HSE National Service Plan for 2013

The HSE today, (Thursday, 10th January 2013), published its National Service Plan 2013 following approval by the Minister for Health; Dr James Reilly T.D. The Service Plan sets out the type and volume of services the Health Service Executive (HSE) will provide directly, and through a range of funded agencies, during 2013. These health and social care services must be delivered within the €13.404 billion funding provided by Government and within the stipulated employment levels.

                Health Minister James Reilly with Councillors Anthony Lavin, Kieran Dennison and Eithne Loftus
The HSE budget for 2013 reflects a net increase of €71.5m and includes unavoidable budget pressures (such as demographic pressures and increased demand for medical cards, drugs, and other budgetary pressures particularly in the acute hospital sector as seen in 2012) of €748m and cost reductions of €721m. Staffing levels in the health service in 2013 be reduced by almost 4,000 (WTEs) in 2013.

The financial framework underpinning this Service Plan seeks to ensure that all areas of the health care system have budgets that are achievable, while also delivering the savings necessary to remain within their allocated budget. For the first time, the allocations outlined in the plan are based on the projected spend rather than on historic budgets with a view to ensuring sustainable budgets, especially in the hospital sector which has struggled in recent years to break even.

CEO / Director General Designate of the HSE, Mr. Tony O’Brien, commented; “In 2013 the HSE continues to face the dual challenge of reducing costs while at the same time improving outcomes for patients.

The approach adopted in this Service Plan places a priority on stabilising hospitals budgetary positions, maintaining community services levels at 2012 levels, and delivering further costs efficiencies in the primary care schemes and drug costs.

The HSE Service Plan 2013 acknowledges the legacy issues by providing each budget holder with a realistic budget that will enable managers to make savings in a targeted way within the context of cost reduction, absenteeism, achieving service targets and productivity.

Budgets for 2013 are based on outturns for 2012, that is to say on actual activity levels, rather than on historic budget positions. Budget holders will be empowered to identify and respond to financial issues as they arise thereby reducing the likelihood of financial crisis in the latter part of the year.

Despite the ongoing challenges, this plan provides for significant investment in key priority areas including mental health, primary care, ambulance services and both colorectal screening and diabetic retinopathy screening programmes. New investment is being funded by targeted savings and cost reductions in the primary care schemes and cost of drugs and in delivering greater savings through the Croke Park Agreement.”

The HSE National Service Plan for 2013aims to:

• Deliver the maximum level of safe services possible for the reduced funding and employment levels.
• Achieve very substantial cost efficiencies in the Primary Care Reimbursement Service (PCRS) in 2013 to save €383m. 
• Expected hospital activity for 2013 is 600,887 in inpatient activity and 830,165 in day cases.
• In addition to the completion of the mental health investment programme of 2012, a further €35m has been allocated for year two of this investment programme.
• A €17m additional provision has been made in 2013 for the increased costs of cancer drugs. 
• Roll out of the colorectal national cancer screening programme and the diabetic retinopathy screening programme
• €20m investment in primary care services to support the recruitment of prioritised frontline PCT posts and to further develop community intervention teams.
• Provide 1.68m hours of personal assistance (in disability services) which is the same as committed to in the 2012 Service Plan. 
• Provide comprehensive home and community supports such as home help and home care packages. Levels of these services will be as planned for in 2012.
• In 2013, the HSE will provide for:

- 10.30m hours of home help service

- 10,870 people in receipt of home care packages

- 22,761 NHSS (Fair Deal) residential care places

Children and Family Services will be disaggregated from the HSE into a new agency, the Child and Family Support Agency. The main priority for the HSE is to plan for this transfer during the year, while maintaining its focus on delivering quality and safe children and family services.

The Service Plan sets out ambitious targets for all areas of the health services in 2013.

• In relation to hospitals these include;
• No adult will wait more than 8 months for an elective procedure (either inpatient or day case)
• No child will wait more than 20 weeks for an elective procedure (either inpatient or day case)
• No person will wait longer than 52 weeks for an OPD appointment (at the end of November 2012 approx 115,000 people or 30% were waiting more than 12 months).
• No person will wait more than four weeks for an urgent colonoscopy and no person will wait more than 13 weeks following a referral for routine colonoscopy or OGD
• 95% of all attendees at Emergency Departments will be discharged or admitted within 6 hours of registration