Sláintecare Action Plan 2023: Right Care Right Place Right Time

Right Care. Right Place. Right Time.
Sláintecare Action Plan

2023
Sláintecare Implementation
Strategy & Action Plan 2021 - 2023
Contents
Foreword 5
Introduction 6
Sláintecare Reform Programmes 2021 – 2023 7
Implementation & Governance 10
Communications & Progress Reporting 12
Sláintecare Action Plan 2023 13
Risk Identification & Management 35
Appendix 36
Sláintecare 2023 Action Plan
Foreword
We will continue the “shift to the left”

through the Enhanced Community Care
Minister (ECC) programme, designed to enable the
of Health reorientation of service delivery towards
general practice and community-based
services, thereby providing health services
closer to people’s homes and reducing
The shared vision pressure on acute hospitals. Almost
of Sláintecare, and all Community Healthcare Networks,
Community Specialist Teams have now
as set out in the been established and we expect to see a
Programme for real impact on delivery in 2023.
Government, is
We are committed to progressing the elective
to introduce a universal health and hospitals programme in Cork, Galway and Dublin
social care system where everyone and in parallel the new surgical hubs in Cork, Galway,
has equitable access to services based Limerick, Waterford and Dublin to help tackle waiting
lists on a shorter-term basis.
on need, and not ability to pay and to
deliver safe, quality health and social We will continue to progress key digital and eHealth
care services that meet the needs of solutions, a new Digital Health Strategic Framework
and continue the foundational changes and
our growing population, and attracts
realignment of community and acute services through
and retains the very best healthcare Regional Health Areas.
clinicians, managers, and staff.
This Sláintecare Action Plan 2023 is the third and final
in the Sláintecare Implementation Strategy & Action
Significant progress was made last year in achieving
Plan. Much remains to be done however and this year
that vision, and I am delighted now to present the
we will also prepare our next multi-annual strategy to
2023 Sláintecare Action Plan. This Sláintecare Action
commence in 2024. This work will begin early in 2023.
Plan 2023 comprises Sláintecare programmes,
projects and Programme for Government priorities
Sláintecare implementation will be undertaken in
and is aligned to the HSE’s National Service Plan and
an open and transparent way. The minutes of the
key policies, national strategies and initiatives and
Sláintecare Programme Board will continue to be
will build on what has been achieved to date. Our
published as a matter of course and the co-chairs of
focus in 2023 will continue to be on improving access,
the Programme Board will continue to engage with
outcomes and affordability for patients by increasing
the Joint Committee on Health on a regular basis. We
the capacity and effectiveness of the workforce,
are all trying to build a better, more equitable health
infrastructure and delivery of patient care.
system for all and through continued collaboration,
spirit and support and engagement from and with
In 2023, we will introduce the Public-only Consultant
key partners and stakeholders, together we can
Contract, a key step in removing private care from
achieve this.
public hospitals. We will implement the Waiting List
Action Plan 2023 and deliver ambitious targets for
sustained reductions in acute scheduled care waiting
lists and waiting times.
5
Introduction
The vision for healthcare set out in the Programme for • Waiting Lists: Overall reductions were
Government is Universal healthcare, a public health complemented by significant reductions in waiting
service which provides the people with access to high times. In 2022, the overall number of patients
quality, affordable care when they need it. The 2017 exceeding the Sláintecare maximum wait time
Sláintecare Report is an essential element in making targets recommended in the 2017 Oireachtas
this vision a reality. The Programme for Government Report (10 weeks OPD, 12 weeks IPDC / GI Scope)
supports Sláintecare as well as adding measures to decreased by 11%.
realise universal healthcare.
• The new Sláintecare Consultant Contract was
This Sláintecare 2023 Action Plan sets out the approved by Government in December 2022.
ongoing reform priorities aligned with the Programme
for Government, the Sláintecare Implementation • Expansion in eligibility including: Acute public in-
Strategy & Action Plan 2021—2023, Department of patient charges for children under 16 years were
Health priorities and the HSE’s National Service abolished in all public hospitals from 21 September
Plan 2023. 2022 and funding allocated in Budget 2023 to
provide for the abolition of all public inpatient
On 14 May 2021, the HSE suffered a major hospital charges.
ransomware cyber attack which caused all of its IT
systems nationwide to be shut down. It was the most • Elective Hospitals received formal Government
significant cybercrime attack on an Irish state agency approval-in-principle for the Preliminary Business
and the largest known attack against a health service Case for the Programme as well as the Project-
computer system. The system recovered from this level Business Cases for Cork and Galway.
attack but the event caused significant disruption
• 2,400 healthcare workers have been recruited to
to services and impacted on some of the reform
the Enhanced Community Care (ECC) Programme,
works underway.
establishing 94 of the planned 96 Community
Throughout the COVID-19 pandemic and the cyber Healthcare Networks (CHNs) and 21 Community
attack, work progressed on the implementation of Specialist Teams for Older Persons and 21
the reform priorities notwithstanding the fact that specialist teams for Chronic Disease Management.
there were some inevitable impacts on timelines, as
• The GP Direct Access to Diagnostics scheme
responding to the pandemic and maintaining service
provides a direct referral pathway for GPs to allow
provision had to be prioritised.
their patients access diagnostic scans. It delivered
Progress in implementing the reform programme over 250,000 diagnostics in 2022.
continued throughout 2022 and some major
milestones achieved in 2022 are:
Key Highlights (additional
Programme for Government):
Key Highlights (Sláintecare and
• A total of 970 additional acute beds have been
Programme for Government):
delivered since January 2020. Latest figures from
• Regional Health Areas: Government approval was the HSE confirm that there are 14,508 beds in
given, in April 2022, on next steps, the programme acute settings (including obstetrics and psychiatric
of work, and timelines for Regional Health Areas beds) against a target of 13,600 beds identified in
(RHAs) implementation. the Health Service Capacity Review.
6
• Critical care capacity now has 323 beds, which • Sharing the Vision Implementation Plan 2022 –
represents an increase of approximately 25% over 2024 was published in March 2022.
the 2020 baseline of 258 beds. This also means
that Phase 1 of the Critical Care Strategy is now • Major Trauma Centre services commenced 2022
delivered and progress underway to deliver at the Mater Misericordiae University Hospital and
Phase 2. on track to start at Cork University Hospital from
early 2023.
• There are 17,298 more WTE working in our health
service than there were in January 2020 – this • The National Forensic Mental Hospital in Portrane
includes an additional 4,592 nurses and midwives, opened in November 2022.
2,654 health & social care professionals and 1,758
• €11m in 2022 secured 149 Advanced Nurse and
doctors and dentists.
Midwife Practitioner new additional posts for the
• Waiting Lists: Without the intervention of the health service.
2022 Waiting List Action Plan, active hospital
• The 1st National Nursing Home Experience
waiting lists would have increased by 42% to over
Survey was launched in March 2022 and results
1 million people. Instead, there were c.1.56 million
were published in November 2022.
patients removed and c.1.53 million patients
added to hospital waiting lists during 2022 – a net
• Health Performance Visualisation Platform (HPVP)
reduction of c.30,000 people (4.1%) to c.690,000.
phase 1 was deployed to 19 hospitals.
• Expansion in eligibility including:
• A Framework for the design and delivery of
post-natal hubs was finalised and approval for the
— A free contraception scheme for women aged
development of five hubs at Kerry, Kilkenny, Cork,
17-25 was launched on 14 September 2022
Sligo and Portiuncula was agreed.
and will be expanded to 26-year-olds on 1
January 2023.
• The Traveller Health Action Plan was launched on
the 28 November 2022.
— The Drug Payment Scheme threshold was
reduced twice in 2022. From €138 per month
• Agreement for additional undergraduate places
in 2018, the threshold has now reduced to €80
in medicine from September 2022 onwards was
per month.
reached with Irish Medical Schools.
— A free national STI home-testing scheme was
Full progress made on the 2022 reform programme is
introduced by the HSE in October 2022.
set out in the Sláintecare Implementation Strategy &
Action Plan Progress report 20221.
• 21.02m of home support hours were delivered
in 2022.
• The National Stop Smoking Clinical Guideline was

published in January 2022.
1 gov.ie/slaintecare-progress-report-2022
7
Sláintecare Reform
Programmes 2021 – 2023
Two Reform Programmes have been prioritised for focused implementation:
• Reform Programme 1 – Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
• Reform Programme 2 – Addressing Health Inequalities -towards Universal Healthcare
Programme Programme
1 2
Improving Safe, Timely Access to Care Addressing Health

and Promoting Health & Wellbeing Inequalities is bringing
is focused on integration, safety, us on a journey towards
prevention, shift of care to the right universal healthcare.
location, productivity, extra capacity and
achieving Sláintecare waiting time targets.
Eleven associated projects have been developed across these two programmes aligned with those reforms set
out in Sláintecare, Programme for Government priorities, and key national strategies, policies and initiatives.
8
Reform Programme 1
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing focusing on - integration, safety,
prevention, shift of care to the right location, productivity, extra capacity and reduction of waiting lists, including:
Project 1
Implement the Health Service Capacity Review (2018) including Healthy Living.
Enhanced Community Care and Hospital Productivity
Project 2
Scale and mainstream Integration Innovation
Project 3
Streamline Care Pathways, from prevention to discharge
Project 4
Develop Elective Ambulatory Care Centres in Dublin, Cork, and Galway
Project 5
Implement a Multi-annual Waiting List Reduction Plan
Project 6
Implement the eHealth Programme
Project 7
Remove private care from public hospitals
- implement the Sláintecare Consultant Contract
9
Reform Programme 2
Addressing Health Inequalities focusing on - moving towards Universal Healthcare, including:
Project 1
Develop a Population Health Approach for Service Planning and Funding
Project 2
Rollout Sláintecare Healthy Communities Programme
Project 3
Develop Regional Health Areas
Project 4
Implement Obesity Policy and Action Plan 2016 - 2025
These Reform Programmes will involve the work, support, and active engagement of key partners, including
the Department of Health, other government departments, their agencies, in particular the HSE, health and
social care workers and their representative organisations, community and voluntary organisations, and the
private sector.
10
Implementation & Governance
Sláintecare Governance and Oversight • Receive formal progress updates from the
Management Board / Executive Management
The Sláintecare Programme Board was established Team project leads, monitor overall implementation
in 2021 to drive the principles of Sláintecare reform progress and address escalated matters.
throughout the health and social care service. The
Board is co-chaired by the Secretary-General of the • Serve as the escalation path to resolve issues and
Department of Health (DoH) and Chief Executive make resource changes to the scope of a project
Officer of the Health Service Executive (HSE) and if necessary.
provides senior official interagency oversight of the
Sláintecare reform programme. The Programme Board • Ensure the Sláintecare reform programmes are
also comprises the joint leads of the reform projects adequately resourced and supported.
from the Department’s Management Board and the
The Programme Board is expected to meet five times
HSE’s Executive Management Team, as appropriate.
in 2023. The Minutes of the Board meetings are
The key roles of the Programme Board include, to: published on the Department website (www.gov.ie/
en/publication/fbc36-slaintecare-programme-board/).
• Provide leadership, direction, oversight, support
and guidance to the Sláintecare reform programme The co-chairs of the Sláintecare Programme Board
to ensure a coordinated, integrated, effective attend the Joint Committee on Health (JCH) on a bi-
approach across DoH and HSE. monthly basis on matters specifically relating to the
implementation of Sláintecare. Four meetings with the
• Ensure effective communication and information JCH have been provisionally scheduled for 2023 in
sharing across all aspects of the programme and relation to Sláintecare.
its constituent projects, throughout the DoH and
HSE, and with all key stakeholders. Detailed updates on the implementation of
Sláintecare, which has the support of and is overseen
• Ensure an integrated approach and planning by the Department of an Taoiseach, will be provided
framework is developed for all projects with through the Cabinet Committee on Health, chaired by
appropriate timelines, deliverables and milestones the Taoiseach, on a bi-monthly basis.
and assignment of appropriate responsibility/
expertise to lead the delivery of the project.
11
Sláintecare Governance and Reporting Structure
Government
Joint Oireachtas Committee on Health
Cabinet Committee on Health
Minister for Health Updates on

implementation
of Sláintecare
reforms
Sláintecare Programme Board

Co-chaired by DoH Secretary General and HSE CEO
Sláintecare Programme
Management Office
DoH SPMO liaises with HSE Strategic
Sláintecare Project Leads Group Transformation Office
Sláintecare Projects
Joint DoH/ HSE teams report on progress
Sláintecare Programme Management Office • Supporting Sláintecare governance through

provision of an effective secretariat to the
Sláintecare delivery is supported by the work of the Programme Board.
Sláintecare Programme Management Office (PMO). Its
role includes: • Supporting Departmental preparations
for attendance at Joint Oireachtas Health
• Ongoing monitoring and reporting on the delivery Committee meetings.
and progress of the agreed annual Sláintecare
Action Plan and overall Sláintecare Implementation • Development of Progress Reports, annual
Strategy & Action Plan 2021 -2023. Sláintecare Action Plans and multi-annual
Sláintecare Implementation Strategy.
• Delivery of all PMO tasks focused on
supporting effective programme management • Building a programmatic approach and project
of Sláintecare reforms. management capacity across the Sláintecare
projects and driving a results-focused approach to
delivery of the Sláintecare reform programme.
12
Communications & Progress Reporting
Our overarching objective for the Sláintecare • Publish minutes of the Programme Board on
communications and engagement programme in 2023 the Department of Health website as a matter
is to communicate the Sláintecare reform programme of course.
clearly so that it is easy for public and staff to
understand and embrace. • Provide regular updates on the implementation
of Sláintecare to the Joint Oireachtas Committee
To ensure effective communication and information on Health.
sharing across all aspects of the programme and its
constituent projects we will: • Publish the Sláintecare Action Plan 2023 and
progress report for the year setting out progress on
plans and implementation.
• Provide regular updates on Sláintecare

implementation to healthcare staff through staff
newsletters and social media channels.
13
Sláintecare Action Plan 2023
This Sláintecare 2023 Action Plan sets out the 2023, with the other €80 million funding various
ongoing reform priorities aligned with the Programme community/primary care initiatives.The 2023 Waiting
for Government, the Sláintecare Implementation List Action Plan is the continuation of a multi-annual
Strategy & Action Plan 2021—2023, Department of approach to reducing and reforming waiting lists. It
Health priorities and the HSE’s National Service will build on the momentum delivered in 2021 and
Plan 2023. 2022 to reduce waiting list backlogs and waiting
times, and close the capacity gaps in specialties and
The detailed plan is set out below and includes key hospitals that create unacceptably long waiting lists.
deliverables to progress the implementation of our
two key reform programmes, Improving Safe, Timely Regional Health Areas (RHAs)
Access to Care and Promoting Health & Well-Being,
and Addressing Health Inequalities — Towards The Government is committed to the implementation
Universal Healthcare. of Regional Health Areas (RHAs), as outlined in the
Programme for Government. A memorandum on next
steps, programme of work, and timelines for RHA
Key areas of focus for 2023 include:
implementation was approved by Government in
Enhanced Community Care April 2022.
The Enhanced Community Care (ECC) programme of A draft of the detailed Implementation Plan
reform represents a population-based approach to is currently being reviewed and refined. The
the expansion of primary and community care and, Implementation Plan will contain a summary of the
importantly, its integration with the acute hospital rationale for RHAs, descriptions of the relative roles
sector, providing health services closer to people’s of the forthcoming RHAs, the HSE Centre and the
homes and reducing pressure on acute hospitals. Department of Health and will set out the clear,
practical steps that will be taken for implementation.
By the end of 2022, 94 of the 96 Community It will pave the way towards implementation of the
Healthcare Networks (CHNs) and 21 of 30 RHAs from 2024.
Community Specialist Teams for Older people and
21 of 30 CSTs for Chronic Disease Management had Consultant Contract
been established under the Programme. It is expected
The new Sláintecare Consultant contract will be
that all CHNs and CSTs will be established in 2023. It
introduced. The contract will only permit holders to
is projected that the impacts of these networks and
engage in public care within the public hospital system
teams over a full year will enable between 16,000 and
and is central to the delivery of the goal of universal,
21,000 ED avoidances.
single-tier healthcare in Ireland.
Waiting Lists
Workforce Planning
The 2023 Waiting List Action Plan developed by
The Department is currently focused on the
the Department of Health, HSE and NTPF was
development of the Health and Social Care Workforce
published in March 2023. The 2023 Plan will allocate
Strategy and Action Plan and Planning Projection
€363 million in funding to deliver ambitious targets
Model. This will provide demand and supply
for sustained reductions in acute scheduled care
projections of numbers required in medicine, nursing
waiting lists and waiting times, as well as progressing
and HSCPs spanning short- (3-5 years), medium- (5-10
longer-term reforms. This is part of the total of €443
years) and long-term (18-20 year) time horizons.
million allocated to addressing waiting lists in Budget
14
Work is currently underway to advance model Through successive budgets over the past three years,
development. The main challenge concerns funding for digital health to fund additional staff,
unanticipated delays on data access and constraints systems, licensing and to build cyber resilience has
on data coverage. Initial workforce planning increased significantly, but further investment will
projections are due to be completed in quarter 3 be required to facilitate integrated electronic health
of 2023. records as recommended under Sláintecare.
The key outcome of this work is that the Department The Department is in the process of refreshing the
will have the tools, processes, and technical capacity 2013 eHealth Strategy taking on board experience
to produce rolling health and social care workforce from other countries, developments in the digital
planning action plans and implement targeted policy health industry, the expectations of patients and
measures for health and social care workforce reform. healthcare professionals, the fact that the population
and patients are now better connected, government
Elective Hospitals policy under the Harnessing Digital Strategy, EU and
international obligations. The revised strategy will
The National Elective Ambulatory Strategy agreed
provide a clear direction for digital health to 2030 and
by Government in December 2021 will continue to
underpin the case for further investment beyond what
be implemented through Government approval of a
has been put in place to date.
Preliminary Business Case for Dublin and progressing
the development of new elective hospitals in Cork, Key initiatives for 2023 include:
Dublin and Galway through the detailed design,
planning and procurement phase of the elective • Publish the Digital Health Strategic Framework
hospitals programme in line with the Public 2023-2030 in April to align with Government’s
Spending Code. Harnessing Digital and update current eHealth
strategy. The HSE will publish a corresponding
In parallel, the development of new surgical hubs in Digital Health Strategic Implementation Plan
Cork, Limerick, Galway, Waterford and Dublin will in 2023.
be progressed.
• Progress the Electronic Health Record for
Sláintecare Integration Innovation Fund (SIIF) Community programme (ICCMS) through the
public spending code approval process.
Projects selected under Round 2 of the SIIF to test
innovative care pathways/initiatives and eHealth • Mobilise the Shared Care record programme as
transformation solutions are underway. These projects an essential enabler to delivering Summary and
will be progressed during 2023 and a launch of Round Shared Care Electronic Health Records for all.
3 of the SIIF fund is planned for quarter 3.
• Develop roadmap and investment case for
eHealth Electronic Health Record (EHR) deployment.
Sláintecare highlighted the need for investment in digi- The key deliverables in 2023, for each of the eleven
tal health solutions and electronic health records as key projects of the two reform programmes are detailed
enablers for reform of the health service. by quarter in the tables below.
15
Sláintecare Action Plan 2023
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
Project 1 Secure resources Complete draft report

Implement Health and commence on HCR refresh to
Service Capacity progress assessment inform 2024 planning
Review (HCR of implementation
2018) of Health Service
Capacity review (2018)
Implementation
Progress &
Capacity Review
Project 1 Progress eLearning Provide eLearning

Implement Health training to frontline training to 5,700
Service Capacity staff on Making Every frontline staff on
Review (HCR Contact Count brief the Making Every
2018) intervention in line Contact Count brief
with plan intervention
Workstream 1
Healthy Living
Workstream 1 Scope and develop a

Healthy Living digital intervention
to support reduced
alcohol consumption
by the general
population using
professional and
community online
support
16
Reform Programme 1:
Workstream 1 Report on progress Implement the

Healthy Living to implement the Physical Activity
Physical Activity Referral Pathway
(Physical Activity)
Referral pathway to support referrals
to support referrals to physical activity
to physical activity programmes with
programmes funded organisation
outside the health
services in partnership
with Sport Ireland
Renew and refresh
the National Physical
Activity Plan while
strengthening support
for physical activity
participation.
Workstream 1 Review Period Poverty

Healthy Living expressions of interest
and allocate funding
(Women’s Health)
for projects.
Workstream 1 Launch the National

Healthy Living Mental Health
Promotion Plan
Workstream 2 Complete recruitment Report on the

Enhanced to enable full operation and the
Community Care operationalisation of impact of 96 CHNs
(ECC) all 96 CHNs
(96 CHNs )
Workstream 2 Complete recruitment Report on the

Enhanced to enable full operation and the
Community Care operationalisation of impact of 30 CSTs
(ECC) all 30 CSTs for older for older people and
people and 30 CSTs 30 CSTs for chronic
(Community
for chronic disease disease
Specialist teams)
17
Reform Programme 1:
Workstream 2 Optimise recruitment to close out the ECC Programme 3,500 during 2023
Enhanced
Community Care
(ECC)
(Recruitment
of 1,005 WTE
to complete
programme)
Workstream 2 Report on collection of ECC metrics on a quarterly basis

Enhanced
Community Care
(ECC)
(Data capture &
Analysis)
Workstream 2 Commence Report on the progress

Enhanced implementation and of the roll out of the
Community Care roll out of the interim interim ICT solution
(ECC) ICT solution and
Develop and seek
capital infrastructure
(Data capture & approval of Public
Programme
Analysis) Sector Spending Code
(PSC) Business Case
for an Integrated
Community Case
management System
(ICCMS) that provides
clinical and operational
functionality required
to support integrated
care across community
services
18
Reform Programme 1:
Workstream 2 Complete Strategic Based on the Strategic

Enhanced Review of GP Services Review of GP services,
Community Care setting out measures prepare proposals for
(ECC) to ensure sustainable a response, including
GP services. consideration of
(Integrated
resource requirements.
General Practice
Service)
Workstream 2 Finalise CES/HSE Complete the Establish the National

Enhanced evaluation of Home recruitment of all Home Support
Community Care Support Pilot approved posts for Scheme Office
(ECC) the National Home
Support Office and
(Older Persons
progress in line with
Care – Statutory
plan
Home Scheme)
Workstream 2 Establish a new

Enhanced framework and pricing
Community Care for the provision of
(ECC) publicly funded home
support services
(Older Persons
Care - Home
support
Workstream 2 Agree finalised

Enhanced regulations for home
Community Care support providers and
(ECC) collaborate with HIQA
on National Standards
Older Persons
Development
Care - (Home
Support) Bring Heads of Bill,
Memo for Government
and Regulatory Impact
Analysis on home
support providers
to Government for
approval
19
Reform Programme 1:
Workstream 2 Complete recruitment Transition to a position

Enhanced of 128 interRAI Care in 2023 whereby,
Community Care Needs Facilitators from December
(ECC) 2023, 60% of all new
home support care
(Older persons
needs assessments
care - Introduction
undertaken by
of interRAI
community staff using
assessments)
the standardised care
needs assessment tool.
Workstream 2 Finalise new

Enhanced operational model and
Community Care implementation plan
(ECC) for publicly funded
residential community
Older persons
care
support
Workstream 2 Develop and finalise a

Enhanced comprehensive reform
Community Care strategy for future Day
(ECC) Service provision in
Ireland for submission
Older persons
to the HSE Board for
support
consideration and
approval
Workstream 2 Commission a review Expand the National

Enhanced of Rehabilitative demonstrator project
Community Care Training Services by establishing 2
(ECC) Nationally to additional Community
understand impact Neuro-Rehabilitation
(Disability
of service and future Teams in CHO
Services)
structures 2,4,6 & 7
20
Reform Programme 1:
Workstream 2 Establish 66 new

Enhanced family forums
Community Care and 9 CHO family
(ECC) representative
groups to ensure
(Disability
service user and
Services)
family participation
in child disability
network team service
development at
national /regional and
local levels
Workstream 2 Complete engagement Launch and publish

Enhanced with DPER and other Disability Action Plan
Community Care departments on draft 2023 - 2026
(ECC) Disability Action Plan
Put in place delivery
2023 – 2026
(Disability and oversight
Services) mechanisms and
commence oversight
of implementation
Initiate work on
specific supporting
actions set out in the
Action Plan
Workstream 2 Provide an update

Enhanced on progress of the
Community Care Personalised Budget
(ECC) Pilot
Workstream 2 Oversee the implementation of Connecting for Life, including oversight of the development and
Enhanced monitoring of the 2023 Connecting For Life implementation plan, the coordination of 9 Department
Community Care of Health action under the strategy throughout 2023 & update on progress on a quarterly basis.
(ECC)
(Mental health)
21
Reform Programme 1:
Workstream 2 Commission an
Enhanced evaluation of the
Community Care current Connecting for
(ECC) Life strategy to guide
the development of a
(Mental health)
successor strategy in
2024
Workstream 2 Monitor all service developments related to youth mental health. Oversee service improvements
Enhanced in CAMHS arising from Maskey report and associated audits and reviews. Report on progress on a
Community Care quarterly basis.
(ECC)
(Mental health)
Workstream 2 Recruit a new Assitant Implement Crisis

Enhanced National Director resolution services
Community Care (AND) Consultant across 5 existing pilot
(ECC) Clinical Lead for Child sites and complete
and Youth Mental interim evaluation
(Mental health)
Health report
Workstream 2 Publish a National

Enhanced Mental Health
Community Care Services Research and
(ECC) Evaluation Strategy
(Mental Health) Progress the Mental
Health Bill
Workstream 2 Support National Implementation and Monitoring Committee (NIMC) for Sharing the Vision and
Enhanced production and publication of quarterly Implementation Monitoring reports.
Community Care
Progress implementation of HSE and non-HSE, Sharing the Vision recommendations within DoH and
(ECC)
with external stakeholders
(Mental Health)
22
Reform Programme 1:
Workstream 2 Implement agreed Implement CAMHS

Enhanced models of care (older hubs and Crisis
Community Care persons & dual Resolution Services
(ECC) diagnosis) in three across 5 pilot sites and
pilot sites each complete an interim
(Mental Health)
evaluation report
Workstream 2 Complete the review Design and implement

Enhanced of the Maternity and 3 Woman’s Health
Community Care Infant Scheme in line Hubs as proof of
(ECC) with the National concept
Maternity Strategy
(Women’s Health)
Implementation Plan
Workstream 2 Finalise the draft adult

Enhanced safeguarding policy for
Community Care public consultation
(ECC)
Workstream 3 Report on progress to Deliver new and

Hospital implement increases in replacement acute bed
Productivity acute and critical care capacity in line with
bed capacity plan (209 beds)
Complete the delivery
of additional Critical
Care bed capacity
in line with plan
– (increase by an
additional 28 beds)
23
Reform Programme 1:
Workstream 3 Expand the initial Plan the development

Hospital phase of major of Trauma Unit with
Productivity trauma services at Specialist Services at
MTC at MMUH, UHG and the Trauma
and commence Units in the Central
the acceptance of Trauma Network at
secondary transfer Our Lady of Lourdes
from other hospitals Hospital, Drogheda
across the Network and in the South
Trauma Network at
Commence the initial
UHW
phase of Major Trauma
Services at CUH
Project 2 Commence monthly Ongoing monthly

Scale and monitoring and report monitoring and report
Mainstream progress on Round 2 progress on Round 2
Integration projects. projects.
Innovation
Project 2 Launch Learning

Scale and Network for Round 2
Mainstream SIIF projects
Integration
Innovation
Project 2 Commence EOI Launch call out and Complete appraisal Complete contracting
Scale and process to select commence appraisal and commence and commence
Mainstream themes for SIIF Round for SIIF Round 3 contracting of SIIF monitoring of Round 3
Integration 3 projects. projects Round 3 projects. SIIF projects.
Innovation
Project 2 Commence EOI

Scale and process to select
Mainstream themes for Round 4
Integration SIIF projects
Innovation
24
Reform Programme 1:
Project 3 Implement seven prioritised scheduled care pathways and measure impact on additional OPD
Streamline Care activity and report on progress on a quarterly basis.
Pathways, from
prevention to
discharge
Project 4 Finalise detailed Seek Gate 2 (pre-

Develop Elective business case, project tender) approval for
Centres in Dublin, brief and procurement the Cork and Galway
Cork, and Galway strategy for the elective hospitals
delivery of Cork
and Galway Elective
Hospitals
Project 4 Oversee progression Seek Gate 2 (pre-

Develop Elective of preliminary tender) approval for
Centres in Dublin, business case for Dublin
Cork, and Galway Dublin through Public
Spending Code Gate 1,
including coordination
of IGEES, EAP and
MPAG reviews and
submit business case
for GATE 1 approval
25
Reform Programme 1:
Project 5 Complete oversight, Continue to implement Continue to implement Complete

Implement a monitoring and the 2023 WLAP the 2023 WLAP implementation of all
Multi-annual reporting of delivery under the governance under the governance actions in the 2023
Waiting Lists of 2022 Waiting List of the Waiting List of the Waiting List WLAP as part of the
Reduction Plan Action Plan (WLAP) Task Force, reporting Task Force, reporting multi-annual waiting
on progress of on progress of list approach to reduce
Prepare, approve and
implementation of all implementation of all and reform waiting
publish 2023 Waiting
actions actions. lists and times
List Action Plan
Plan for development
of the 2024 Waiting
List Action Plan as
the next stage of
the multi-annual
approach to reducing
and reforming waiting
lists and times -
incorporating progress
and lessons learned
from the 2023 WLAP
Project 6 Prepare and submit Deliver eHealth

Implement Digital Health programme targets
the eHealth Strategy and defined in the
Programme Implementation plan approved 2023 ICT
and eHealth Capital
Plan
Project 6 Report on progress Progress digital

Implement on digital solutions to solutions to support
the eHealth support clinical and clinical (point of
Programme corporate functions care) and corporate
including through SIIF functions including
Round 2 Theme 8 through SIIF Round
Digital Innovation 2 Theme 8 Digital
Innovation
26
Reform Programme 1:
Project 6 Complete General Scheme and Regulatory Impact Analysis (RIA) and publish the Health Information
Implement Bill by quarter 4 2023. Report on progress on a quarterly basis.
the eHealth
Programme
Project 6 Implement Phase

Implement 2 of the Health
the eHealth System Performance
Programme Assessment
Framework (HSPA) in
line with agreed plan
and timeframe
Project 6 Deliver GP Laboratory Deliver a modern

Implement eOrdering solution to digital cloud-based
the eHealth 4 pilot sites – Galway, desktop experience for
Programme Waterford, Navan, 80% of users
Beaumont
Project 7 Implement the public-

Remove private only Consultant
care from Contract
public hospitals
– implement
the Sláintecare
Consultant
Contract
27
Reform Programme 2:
Addressing Health Inequalities – towards Universal Healthcare
Project 1 Establish structures to Complete inclusion

Develop a Citizen develop population- health framework to
Care Masterplan based resource guide provision of
allocation methods healthcare services
Workstream 2
for socially excluded
Population needs
groups
assessment
Workstream 2 Progress healthcare

Population needs services for people
assessment who are homeless that
support their exit from
homelessness (e.g.
Housing First)
Workstream 3 Agree PBRA model

Development
of Population-
Based Resource
Allocation Funding
Model (PBRA)
Workstream 4 Approval and Report on the

Develop policy enactment of expansion of GP Visit
proposal and legislation to remove Cards to people where
options for a the acute public in- median household
plan to achieving patient charge of €80 income is €46,000
universal eligibility for all public patients or less
in all public hospitals.
Commence expansion
of GP Visit Cards to
people where median
household income is
€46,000 or less
28
Reform Programme 2:
Workstream 4 Work with the DoH and stakeholders on the extension of GP cover for children aged 6 / 7 years,
Develop policy expansion of eligibility for free GP visit cards
proposal and
options for a
plan to achieving
universal eligibility
Workstream 4 Approval and

Develop policy enactment of
proposal and legislation to expand
options for a access to medical
plan to achieving cards for persons who
universal eligibility are terminally ill
Workstream 4 Undertake scoping

Develop policy work for a strategic
proposal and review of eligibility
options for a policy and the
plan to achieving implementation
universal eligibility of appropriate
amendments to the
eligibility framework.
Workstream 4 In collaboration
Develop policy with the Women’s
proposal and Health Taskforce and
options for a Executive, expand the
plan to achieving free contraception
universal eligibility scheme to women
and girls aged 16-30
in 2023 and provide
increased supports
for period poverty
mitigation
29
Reform Programme 2:
Workstream 6 Work in collaboration

Workforce with DFHERIS and
Planning Higher Education
sector to increase
undergraduate supply
in Medicine, Nursing
& Midwifery and
Health and Social
Care Professions in
September 2023.
Workstream 6 Identify the most Following the

Workforce appropriate model for successful completion
Planning community nursing of Pilot testing
and midwifery in (submission of
Ireland, following 12-month impact
completion of both report), submit a
a mapping of current National Policy for
community nursing Safe Staffing and
and midwifery Skill Mix in Long
resources and a Term Residential
review of international Care Settings for
evidence Older Persons to the
Minister.
Workstream 6 Progress development Submit an evaluation

Workforce of a Framework for of the Framework
Planning Safe Nurse Staffing for Safe Nurse
and Skill Mix in Staffing and Skill
Community Care Mix in Community
Settings using an Care Settings for
appropriate and the Minister’s
evidence based model consideration
for community nursing
and midwifery.
30
Reform Programme 2:
Workstream 6 Oversee, co-ordinate,

Workforce and report on
Planning Implementation of
the recommendations
of the Report of the
Strategic Workforce
Advisory Group
on Home Carers &
Nursing Home Health
Care Assistants
Workstream 6 Oversee
Workforce implementation of
Planning final stage of reformed
public health model
as envisaged in Crowe
Howarth report.
Workstream 6 Increase postgraduate Report on progress

Workforce medical education of the Report and
Planning and training places recommendations of
and supply of medical the National Taskforce
professionals in on NCHD Workforce
collaboration with which aims to improve
HSE NDTP and key NCHD structures and
stakeholders in the supports at clinical site
context of the Forum level in Ireland.
of Postgraduate
Medical Training
Bodies Strategic
Framework 2021–
2030 with a focus on
(i) medical workforce
planning (ii) reform of
medical education and
training, (iii) policies to
support recruitment
and retention of
doctors.
31
Reform Programme 2:
Workstream 6 Complete Health & Develop Health and Report on

Workforce Social Care Strategy & Social Care Workforce recommendations for
Planning Action Plan Planning Projection health and social care
Model and Gap workforce reforms
Analysis
Project 2 Deliver targeted

Implement initiatives through
Sláintecare 20 Sláintecare
Healthy Healthy Communities
Communities to address health
Programme inequalities including:
• Smoking Cessation
services
• Healthy food made

easy courses
• Social prescribing
• Parenting courses
Project 2 Rollout of healthy Strengthen provision

Implement community initiatives of supports for health
Sláintecare funded by “Seed and wellbeing at
Healthy Funding” local level through
Communities the Sláintecare
Programme Healthy Communities
Programme
32
Reform Programme 2:
Project 3 Finalise and agree Finalise and agree Complete the

Develop Regional implementation plan the organisational redefinition of existing
Health Areas for RHAs structure and CHO/HG geographical
associated processes boundaries aligned
and relationships for with RHA boundaries
HSE national and to include associated
RHAs changes regarding HR
and Finance
Commence
recruitment of 6 RHA
CEOs
Commence
recruitment of 6 RHA
Senior Management
Teams
Project 3 Progress RHA

Develop Regional Implementation
Health Areas Oversight & Actions in
line with plan
Project 4 Establish specialist

Implement weight management
Obesity Policy and service for children
Action Plan 2016- and young people in
2025 CHO 5 & 7 with a
view to testing the
approach
Project 4 Report on progress of Progress the

Implement implementation of the implementation of the
Obesity Policy and Obesity Action Plan Obesity Policy Action
Action Plan 2016- Plan with particular
2025 focus on healthy
weight campaign, food
reformulation and
developing healthy
eating guidelines for
specific audiences.
33
Enabling Programmes
Patient Safety and Deliver the

Quality Initiatives expanded National
Care Experience
Programme suite of
surveys, embedding
patient experience as
a key measure within
the system through
the HSPAF quality
domain.
Public and political Establish a working Publish the first

engagement and group to develop an monthly nationally
empowerment implementation plan representative survey
on better engagement reporting on public
– The Health Services levels of trust in the
Patient Engagement HSE
Road Map Launch,
with equal HSE/
Patient representative
membership
Public and political Deliver an integrated

engagement and communications
empowerment and engagement
programme to support
the rollout of the
RHA’s and design an
effective operating
model for RHA
communications teams
Public and political Prepare and Publish Initiate engagement to Finalise and
engagement and 2022 progress report inform development publish Sláintecare
empowerment of Sláintecare Implementation
Prepare and publish
Implementation Strategy & Action Plan
Sláintecare Action Plan
Strategy & Action Plan 2024 – 2026
2023
2024 – 2026
34
Enabling Programmes
Public and political Communicate on Communicate on

engagement and progress of key progress of key
empowerment initiatives including: initiatives including:
• Healthy Ireland – • Healthy Ireland –
Healthy Weight and Healthy Weight and
Citizen Engagement Citizen Engagement
• Women’s Health • Women’s Health

Action Plan Action Plan
• Waiting Lists Action • Waiting Lists Action

Plan Plan
• Implementation of • Implementation of
Regional Health Regional Health
Areas Areas
• Sláintecare
Integration Fund
webinars & Learning
Network meetings
35
Risk Identification & Management
Risk management is a key enabling support to the effective delivery of Sláintecare reform programmes and
projects. The Sláintecare Programme Management Office (SPMO) have developed clear guidelines, based on best
practice, for the identification and management of risks for the Sláintecare Programmes and projects.
Each Sláintecare project lead will support the preparation and delivery of a risk register and risk mitigation plan
for their project. The SPMO risk co-ordinator will collate the highest rated risks from each project risk register
and consolidate into the Sláintecare Programme risk register as well as identifying any other high-level risks that
could impact on the delivery of the reform programme.
The Sláintecare Programme Board will review the Sláintecare programme risk register and risk mitigation plans as
part of the regular PB progress reviews and will address any key matters requiring their support.
36
Appendix
Glossary of terms
AND Assistant National Director IGEES Irish Government Economic Evaluation
Service
CDM Chronic Disease Management
IHI Individual Health Identifiers
CHN Community Healthcare Network
JCH Joint Committee on Health
CHO Community Health Organisation
LTI Long Term Illness
CST Community Specialist Team
MDTs Multi-disciplinary Teams
CUH Cork University Hospital
MMUH Mater Misericordiae University Hospital
DCEDIY Department of Children, Equality,
Disability, Integration and Youth MPAG Major Projects Advisory Group
DFHERIS Department of Further and Higher MTC Major Trauma Centre

Education, Research, Innovation and
Science NCHD Non-Consultant Hospital Doctors
DoH Department of Health NIMC National Implementation Monitoring

Committee
DPER Department of Public Expenditure and
Reform NTPF National Treatment Purchase Fund
EAP External Assurance Process OPD Outpatient Department
ECC Enhanced Community Care PB Programme Board
ED Emergency Department PBC Preliminary Business Case
EHR Electronic Health Record PBRA Population-Based Resource Allocation
EOI Expression of interest PMO Programme Management Office
HCR 2018 Health Service Capacity Review RHA Regional Health Areas
HSCP Health and Social Care Profession RIA Regulatory Impact Assessment
HSE Health Service Executive SIIF Sláintecare Integration Innovation Fund
HSPA Health System Performance Assessment STI Sexually Transmitted Infection
HSPAF Health System Performance Assessment UHG University Hospital Galway

Framework UHW University Hospital Waterford
ICCMS Integrated Community Case WLAP Waiting List Action Plan
Management System
WTE Whole Time Equivalent
ICPOP Integrated Care Programme for Older
Persons
37
Notes
38
Notes
39
40
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Right Care. Right Place. Right Time.

Sláintecare Action Plan

Sláintecare Reform Programmes 2021 – 2023 7

Implementation & Governance 10

Communications & Progress Reporting 12

Sláintecare Action Plan 2023 13

Risk Identification & Management 35

We will continue the “shift to the left”

• The National Stop Smoking Clinical Guideline was

Two Reform Programmes have been prioritised for focused implementation:

• Reform Programme 2 – Addressing Health Inequalities -towards Universal Healthcare

Improving Safe, Timely Access to Care Addressing Health

Addressing Health Inequalities focusing on - moving towards Universal Healthcare, including:

Implementation & Governance

Sláintecare Governance and Reporting Structure

Joint Oireachtas Committee on Health

Cabinet Committee on Health

Minister for Health Updates on

Sláintecare Programme Board

Sláintecare Programme Management Office • Supporting Sláintecare governance through

Communications & Progress Reporting

• Provide regular updates on Sláintecare

Sláintecare Action Plan 2023

Sláintecare Action Plan 2023

Project 1 Secure resources Complete draft report

Project 1 Progress eLearning Provide eLearning

Workstream 1 Scope and develop a

Workstream 1 Report on progress Implement the

Workstream 1 Review Period Poverty

Workstream 1 Launch the National

Workstream 2 Complete recruitment Report on the

Workstream 2 Complete recruitment Report on the

Workstream 2 Report on collection of ECC metrics on a quarterly basis

Workstream 2 Commence Report on the progress

Workstream 2 Complete Strategic Based on the Strategic

Workstream 2 Finalise CES/HSE Complete the Establish the National

Workstream 2 Establish a new

Workstream 2 Agree finalised

Workstream 2 Complete recruitment Transition to a position

Workstream 2 Finalise new

Workstream 2 Develop and finalise a

Workstream 2 Commission a review Expand the National

Workstream 2 Establish 66 new

Workstream 2 Complete engagement Launch and publish

Workstream 2 Provide an update

Workstream 2 Recruit a new Assitant Implement Crisis

Workstream 2 Publish a National

Workstream 2 Implement agreed Implement CAMHS

Workstream 2 Complete the review Design and implement

Workstream 2 Finalise the draft adult

Workstream 3 Report on progress to Deliver new and

Workstream 3 Expand the initial Plan the development

Project 2 Commence monthly Ongoing monthly

Project 2 Launch Learning

Project 2 Commence EOI

Project 4 Finalise detailed Seek Gate 2 (pre-

Project 4 Oversee progression Seek Gate 2 (pre-

Project 5 Complete oversight, Continue to implement Continue to implement Complete

Project 6 Prepare and submit Deliver eHealth

Project 6 Report on progress Progress digital

Project 6 Implement Phase

Project 6 Deliver GP Laboratory Deliver a modern

DFHERIS Department of Further and Higher MTC Major Trauma Centre

DoH Department of Health NIMC National Implementation Monitoring

HSPAF Health System Performance Assessment UHG University Hospital Galway