oncology facilities throughout the country. It is expected that the first of these new facilities at St James’s and Beaumont Hospitals in Dublin will be opened before the end of the year.

Community services provided to older people in 2010 will include almost 12 million home help hours to over 54,000 people, 5,100 home care packages benefiting over 9,613 people and over 21,000 day care places.

Service levels for people with disabilities will be maintained and day care and residential facilities for people with disabilitieswill be completed.Additional funding of €19.5m will be available to develop 100 more residential places, 400 more day places and 140,000 additional Personal Assistant hours. €6m has been made available to staff two new 20 bedded Child and Adolescent Mental Health acute units in Cork and Galway. The reconfiguration of mental health services in line with Vision for Change will create further opportunitiesduring the year for efficiency improvements.

Children and Families services will be maintained during 2010. In addition €6m has been provided to deal with increased demand for foster care placements and the recruitment of additional social workers is being prioritised.  €14 million has been made available for the implementation of the Ryan Report in line with the implementation plan published by the Minister for Children & Youth Affairs last year.  

 To read or download the National Service Plan 2010 click here