June 17, 2008
A record number of patients and clients were cared for by the HSE and HSE funded agencies during 2007 and the pattern is continuing into 2008.
This is the second year in a row that hospital and community based services have increased on a year on year basis.
Speaking at the launch of the Annual Report, Mr Liam Downey, Chairman of the HSE Board said:
“We have made good progress during 2007 on the reform agenda within the health services. This involves a variety of initiatives including reconfiguration of services to deliver better quality, changing work practices and better measurement and monitoring of outputs in order to improve services for patients. While much of this is difficult and challenging to implement we have established a clear direction and platform for change in many important areas”.
Also speaking at today’s publication Professor Brendan Drumm, CEO, thanked staff for their valuable contribution during 2007.
He stressed that transformation of the health service was progressing well and would benefit from more community support for the change programme.
“Our task ofmodernising the health service, where 80-90% of care is provided outside acute hospitals, would benefit greatly from more support from those who are in a position to influence change such as those who work in the health arena, social partners, public representatives, media and advocacy groups”.
A day in the Life of the HSE
The HSE’s 2007 Annual Report outlines the comprehensive and complex range of services which the HSE provides and underlines ongoing increases in the amount of people in receipt of these as well as pointing to significant new services developed. The report illustrates that during a typical “Day in the Life”of the HSE in 2007 there were:
- 11,898 inpatients in our acute hospitals;
- 1,618 day case patients receiving treatment;
- 8,289 people attending outpatient departments;
- 570 calls to the ambulance service;
- 3,148 people attending emergency departments;
- 192 babies born;
- 33,839 home help hours delivered;
- 2,278 callers to the GP out of hours services;
- 140 food inspections carried out;
- 7,100 people in sheltered work;
- 5,322 children in care;
- 2,840 people in rehabilitation training; and
- 193 callers to the HSE Information Line–1850 24 1850
- €6.8m spent each day on demand led schemes such as Medical Cards
Transforming community services
Professor Drumm said that the HSE’s strategy to expand community based service was delivering more benefits to local communities.
In 2007, the HSE built on many community based initiatives and added more -
- People in receipt of Home Care Packages at year end up by 52%
- Nursing Home Subvention payments up 11%
- 646 additional long term respite care beds
- 29% increase in medical cards (to a total of 1.276 million people)
- 46% increase in GP Visit cards (to a total of 75,589 people)
- 1000 extra disability places
Four Community Intervention Teams located in Cork, Limerick and Dublin teams now serve a population of around 1 million people and provide rapid response care so patients can avoid Emergency Department visits and hospital admissions and speed up discharges. They dealt with over 3000 referrals during the year.
The HSE has also expanded its GP out of hours services with 90% of the community now having access to GP services 24 hours a day. The number of calls to GP out of hours and calls attended to increased by almost 11%.
Primary Care Teams and facilities
Professor Drumm emphasised that the HSE remained fully committed to having half of the targeted 530 Primary Care Teams in place by the end of 2009 and welcomed the commitment of primary care professionals to this goal.
The HSE has received 450 proposals from the private sector to provide facilities for Primary Care Teams in 131 locations and negotiations are well underway. In addition, the HSE will shortly be advertising for proposals to develop primary centres in more locations. These are in addition to the 70 primary care centres already developed and being developed by the HSE.
Central to the Primary Care Team (PCT) approach is the assignment of existing community based staff such as therapists, public health nurses, general nurses and home care workers along with General Practitioners to specific teams. This is to ensure they can all work together effectively as multidisciplinary teams and maximise all opportunities to plan and deliver fully integrated services to their local populations.
Approximately 630 HSE allied health professionals have been assigned to PCTs. In addition there are over 500 GPs participating in PCTs in various stages of development together with a number of practice nurses and other GP practice resources.
222 new posts have been filled and allocated to Primary Care Team around the country and a further 77 are in the process of being filled. Another 300 posts have been allocated and it is envisaged that recruitment of these will start at the end of the year.
More hospital services than ever before
The level of all the main services provided in our hospitals rose in 2007:
- Inpatient numbers were up 3.7%
- Day Cases were up over 5%
- Out Patient attendances were up 5%
- Births were up almost 12%
- Emergency Department attendances were up over 3%
This trend is continuing and during the first quarter of this year - many services are ahead of target.
Professor Drumm took the opportunity of today’s launch to re-emphasise that there was no recruitment embargo in the HSE. He said -
“We are absolutely committed to getting better value for patients without compromising quality or access. This is a completely different to a recruitment embargo.
“To continue to provide more care to more people, as we have been doing for the past two years, we must all deliver better value. This demands that we challenge everything we do, every post and every service we provide to make sure that they deliver the best possible value to patients and clients in terms of access and outcomes”.
Professor Drumm said that since January 3,584 posts had been approved and were being filled. This represented almost 90% of all approval requests and of these posts, 80% represented medical/dental, nursing, health and social care professionals and other patient and client care staff.
“We know from performance data that in some facilities the ratios between staff and the number of patients they see is relatively low, while neighbouring facilities could make better use of more staff to provide better care.
“At a time when the demand for existing and new services is so great, we have to prioritise our investment in facilities that give patients and clients the best value.”
The CEO went on to point out that delivering better value is about making better use of what we have and not simply more of the same -
“A significant number of clinical leaders are accepting this. They are also accepting the need to reconfigure some hospital services so they can concentrate on delivering services to the highest international quality standards.
“If we want to deliver the safest possible care we have to stop doing complex procedures in some hospitals and particularly those where the volume of procedures are too low to guarantee the best results.”
The Annual Report also points to significant challenges facing the Irish health services. Population growth and an improvement in life expectancy means there are more demands on the HSE to provide a mix of social services to an ageing population and there are also more people with chronic illnesses to take care of.
In 2007 there were 4.34 million people living in the Republic of Ireland, an increase of 106,100 on 2006. The following factors, in particular, impacted directly on the delivery of health services:
- high inward migration –nearly two-thirds of the population increase, 67,300, was caused by net migration;
- and an increase in births –over 70,000 babieswere born in 2007, the highest number for 25 years.
Last updated on: 17 / 06 / 2008