Opening Statement to the:

Joint Oireachtas Committee

on Health

by

Laura Magahy

Executive Director, Sláintecare Programme Implementation Office

23rd October 2019

Contents

One Year into Implementation

Action Plan Update

Implementation Analysis

Next Steps

Dependencies

Governance(one year into implementation)

Sláintecare Implementation GovernanceQ3/4 2018

Q1 2019

Q2 2019

Q3/4 2019

Sláintecare Oversight

Sláintecare

Implementation

Advisory Council

Joint Oireachtas

Committee 2018 Sláintecare Programme

Implementation Office

Sláintecare High

Level Delivery

Board

Action Plan Update (at September 2019)

Workstream 1

Service Re-Design and

Supporting Infrastructure

Workstream 2

Safe Care, Co-ordinated

Governance & Value for Money

Workstream 3

Teams of the Future

Workstream 4

Sharing Progress

4.5

Communicat-

ions &

Recognising

Success

Programme

1.3 Service

Re-design

Framework Programme

1.1 Data

Research and

Evaluation

Programme

1.5

E-Health

Programme

1.2 Population

based

Planning Programme

1.4 Capital

Planning

Implementation

Programme

4.3 Evaluation

Framework &

Reporting

Progress

Programme

4.1 Citizen

& Staff

Engagement &

Empowerment

Programme

4.2 Sláintecare

Implementation

Programme

Office &

Governance

Programme

4.4 Integration

Fund &

Sláintecare

Budget

Management

Programme

3.3 Culture

Change and

new ways of

Working

Programme

3.1 Workforce

Planning

Programme

3.5 Future

Intelligence /

Influencers

Programme

3.2 Training

Pipeline and

new ways of

Training

Programme

3.4 Innovation

/ Capacity

Building

Programme

2.3 Public and Private Partners Programme

2.1 Geoalign

-ment and

RICO’s

Structure Programme

2.5 Financing

Reform Programme

2.2 Corporate and Clinical Governance Programme

2.4Eligibility / Entitlement Programme

Sláintecare Q3 Deliverables

114 deliverables to September

2019

93% on track with 7% having

minor challenges (to be delivered before year-end)

On Track, 106,

93%

Minor Challenge,

8, 7%

January to September 2019 Status

Overview of Deliverables

On Track Minor Challenge

Significant Challenge On Hold

Implementation Analysis

Foundational Decisions

Six new Regional Health Areas

New HSE Board & CEO in place

GP Contract

Enhanced Nurse Contract agreed

National Clinical Programmes Review and Recommendations

Multi-annual commitment to recruiting staff in the community

Dialogue Forum to strengthen relationship with Voluntary providers

Enablers put in place Implementation Oversight group for role of Public Health Doctors

Postgraduate Medical Education Strategy Forum

IHI Office

E-pharmacy governance

Housing Options for our Ageing Population implementation group

Elective Hospital Oversight Group

Clinical Lead for Trauma

Single Assessment Tool

Budget 2020

Budget 2020 and Sláintecare, including..

Amount 2020 Funding Areas

€10 million Enhanced

Community Fund

(€60 million in 2021)

Up to 1,000 therapists, nurses and other frontline staff to care for people in the

community, including advisers for people with Dementia. This will allow us to treat

people in the community, closer to their own homes, reducing community waiting

lists.

€20 million Integration

Fund

Scaling successful projects for:

-Engagement and Empowerment of People in the Care of their own health

-Moving care from the hospital to the community

-Care of Chronic Diseases and Older Persons

€12 million Care

Redesign Fund

Care redesign - providing care at the least form of complexity, in accordance with the

clinical care programmes, to people in the right location.

Citizen and Staff Engagement

Working together, across the system

MECC Phlebotomy

Diagnostics

Public health

AmbulanceRehabilitation

Integrated care

programmes

Podiatry

OptometryDietician

Social prescribing

Pharmacy

Mental Health

Family

Community health

workers

Ambulatory Care

Emergency Community Response

Specialist HSCPs

GP

Social Groups

Exercise groups

Dental

Physiotherapy

Social care & social workers

Informal & Voluntary support

Palliative Care

Hospitals

Self- Care

Speech & Language TherapistOccupational

Therapist

-Quarterly Action Plan Progress Reports

-Committee Attendances

-Briefings

-Staff Engagement Fora

-Values in Action Movement

-Conferences and Briefings

-Healthy Ireland Joint Initiatives-Health Reform Alliance Event -Consultation Events

Elected Representatives Healthcare Staff

Citizens

Citizen and Staff Engagement

Integration Fund

Integration Fund

477 applicants122 successful projects

● Promote the engagement and empowerment of citizens in the care of their own health

● Scale and share examples of best practice and processes for chronic disease management and care of older people

● Encourage innovations in the shift of care to the community or provide hospital avoidance measures

A few sample projects

Jigsaw OnlineAn e-mental platform by Jigsaw, the National Centre for Youth Mental Health.

Epilepsy IrelandDeveloping a Pathway of Community Care Supports for People with Epilepsy in Ireland

ALONEBConnect

Supporting older people to age at home: Linking healthcare, social care and community care together using technology and services

The Asthma Society

Beating Breathlessness

A personalised nurse-led instant

messaging service delivered

through the WhatsApp platform

Cork/Kerry Health and Wellbeing Community Referral

Croí, West of Ireland Cardiac Foundation

‘MySláinte’ community lifestyle

programme

Diabetes care in the Mid-WestA Podiatry led pathway for timely provision

of footwear and orthotics in the community

FITT Teams in Mullingar, Wexford, and West Wicklow/SVUH

And others… 300 staff within the Integration Fund projects

Next Steps

Eligibility and Entitlement

Eligibility & Entitlement Next Steps

• Submit Memo to Government on de Buitléir Report

• Develop roadmap for Universal Access

• Establish Interdepartmental Group on eligibility and entitlement

• Citizens Assembly?

Access and Capacity

Sláintecare Action Plan 2020 – 2022

WS 1 - Service ReDesign & Supporting Infrastructure HSE -Sláintecare Joint Implementation Office

Regional Integrated Care Areas (RICAs)

Programme

Capacity – Access Programme

e-HealthWorkforce

PlanningData, Research &

Evidence

Enabling Programmes

WS 3 – Teams of The Future

WS 4 – Sharing ProgressWS 2 – Co-ordinated

Governance and Value for Money

Eligibility and Entitlement Programme

Corporate and Clinical Governance Programme

Financing Reform Programme

Training Pipeline Programme

Future Intelligence /Influencers Programme

Integration Fund/Innovative

Services Programme

Oversight –Reporting –Communications

Evaluation Frameworks Programme

Policy & Support Programmes

Implementing the Capacity Plan -creating more Access

Key Projects for 2020-2021

Healthy Living:1. Scale patient empowerment integration fund programmes2. Implement Housing Options for our Ageing Population

Enhanced Community Care:1. Recruit 1000 new frontline community staff2. Implement alternative paths for unscheduled care & diagnostics3. Procure Shared Care Record

Hospital Productivity Improvements1. Optimise usage of existing hospital beds 2. Decide locations of elective hospitals and procure design teams

Regional Integrated Care Areas

Regional Integrated Care Areas

Implementing Regional Integrated Care AreasCo-design of service delivery

Develop 6 Integrated Regional Plans

Conduct regional population profiling & mapping of existing resources/services

Designate national/regional services

Decide capacity planning requirements/targets per region

Healthy Living Enhanced community care Hospital productivity improvement

Assess regional population needs

Allocate budget per region

Set up six regional planning teams

Host regional stakeholder engagement

Establish enablers (E-health, capital & workforce planning) per region

Design optimum pathways of care per region

Regional population profiling and segmentation - Example

Dependencies

Dependencies

Maintaining all-party support

Government continuing to take key strategic decisions

Resourcing the decisions

Continued stakeholder buy-in

Thank you