Second Implementation Plan for Activity Based Funding (ABF) Published

We are pleased to publish the second Implementation Plan for Activity Based Funding (ABF) in Ireland, as part of a programme of work to support the delivery of the Sláintecare Implementation Strategy.

This Plan represents an important step forward in increasing transparency in funding, encouraging efficiency, value for money and sustainability, and ultimately providing greater accountability for the way resources are allocated in the Irish healthcare system.

Since the Government committed to introducing ABF in 2012, we have worked to build the skillsets and underlying data needed to do this, and to establish an annual price development cycle to support funding decisions. The first Implementation Plan (2015) laid the groundwork for this with the establishment of the Healthcare Pricing Office (HPO) centrally within the Health Service Executive (HSE) and the development of patient-level costing at 19 hospitals. 39 hospitals have been funded by ABF for 70% of their total funding, moving away from historic block funding and increasing transparency and accountability.

In 2018 the Government reconfirmed its commitment to ABF as part of the Sláintecare Implementation Strategy and included actions in the Strategy to progress ABF. This second ABF Implementation Plan provides a vehicle to continue to progress these actions including preparatory work around introduction of structured healthcare purchasing, taking foundational steps towards the necessary costing and data improvements needed to support pricing for community services, and building on the work already undertaken to further expand and enhance the costing and pricing of hospital services.

This Plan signals a shift from the necessary foundational and technical work around the costing and pricing of services towards creating a more holistic healthcare resourcing and purchasing process that links insights from key clinical, operational and patient stakeholders, with the core Sláintecare intent around integrated care, in the least complex setting appropriate, as close to home as practical.

COVID-19 has had a significant impact on the healthcare system and has created major challenges for in accounting for new and unknown patterns of healthcare usage and costs. Whilst emergency measures have included temporary increases to block funding, ABF and its building blocks have proved useful in providing the information needed to monitor the impact and effects of the disease and make important decisions as to where resources should be deployed, and will continue to be critical for health system insights and funding into the future.

However, COVID-19 has also demonstrated the significant capacity of the health system to respond effectively to the need for rapid change and improvement. Many aspects of the changes introduced over the last 21 months are fully consistent with the intent of Sláintecare, and will be maintained after the pandemic has ended. This period has also seen step changes both in the trust and confidence of the public in the HSE and in the Government’s investment in both permanent additional health service capacity and COVID-19 response measures. We look forward to working across the healthcare system to increase efficiency, transparency and value for service users, and welcome the opportunity which ABF provides to do just this.

Last updated on: 30 / 12 / 2021