Home > HSE National Service Plan 2015.

Pike, Brigid (2015) HSE National Service Plan 2015. Drugnet Ireland, Issue 53, Spring 2015, pp. 16-18.

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The HSE’s National Service Plan 2015 (NSP), approved by the government in December 2014, sets out the HSE’s priorities and targets for tackling tobacco and alcohol misuse, and drug addiction, in 2015.1 The HSE’s divisional  plans, on which the NSP is based, list specific operational tasks with timeframes, and a ‘balanced scorecard’ of performance targets. The following account draws on both the aggregated NSP and the more detailed operational plans for the Health and Well-Being and the Primary Care divisions, which share responsibility for tobacco, alcohol misuse and addiction services.

 

Tobacco and alcohol misuse

The Health and Well-Being Division will focus on the ‘key modifiable risk factors for chronic disease and ill-health’ including tobacco and alcohol misuse.2 The Division is preparing for the roll-out of the relevant provisions in both tobacco and alcohol legislation in consultation with the Department of Health and in line with existing resources. Key actions and performance targets for 2015 are as follows:

 

Tobacco Free Ireland 3   

  • Implement priority actions, with a particular focus on the continued roll-out of the tobacco free campus policy in primary care (100%); mental health (100% approved centres & 25% residential services); disability and social care residential services (disability [25%] and older persons [20%]); and Tusla sites (100%)
  • Reduce tobacco usage in the general population by undertaking training, intervention, surveillance, evaluation, enforcement of legislation and social marketing activities. Targets for 2015 include 1,500 frontline healthcare staff trained in brief intervention for smoking cessation; 9,000 smokers receive intensive cessation support; and 2,450 smokers who enter a cessation programme quit at one month.

Performance Target: 100% health care centres tobacco-free

 

National Substance Misuse Strategy 4

  • Further develop a co-ordinated approach to prevention and education interventions in alcohol between all stakeholders including 3rd-level institutions. Target is to have a national accreditation system in place in a number of 3rd-level colleges.
  • Support pilot community mobilisation alcohol initiatives in five drugs task force areas (North Inner City, Tallaght, Dun Laoghaire/Rathdown, North West and South) through grant agreement with Alcohol Forum.5 Five local alcohol action plans developed by end of year. 

Community Oncology Cancer Control Programme (COCCP)

In the Primary Care Division of the HSE, the COCCP has a commitment to ‘implement a national standardised algorithm for the treatment of tobacco addiction’ by the end of 2015.6 Further measures to combat problem alcohol use have also been identified by Addiction Services. These are described below.

 

Addiction services

In the Primary Care Division of the HSE, a key priority for the Social Inclusion Services is to ‘achieve improved health outcomes for people with addiction issues’.6 Seven key actions and associated tasks have been identified for 2015:

 

1. Progress the integration of drugs task force projects and developments within the wider addiction services in line with objectives in the NDS7

  • Ensure that each local and regional drug and alcohol task force (DATF) project is governed by the HSE grant aid agreement/service arrangement for 2015.
  • Additional funding of €1.023m has been notified to support measures to tackle substance misuse. This funding will support community and voluntary groups or other relevant bodies to undertake one-off prevention initiatives in line with the National Substance Misuse Strategy.
  • Assist projects to participate in planning and reporting in line with the monitoring tool developed by the National Addiction Advisory Governance Group, within the Section 39 Governance Framework.
  • Ensure that funded organisations:
  • support and promote the aims and objectives of the NDS to significantly reduce the harm caused to individuals and society by the misuse of drugs. Their annual plans must be linked to both the national strategic actions and local drug strategy/implementation plans;
  • provide the HRB with data on each service user entering and existing service in compliance with the National Drug Treatment Reporting System (NDTRS);
  • engage with a Quality Standards Framework such as QuADS through the Quality Standards Support Project; and
  • implement case management process as guided by the National Drugs Rehabilitation Framework. 

2. Implement priority actions from the NDS (Programme for Government Primary Care Funds €2.1m) – implement the clinical governance framework for addiction treatment and rehabilitation services

  • Develop integrated drug and alcohol services in line with the NDS and the National Substance Misuse Strategy, which provide drug-free and harm reduction approaches for problem substance users, and
  • facilitate problem substance users to engage with, and avail of, such services;
  • ensure that each patient has an appointed key worker and a clearly documented care plan that is subject to a regular review and update;
  • measure transfers from HSE clinics and level-2 GPs to level-1 GPs; and
  • carry out a client satisfaction survey of all the addiction services.
  • Participate in the European Union Reducing Alcohol Related Harm (RARHA) Project.
  • Develop national guidelines for alcohol consumption to reduce health risks from drinking.
  • Implement a naloxone demonstration project to assess and evaluate its suitability and
  • impact (in line with NDS Action 40).
  • Develop a clinical and organisational governance framework (in line with NDS Action 45).
  • Finalise, launch and maintain an on-line directory of drug and alcohol services and specialist drugs and alcohol treatment programmes (in line with the recommendations from the Working Group on Drugs Rehabilitation, Action 32).
  • Screening and brief intervention (SBI):
  • Roll out SAOR (Support, Ask and Assess, Offer Assistance and Refer) screening and brief intervention training for alcohol and problem substance use within tier 1 and tier 2 services (25 SAOR training programmes to 300 staff and 3 train-the-trainer programmes will be delivered nationally) in partnership with Health Promotion and Improvement and the National Addiction Training Programme.
  • Develop and implement an SBI implementation plan to support the roll-out of national SBI protocol.
    • Hidden harm:
  • Finalise a strategic statement regarding hidden harm together with Tusla and drug and alcohol services. This statement will guide two pilot sites (north-west and Midlands) to ensure early intervention.
  • Commission training on hidden harm on behalf of Tusla and drug and alcohol services staff.
  • Participate on the North-South Alcohol Policy Advisory Group.
    • National Addiction Training Programme:
  • Finalise a training needs analysis and workforce development plan in line with NDS Action 47.
  • Co-ordinate the provision of training within the substance misuse framework, i.e. Addiction Training Programme, in line with NDS Action 47. 

3. Implement the outstanding prioritised recommendations of the Opioid Treatment Protocol, including the development of an audit process across the full range of drug services. This will incorporate person-centred care planning through the Drug Rehabilitation Framework and increase opioid substitution treatment (OST) patient numbers

  • Develop an audit process across the full range of drug services that incorporates person-centred care planning through the Rehabilitation Framework, in line with the introduction of the Opioid Treatment Protocol recommendation 2.3.
  • Increase the maximum number of OST patients from 15 to 25 for level 1 prescribers, and in exceptional circumstances from 35 to 50 for level 2 prescribers, in line with Opioid Treatment Protocol recommendations 3.4 and 3.5.
    • Performance targets:
  • no of clients in receipt of OST (outside prisons): 9,400
  • no of clients in receipt of OST (in prisons): 490
  • % of substance misusers over 18 years for whom treatment has commenced within one calendar month of assessment: 100%
  • % of substance misusers under 18 years for whom treatment has commenced within one week of assessment: 100% 

4. Implement referral and assessment for residential services using a shared assessment tool agreed between the HSE and service providers in line with the Drug Rehabilitation Framework

  • Develop a shared assessment tool between HSE and Tier 4 service providers in line with the Drugs Rehabilitation Framework and National Protocols and Common Assessment Tools. 

5. Implement the findings of the evaluation of the Pharmacy Needle Exchange Programme (PNEX)

  • Increase the level of knowledge of pharmacies in relation to harm reduction as per the PNEX.
  • Provide training for PNEX staff to reflect the wider range of service provision.
  • Strengthen integrated care pathways and referral pathways for patients.
  • Enhance advice and information giving on sexual health including appropriate referral for BBV testing and increased condom distribution.
  • Performance target:
  • Number of unique individuals attending pharmacy needle exchange: 1,200 

6. Implement prioritised recommendations of the Tier 4 Report (Residential Addiction Services)

  • Develop a Clinical Audit team and draw up an approved list of residential services based upon adherence to best practice quality standards in relation to staff competencies and clinical operations. 

7. Develop joint protocols for integrated care planning between mental health services and drug and alcohol services

  • Develop joint protocols between mental health and drug and alcohol services for patients with severe mental illness and substance misuse problems, in line with National Substance Misuse Strategy 2011, Recommendation 10, and NDS Action 33).

 

Monitoring progress

Each month the HSE issues a Performance Assurance Report (PAR), analysing key performance data year-to-date against the performance targets set in the annual NSP. It is based on metadata, which are also published by the HSE. These reports are available at  http://www.hse.ie/eng/services/publications/corporate/performanceassurancereports/ 

 

 

1 Health Service Executive (2014) National service plan 2015. https://www.drugsandalcohol.ie/23052/

2  Health Service Executive (2014) Health and well-being operational plan 2015.  Dublin: HSE. https://www.drugsandalcohol.ie/23275/

3  Tobacco Policy Review Group (2013) Tobacco free Ireland. Dublin: Department of Health. www.drugsandalcohol.ie/20655/

4  Department of Health (2012) Steering group report on a national substance misuse strategy. Department of Health, Dublin. https://www.drugsandalcohol.ie/16908/

5  North West Alcohol Forum Ltd (NWAF) is an NGO established to work in partnership with all sectors  to reduce hazardous drinking and its consequences to the individual, the family and the community.

6  Health Service Executive  (2014) Primary care divisional operational plan 2015.  Dublin: HSE. https://www.drugsandalcohol.ie/23193/

7 Department of Community, Rural and Gaeltacht Affairs (2009) National Drugs Strategy (interim) 2009-2016. Dublin: Department of Community, Rural and Gaeltacht Affairs.  https://www.drugsandalcohol.ie/12388/

Item Type
Article
Publication Type
Irish-related, Open Access, Article
Drug Type
Tobacco / Nicotine
Intervention Type
Harm reduction
Issue Title
Issue 53, Spring 2015
Date
March 2015
Page Range
pp. 16-18
Publisher
Health Research Board
Volume
Issue 53, Spring 2015
EndNote

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