Transcript 301.doc

Service Progress Report
2003
Presentation to Board Members
Laverne McGuinness
Assistant Chief Executive
22nd January 2004
Financial Allocation 2003
 Initial allocation €502.8m for 2003.
 Final Determination €582.746
 LETTER OF DETERMINATION: Strongly emphasised importance of controlling
spending and managing within limits of financial and
staffing resources.
 Existing Level of Services (ELS) principle introduced.
 No consideration to Supplementary Estimate in 2003
without exception.
 Board’s Defecit 2002 - €8.3m
 First charge on 2003 allocation.
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Provider Plan 2003
Provider Plan 2003 prepared within
parameters of operational budget, statutory
responsibility to breakeven.
Staff Ceiling Constraints.
Cost Containment Programme also prepared.
Main focus 2003 – consolidation of existing
services and demonstrable value for money.
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Review - 2003
2003 challenging year for our Board.
Continuing Service Delivery within constraints
in a number of service areas.
Increase demand and rising expectations.
Limited new development funding.
Long term effects of inadequate capital
funding.
Increased costs of technological advances.
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Children and Family Services
Budget €75.173m
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Youth Advocacy Project.
Services Homeless Youth.
Caretakers Residential Project.
Salvation Army.
Key service provision – ‘early years services’,
family support services, child protection, alternative
care and services for homeless youth.
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Targeted Efficiencies
 Individual special arrangements kept to minimum.
 Additional foster carers recruited.
Activity
Number of Children in Care
2002 = 735
2003 = 680
Reduction of 7.5%
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Number of Children Admitted to Care
2002 = 209
2003 = 182
Reduction of 12.9%
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Intellectual Disability and
Rehabilitative Training
Budget €39.337m
New Development funding €2.982m
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Additional Funding of New Residenital
Places of €2.050m
Additional Funding of New Day Places of
€.486m
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Targeted Efficiencies
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St. Joseph’s Intellectual Disability Service reduction in over time, staff redeployment,
waste management, telecommunications.
Health Strategy Objectives
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Action 53 - more appropriate community
residential type settings - acquisition 2
community houses. Long stay ward St.
Joseph’s ID service closed.
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Activity
Number of Clients in receipt of Day and Residential
Services.
Residential
2002 = 1,112
2003 = 1,142
3.2% Increase
Day
2002 = 2,573
2003 = 2,737
6.4% Increase
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Monitoring and Evaluation
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St. Joseph’s ID Service chosen as pilot site in
National Disability Authority’s Pilot Project
on development of National Standards
within Disability Services.
Clonmethon Lodge received Fingal Chamber
of Commerce Award for best public service,
as recognition of the quality of service being
provided.
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Physical and Sensory Disabilities
Budget €26.518m
Additional Funding
€2.429m
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Placement of identified clients in appropriate
residential care settings.
Home Support Services.
Transfer of clients to community House Donabate.
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Additional Funding €1.287m
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• Delayed Discharge Initiative for Young Disabled
transferred from Acute Hospitals
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National Health Strategy Objectives
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Action Point 53 - Transfer of clients to community
setting house in Donabate.
24 clients (Delayed Discharge Initiative) discharged
from acute hospitals to more suitable setting.
Activity
Day Service
No. of Places
No. of Clients receiving
Care Attendant Service
2002
114
2003
227
96
119
%Increase
50%
24%
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Mental Health Services
Budget €77.549m
 €700k Capital funding - improved facilities for
Area 7/Mater.
 Refurbishment work on Lindsay House.
 Enhancement of community services Area 7 –
Bloomfield Hospital.
 Development of new Rehab Team Area 7.
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Acute Units
Building of acute unit JCMH complete – transfer
St. Brendan’s Hospital. Plans for new acute unit at
Beaumont Hospital advanced.
Community Services
Development of mental health resource centre in
Fingals – incorporates a day hospital.
Plans advanced for sector headquarters in
Blanchardstown.
Appointment of Consultant Psychatrist Area 8
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Psychiatry of Old Age
 Considerable work undertaken on assessment of elderly
long stay patients in St. Brendan’s, St. Ita’s and Verville
Retreat – 130 patients transferred to community based
nursing home care.
Community Accommodation
 Residence Blanchardstown opened – 5 clients.
 Fingal County Council two houses Castlecurragh,
Mulhuddart – 6 residents.
 Lindsay House, Glasnevin commissioned – 6 residents.
 Fingal County Council – house in Rush – commissioned as
medium support hostel. Two houses Donabate currently
being furnished – 8 residents low support.
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Targeted Efficiencies
Major programme carried out in St. Ita’s and St.
Brendan’s to identify and access alternative care
settings for patients in line with care needs.
Rationalisation of catering, transport and other
support services and staff redeployment.
Activity
Number of Places in
Community Houses
2002
357
2003
370
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Alcohol and Addiction Services
Budget - €18.814m
Services 2003
Focus on quality in service delivery in 2003
Implementationof a comprehensive set of policies
and procedures including a service users charter.
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Alcohol Service
Stanhope Centre offered wide range of treatment
services to problem drinkers and their families.
64 clients availed of residential treatment
programme in Barrymore House.
1423 clients availed of the Substance Abuse Nurse
led service at St. Vincent’s Hospital, Fairview.
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Addiction Services
Treatment
 Small increase in overall numbers receiving treatment
 Increase in GPs and Pharmacists.
 Hep C Liaison nurse appointed.
Counselling
 Review of services resulted in change in the deployment of
counselling resources.
Outreach
 Review completed which recommended an enhanced
management strucutre and development of ongoing
training opportunities for outreach workers
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Activity
Needle Exchange Attendance
• 2002 = 2,883
• 2003 = 3,017
Increase of 4.6%
Number of Clients availing of services
• 2002 = 262
• 2003 = 297
Increase of 13.4%
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Asylum Seekers/Refugee Services
 Decrease in uptake of persons availing of medical
screening.
Travellers Services
In addition to mainstream services our Board provided the
following specific initiatives for travellers:
 Primary Health Care Project with Pavee Point.
 Traveller Mobile Clinic.
 Travellers Health Unit (managed by SWAHB).
Adult Homeless
Development of new Action Plan on homelessness with
key partners.
 3049 homeless cases 2002
 2988 homeless cases 2003
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Decrease of 2%
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Acute Hospital Services
Budget - €68.680m
Key Developments 2003 – JCMH
€96.37m Capital Project at Hospital completed on
target and within budget.
JCMH awarded Pre-acrediatiation Early Status by
the Irish Hospital Accrediation Board in 2003.
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High levels of performance achieved in the
provision of outpatient and A & E services.
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Individual appointment times offered to 96% of
all outpatients.
100% seen by Consultant on first visit and
within 60 minutes of appointment time.
99% of all A&E attendees were seen within
standard waiting time for all five triage
categories.
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Activity 2003
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Admissions – Inpatient
Bed Days
Out Patient Attendances
Theatre Procedures
Accident & Emergency Attedances
Day Surgery Procedures
Medical Day Unit Procedures
7,156
110,308
70,711
5,415
30,514
2,653
1,516
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Key Developments 2003 – St. Joseph’s, Raheny
Focus in 2003 on increasing public activity in
partnership with Beaumont.
900 public patients in theatre – 1000 public
patients from Beaumont waiting lists.
July 2003 development plans to facilitate transfer
of operational responsibility for the hospital to
Beaumont Hospital to enable the hospital to
achieve maximum potential public activity.
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Targeted Efficiencies
32 beds JCMH closed in May 2003.
Redeployment of Staff
Efficiencies in Non Pay Areas
Significant reduction in staffing numbers .
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Services for Older Persons
Budget - €66.62m
New Development funding- €1.8m
 Home First Project – Restricted due to staff
ceiling. Funding diverted to critical areas eg.
St. Mary’s Hospital – preventing closure of
beds.
Additional Funding Initiative - €1.1m
 Acute Hospital Delayed Discharges Initiative.
 Enabled discharge of approximately 144 clients
from Acutes.
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Targeted Efficiences
 Bed Management System – greater bed days.
 New Nursing Home Subvention Guidelines –Home Care
Packages.
 Full review of Nursing Home Inspection Service.
 Rapid Access Clinic to reduce referrals to A & E.
 Falls Research Clinic.
Activity
 Meals on Wheels
 Attendance of Day Care
=
=
430,797
209,293
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Primary Care Services
Budget - €44.774m
New Development Funding - € 2.43m
General Practice Unit
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Expansion of team and practice model.
Courier service for the direct delivery of
vaccines to general practices.
Participated in regional ‘macro’ need
assessment which reviewed health need and
service provision based on demography.
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Dental Services
2 additional dental hygienists employed.
Orthodontic Service
785 patients assessed - 747 in treatment.
Waiting time for a Category 1 assessment
appointement has been reduced from <12
months to < 3 months.
€0.605m from Treatment Purchase Fund for
orthodontic services – 207 patients commenced
treatment.
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Immunisation Service
Quarter 3 uptake rates
 Men C 73.8%
 MMR 79.4%
 Polio at 12 months 76.3%
 Polio at 24 months 82.9%
Opthalmic Services
Community Opthalmic Physican appointed May
2003 .
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Health Promotion
Health Promotion - services delivered across all
settings including prisons, schools, health
servicews and workplaces.
Regional breastfeeding policy developed.
187 people trained in intervention in smoking
cessation.
Target – Each GP to recruite 15 Heartwatch
patients – 640 out of 705 recruited to date.
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Health Promotion
In addition to Cardiovascular Strategy
developments:
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Developing framework document for strategy
to address suicide.
Training on suicide prevention and mental
health promotion to teachers, health services
staff and young people.
Needs assessment completed in
Darndale/Belcamp
Development of falls prevention programme
in residential units for older persons.
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Summary
Throughout 2003 services were delivered in
tandem with a strict control on finances and
staff ceiling.
Management Team and Senior Managers and
all staff worked in synergy to achieve the
targets set.
THANK YOU
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