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Sláintecare Action Plan 2023: Right Care Right Place Right Time
Sláintecare Action Plan 2023: Right Care Right Place Right Time
Sláintecare Implementation
Strategy & Action Plan 2021 - 2023
Contents
Foreword 5
Introduction 6
Appendix 36
Sláintecare 2023 Action Plan
Foreword
5
Sláintecare 2023 Action Plan
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
Sláintecare 2023 Action Plan
• 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.
1 gov.ie/slaintecare-progress-report-2022
7
Sláintecare 2023 Action Plan
Sláintecare Reform
Programmes 2021 – 2023
• Reform Programme 1 – Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Programme Programme
1 2
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
Sláintecare 2023 Action Plan
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
Sláintecare 2023 Action Plan
Reform Programme 2
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
Sláintecare 2023 Action Plan
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 2023 Action Plan
Government
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
12
Sláintecare 2023 Action Plan
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.
13
Sláintecare 2023 Action Plan
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
Sláintecare 2023 Action Plan
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 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
16
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
17
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
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)
18
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
19
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
20
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
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
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
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 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
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
23
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
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
24
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
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
25
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
26
Sláintecare 2023 Action Plan
Reform Programme 1:
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
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
27
Sláintecare 2023 Action Plan
Reform Programme 2:
Addressing Health Inequalities – towards Universal Healthcare
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
28
Sláintecare 2023 Action Plan
Reform Programme 2:
Addressing Health Inequalities – towards Universal Healthcare
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
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 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
Sláintecare 2023 Action Plan
Reform Programme 2:
Addressing Health Inequalities – towards Universal Healthcare
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
30
Sláintecare 2023 Action Plan
Reform Programme 2:
Addressing Health Inequalities – towards Universal Healthcare
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
Workstream 6 Oversee
Workforce implementation of
Planning final stage of reformed
public health model
as envisaged in Crowe
Howarth report.
31
Sláintecare 2023 Action Plan
Reform Programme 2:
Addressing Health Inequalities – towards Universal Healthcare
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
• Social prescribing
• Parenting courses
32
Sláintecare 2023 Action Plan
Reform Programme 2:
Addressing Health Inequalities – towards Universal Healthcare
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
33
Sláintecare 2023 Action Plan
Enabling Programmes
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
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
Sláintecare 2023 Action Plan
Enabling Programmes
Project/ Q1 Q2 Q3 Q4
Workstream Deliverables Deliverables Deliverables Deliverables
• Implementation of • Implementation of
Regional Health Regional Health
Areas Areas
• Sláintecare
Integration Fund
webinars & Learning
Network meetings
35
Sláintecare 2023 Action Plan
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
Sláintecare 2023 Action Plan
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
HCR 2018 Health Service Capacity Review RHA Regional Health Areas
HSCP Health and Social Care Profession RIA Regulatory Impact Assessment
37
Sláintecare 2023 Action Plan
Notes
38
Sláintecare 2023 Action Plan
Notes
39
Sláintecare 2023 Action Plan
40
gov.ie/Sláintecare