New HSE plan aims to keep patients out of hospitals and cut numbers in residential care

The health service will seek to reduce the need for people to attend hospital in the years ahead and reduce the numbers of older people in residential care as part of a new “home first” approach.

The HSE also said it would seek to deliver significant reductions in waiting times for scheduled care as part of a new three-year corporate plan which it released on Tuesday.

It said it would also work to increase capacity by implementing elective-only care centres, purchasing additional capacity from the private sector, funding more hospital beds and using resources more effectively.

The plan also seeks to accelerate the digitisation of health services .

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HSE chief executive Paul Reid acknowledged the health service was "far off the mark" in terms of meeting waiting time targets at present. He said the HSE would engage collaboratively with its board, the Minister for Health and the Department of Health on the best use of the €240million 'access to care' fund for this year, as well as the €125million fund provided to the National Treatment Purchase Fund (NTPF) to map out priorities for 2021.

There is no single overall cost set out in the plan for delivering its objectives.

As part of six overall objectives, the plan aims to manage the Covid-19 pandemic while delivering healthcare safely to the public. It says the HSE will “based on risk and clinical need, retain capacity for potential surges in order to meet patient care needs”.

The plan also envisages boosting primary and community services and reducing the need for people to attend hospital.

“We will establish 96 community healthcare networks and 32 community specialist teams for older people and chronic disease supporting our 26 hospitals ensuring integrated care is provided locally at the appropriate level of complexity.”

“We will expand community diagnostics to improve access for general practice and community specialist teams.”

The plan says the HSE will implement an agreement reached with family doctors in 2019 which will provide for a structured programme of chronic disease management in the community for about 430,000 people with medical cards and GP visit cards.

The plan also says “we must reduce the number of older people in residential care settings by providing services to people as close to home as possible which will allow our ageing population to maintain their independence and live well in the community”.

The new plan says the HSE will deliver significant reductions in scheduled care waiting times. It says it will aim to make “significant progress towards achieving waiting times outlined within the Sláintecare report; 10 weeks for a new outpatient appointment, 12 weeks for an appointment for a procedure, and 10 days for diagnostics”.

“We will work to increase capacity by implementing elective-only care centres, purchasing additional capacity from the private sector, funding more hospital beds and using resources more effectively.”

“We will establish dedicated teams at national, regional and hospital levels, to support the effective planning and delivery of the scheduled care reform.”

The plan says the HSE will progress the implementation of the new policy on mental health. It says it will prioritise “child and adolescent early intervention, and enhancing early interventions for adult mental health services”.

The plan says the HSE will “work to re-imagine disability services, to be the most responsive, person-centred model achievable with greater flexibility and choice for the service user”.

The plan says at present the health service “continues to be held back with inefficient, and often paper based patient interactions, with patient presence required due to the lack of tools rather than the patient need”.