PDF P.29 Tobacco control and substance misuse

•  Further Tobacco Free Ireland by implementing priority actions with a particular focus on the continued roll out of the Tobacco Free Campus policy.
•  Reduce tobacco usage within the general population by undertaking a range of training, intervention, surveillance, evaluation, enforcement of legislation and social marketing activities in line with the recommendations of Tobacco Free Ireland.
•  Progress the implementation of the National Substance Misuse Strategy including the community mobilisation pilot on alcohol initiatives in five drug task force areas and the further development of a coordinated approach to prevention and education interventions in alcohol between all stakeholders including third level institutions.
•  Prepare for the future roll out of the relevant provisions outlined in both tobacco and alcohol legislation in consultation with the Department of Health and in line with existing resources.

P.31 - Develop joint protocols for integrated care planning between mental health services and drug and alcohol services.

P.33 2015 Budget - Primary Care €m726.0 + Drugs Task Force €m21.6 = TOTAL €m747.6

P.36-37 Social inclusion - Key priorities with actions to deliver in 2015

•  Achieve improved health outcomes for persons with addiction issues.
•  Progress the integration of Drug Task Force Projects and developments within the wider addiction services in line with objectives of the National Drug Strategy 2009-2016.
  - Implement priority actions from National Drugs Strategy 2009-2016. (Programme for Government Primary Care Funds €2.1m)
  - Implement the clinical governance framework for addiction treatment and rehabilitation services.
  - 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 patient numbers.
  - Implement prioritised recommendations of the Tier 4 Report (Residential Addiction Services).
  - 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.
  - Implement the findings of the evaluation of the Pharmacy Needle Exchange Programme.
  - Develop joint protocols for integrated care planning between mental health services and drug and alcohol services.

HIGHLIGHTS OF NSP 2015

Patient Quality and Safety

The HSE placed a significant focus on quality and patient safety during 2014.  This focus will be further strengthened in 2015, to ensure that quality and patient safety remains at the heart of health service delivery. This emphasis aims to ensure that people’s experience of the health service is not only safe and of high quality, but also caring and compassionate. 

To enable the health services to deliver on this objective, the HSE has redesigned its National Quality and Patient Safety function to give it an enhanced role in relation to both quality improvement and quality assurance, within an environment where patients, service users and staff are involved, their opinions sought and their voice is heard.  The HSE has established a Quality and Patient Safety Enablement Programme which will give effect to these changes and this is included as a Schedule in the National Service Plan.

Accountability Framework

The HSE recognises the critical importance of good governance and of continually enhancing its accountability arrangements.  In this regard and in the context of the establishment of the Hospital Groups and Community Health Organisations, the HSE is strengthening its accountability arrangements and is putting in place a new Accountability Framework.

This enhanced governance and accountability framework makes explicit the responsibilities of all managers to deliver on the targets set out in the Service Plan across the Balanced Score Card in relation to access to services, the quality and safety of those services, finances and workforce. The process involves the introduction of a formal escalation, support and intervention process for underperforming services which will include a range of sanctions for significant or persistent underperformance.

In this regard, any over run from 2015 onwards will fall to be dealt with by the HSE in the subsequent financial year. This places further emphasis on the need for managers of services to operate within their allocated resource limit in 2015. Failure to achieve this will result in having to deal with any overrun as a first charge on their resources the following year.

Dealing with Delayed Discharges

The numbers applying for support under the Nursing Home Support Scheme continues to grow which is impacted by the growing number of older persons in Ireland. The over-80 years population, with the greatest need for health services, is growing by some 4% annually.  The NSP has allocated €25m to begin to address delayed discharges.  This funding will be targeted at, among other initiatives, the provision of intensive home care packages, long term care beds and intermediate care beds.  Approximately €10m of this relates to the Nursing Home Support Scheme (Fair Deal), which provides for an additional 300 long-stay beds.

Mental Health

An additional €35m is provided as part of Programme for Government funding. In addition, €23m is provided for both 2013 and 2014 posts. There will be a continued focus by the Mental Health Services on mental health promotion and suicide prevention throughout 2015. Furthermore, community services will continue to be strengthened with improved access to CAMHS and counselling/psychotherapy interventions.

Disability Services

An additional €20m funding has been provided for disability services for 2015. It is expected that additional day services will be provided for up to 1,400 young people who are due to leave school and rehabilitative training. Furthermore, there will be a progression of disability services for children and young people. Funding is provided for transitioning 150 people from congregated settings to the community.

Staffing Levels

Greater autonomy has been delegated to the HSE to manage its staffing levels within the overall pay Framework.  This is an important development as it will assist the health services in placing a focus on quality and patient safety across its services and in reducing agency costs.

Information Technology

The NSP has provided for €55m for ICT capital.  This will be used to support the maintenance and development of the HSE infrastructure. This will include investment in both acute and community based systems.