The Healthy Ireland Outcomes Framework, published in late 2018, aims to monitor and drive the achievement of Healthy Ireland’s targets and performance indicators. It provides a structured approach to report relevant data which can be used to build awareness of the social determinants of health, to support assessment of the impact of policies on the agreed outcomes, and to monitor the effectiveness of the Healthy Ireland Framework and other interconnected policies supporting health and wellbeing. It can also be said that the Outcomes Framework indirectly measures whether the well-being scenarios outlined in the Health Service Capacity Review are having the necessary effect. It should be noted that the Healthy Ireland Outcomes Framework complements and will be an important input into the Health System Performance Assessment (HSPA) Framework. The latter will provide an overarching tool for assessing the overall performance of the health system with measurable and quantifiable outcome-based indicators which can be linked to relevant health policies, strategies and decision-making cycles. 

The HSPA Framework includes a total 260 indicators, specifically to:
• measure performance of the delivery system (health and social services);
• provide information (accountability) to the public regarding the effectiveness of policies and strategies of the DoH and HSE on overall population health; and
• monitor the progress of the Sláintecare reform programme.

Phase 2 of the HSPA project, which focuses on operationalising and implementing the Framework in the health system, is currently ongoing and is expected to last 12 – 18 months. There are also clear connections across all of the Healthy Ireland Outcomes Framework indicators with the Well-being Framework for Ireland, a Programme for Government commitment to develop a set of well-being indices to create a well-rounded, holistic view of how Irish society is faring. Specifically, the Outcomes Framework indicators can be mapped to at least eight of the eleven dimensions within the Well-being Framework, with the majority located in Mental and Physical Health, Knowledge, Skills and Innovation; and Environment, Climate and Biodiversity. Further information on the Wellbeing Framework for Ireland can be found in Appendix 2.

P.12 Current smoking rate and alcohol consumption

P.14 Illicit drug (cannabis) use
Cannabis use can have harmful effects on cognitive development and mental health, especially among young people. ³⁷ Preventing drug use among children and young people, and reducing the associated harms, is a strategic priority in the National Drugs Strategy. This indicator measures the prevalence of cannabis use in the past year among individuals aged 15+. The National Drug and Alcohol Survey 2019-20³⁸ found that recent (last year) use of cannabis was reported by 5.9% of the adult population (7.1% among 15–64-year-olds) and was higher among males (8.2%) than females (3.6%). Of the general population, 45,000 met the criteria for cannabis use disorder. This corresponds to 19.6% of those who reported last year cannabis use. With regard to cannabis use by children, the HBSC 2018 Survey reports statistically significant differences by gender and age group. Overall, 8% of boys and 6% of girls report cannabis use in the past 12 months. Younger children are less likely to report usage in the last 12 months than older children. There are no statistically significant differences across social class groups.

P18 Indicator 13. Illicit Drug Use - The prevalence of illicit drug (cannabis) use in the past year among individuals aged 15+

P.16 Indicator 9. Alcohol Consumption - Prevalence of heavy episodic drinking, defined as drinking 6 or more standard drinks in a single drinking occasion

P20 Drug-induced mortality - This indicator measures the consequences of high-risk drug use and is a strategic priority in the National Drugs Strategy and the EU Drugs Strategy.⁵⁹ Drug-induced deaths are poisoning deaths due to the toxic effect of a drug, or combination of drugs (including prescribable drugs, illicit drugs and alcohol). The annual number of poisoning deaths increased by 1.6% from 370 in 2015 to 376 in 2017. (Note that these data also include poisoning deaths due to alcohol only, which since 2015 have accounted for between 14%-16% of poisoning deaths). The majority of poisoning deaths are among men (70% in 2017). It can also be noted that the median age for poisoning deaths has increased from 38 years of age in 2008 to 43 years of age in 2017.

P25 Indicator 19. Drug-induced mortality - Annual number of poisoning or overdose deaths due to the toxic effect of a drug, or combination of drugs (including prescribable drugs, illicit drugs and alcohol.