Building a high quality health service for a healthier IrelandLaverne McGuinnessDeputy Director General, HSE

National Healthcare Conference, 28th May 2015

Ambition for the Health Service over next 3 years set out in Corporate Plan

In defining a Vision Reflect on •The Health Service we have •The Health Service people want

What do people think of it ?

Media

Service Users

Patients

Strategic Direction for the Health Service 2015 - 2018

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Public

Politicians

Patient and Service User Experience

Varying responses depending on the “ Experience”

Good Experience - Most of the patients have a good experience

• 1.4m receive inpatient or day case treatment each year

• 3.2m attend a hospital outpatient department each year

• 1.2m attend emergency departments each year

Behaviour & Attitude Survey – Overall Experience within past year

• Hospital for a procedure: 97% reported an excellent or good experience

• Local Health Centre: 92% reported an excellent or good experience

• A&E at hospital: 62% reported an excellent or good experience

Poor Experience - Example Portlaoise

Lack of Compassion, Dignity and Respect

Lack of transparency, Lack of Kindness

“Uncaring culture”

Key Message• Improvements have and continue to be made but we need

to do better

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Vision and Ambition

Vision

A healthier Ireland with a high quality health service

valued by all

Ambition Translated

• HSE has identified 5 key Goals

• Delivery of these goals and measures of success will be set out

each year in the Annual Service Plan

• Delivery will take place though the 7 Hospital Groups and 9

Community Healthcare Organisations

• Delivery Underpinning each of these goals are our values

Care

Compassion

Trust

Learning 5

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Promote health and wellbeing as part of everything we do so that people will be healthier

Goal1

Goal2

Goal3

Goal4

Goal5

Provide fair, equitable and timely access to quality, safe health services that people need

Foster a culture that is honest, compassionate, transparent and accountable

Engage, develop and value our workforce to deliver the best possible care and services to the people who depend on them

Manage resources in a way that delivers best health outcomes, improves people’s experience of using the service and demonstrates value for money

Each Goal Represents a Journey of Travel Between:

Where we are now

Where we want to be

What we will do

to get there

Where we are now

Where we want to be

What do we know?

• Cancer rise by 4% - 36,000 new cases

• Chronic disease increase by 4%

• 1 in 10 over 50 have diabetes

• 3 in 5 adults overweight

• I in 5 children overweight

How we measure it?

• 3% more people within healthy weight range

• Percentage who smoke reduced from 19.5% (898,755) to <15% (691,350)

• Achieve 60% uptake on bowel screening

• Achieve 80% uptake on Diabetic Retina Screening

• Amount of alcohol consumed each year by people aged 15 and over reduced by 0.5 litres of pure alcohol

Goal1

Promote health and wellbeing as part of everything we do so that people will be healthier

What will we do?

Focus on prevention to reduce chronic disease • Smoking• Obesity • Diet and exercise• Alcohol

Focus on early detection and treatment• Expand cancer

screening programmes

Focus On Smoking Prevention and Lung Cancer

Goal1

Promote health and wellbeing as part of everything we do so that people will be healthier

What we know• The number of people who smoke is 898,755

• Over 90% of lung cancer in Ireland is attributable to smoking and is therefore preventable

• Lung cancer the third most common invasive cancer in Ireland and

• Highest mortality rate of all cancers

• In 2007 lung cancer overtook breast cancer in women as cancer with highest mortality rate

• 2,400 new cases diagnosed annually

• Number of cases to increase by 88% by 2040

• Each year, approximately 5,200 Irish people die from smoking related illnesses

Focus On Smoking Prevention and Lung Cancer

Goal1

Promote health and wellbeing as part of everything we do so that people will be healthier

https://www.youtube.com/watch?v=Mposl7PnHZw

What we are doing Prevention• Target smoking cessation and prevention in schools• Quit campaign - 2,979 supported to quit in Q1 2015• By 2017 target to reduce the number of smokers by

207,405 (from 898,755 to 691,350)• Restriction on advertising by Tobacco Companies

Early Detection, Treatment & Access• Established Rapid Access lung clinic in each of the

eight cancer centres since 2011• 10,711 patients attended the rapid access clinics

between 2011- 2014 of which 3,501 diagnosed with a primary lung cancer and 500 other type of lung cancer

• In 2014 94.5% of all urgent referrals seen with 15 working days

• Target 2015 is 95% seen within 10 working days, current performance is 90.4%

• 5 year survival rate increased from 10% in 1999 to 15% 2011

Provide fair, equitable and timely access to quality, safe health services that people need

• Big issue people have with the health service is the length of time they have to wait to be seen and treated

• Current target for waiting list for inpatient and day cases is

• < 18 months by the end of June • < 15 months by the end of Dec 2015• Goal: < 5 months by the end of Dec 2017

• Current outpatient target < 18 months • Goal < 5months by the end of Dec 17

Goal2

Focus on Waiting Lists

What we know• Number of elective inpatients annually

100, 650• 95.6% adults seen within 18 months

809 waiting greater 18 months

Day Cases • Number of Day cases per year 861,000 • 98.2% adults seen within 18 months

748 waiting greater 18 months

Outpatient attendances 3.2 million• Total waiting list 405,501 • 92.6% seem within 18 months

30,092 waiting greater 18 months

Goal2

Provide fair, equitable and timely access to quality, safe health services that people need

Target : 100% of patients receive their day case or inpatient procedure within 5 months of referral – outpatient s 8 months

What we are doing• Focus on improving patient flow

– ED Taskforce Plan – €74m delayed discharge investment

Plans to reduce the waiting lists • Target longest waiters to meet June

target of no patient waiting greater than 18 months

– 3,322 requiring treatment by end June if 18 month target is to be achieved

– Plans in place to treat 3,016 of the 3,322 at cost of approx €5.4m

• Further plans to deal with achieving 15 month target

• Development of plans to achieve 5 month target

Outpatients• Challenge is the volume development

of plans to achieve target

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Promote health and wellbeing as part of everything we do so that people will be healthier

Goal1

Goal2

Goal3

Goal4

Goal5

Provide fair, equitable and timely access to quality, safe health services that people need

Foster a culture that is honest, compassionate, transparent and accountable

Engage, develop and value our workforce to deliver the best possible care and services to the people who depend on them

Manage resources in a way that delivers best health outcomes, improves people’s experience of using the service and demonstrates value for money

Thank You