The annual National Service Plan (NSP2010) setting out the type and volume of health and personal social services to be provided by the Executive during the period, was approved by the Minister for Health and Children on 5th February. This plan reflects the strategic direction and key objectives outlined in the HSE Corporate Plan 2008 – 2011. The NSP is the basis on which the Minister for Health and Children evaluates our performance and our annual progress in meeting out legislative obligations.
NSP2010 is framed within the context of health service reform, a rapidly changing economic environment and a climate of reducing resources. Prioritization is targeted at continued investment in community services, emergency services, the National Cancer Control Programme and the shift to day services.
NSP2010 builds on the work of previous years and concentrates on setting out the type and volume of health and personal social services to be provided by the Executive. It incorporates greater and more explicit links between funding, staffing and service activity including more specific empirical targets and clearly defined timescales. It also highlights the challenges and risks for the organization in the successful delivery of the plan particularly in terms of the human resource and industrial relations environment.
The plan outlines a commitment to maximise the available resource in order to deliver services at the same level as in 2009 except in the case of acute hospitals as well as increases in a number of areas which have received specific additional funding. Focus for 2010 in acute hospitals is to continue to provide for emergency admissions and priority service workload, including elective surgery, while controlling the overall level of acute work within the context of a reduced resource. People will be treated in a more effective way with no reduction in access to appropriate services. There will be a continued shift to care on a day case basis with plans to deliver an increase of 6.5% over the day case target set in NSP2010.
In order to deliver the level of services it is committing to, the HSE faces significant challenges, reducing and avoiding costs in both support and frontline services as well as reconfiguring many services. These service reconfigurations are in keeping with the overall strategic direction as set out in the HSE Corporate Plan 2008-2011 and include:
- § conversion of inpatient work to day case work
- § a focus on reducing patient length of stay in acute hospitals
- § the implementation of hospital avoidance strategies and
- § the provision of more services in community settings thus reducing the dependency on inpatient beds
These actions will ensure that with reduced funding we will seek more efficiency than ever before.
The vote in the Abridged Estimate Volume for the HSE in 2010 is €14,070 bn, a decrease of €668m on the 2009 outturn. There is also a dependency on income collection which is €745m higher than in 2009. A specific 2010 VFM target of €106m has been set for the HSE which is reflected in the plan. There are further efficiencies of approximately €200m required to enable the HSE to deliver the level of services outlined in the plan as well as dealing with the service impact of a €103m retraction of funding for the impact of the government moratorium on recruitment for 2009/2010.
The allocation includes an additional €55m for the costs associated with H1N1 in 2010, innovative service delivery fund of €17m, €117m (€20m in respect of 09 funding) for A Fair Deal, an additional €20m for the Cancer Control Programme, €10m for home care packages for Older People and €230m for Demand Led Schemes.
It also includes an additional €70m to meet service pressures arising from demographic change, which will fund service increases in areas where there are unavoidable demographic and other pressures (including €20m in respect of demographic funding withdrawn in mid 2009 which has been returned).