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Dáil Éireann debate -
Tuesday, 5 Nov 2002

Vol. 556 No. 3

Written Answers. - Strategic Management Initiative.

Richard Bruton

Question:

549 Mr. R. Bruton asked the Minister for Health and Children the key performance indicators being used by his Department; the performance in respect of these for the past five years; and if a commentary is published on these performance indicators linking them to objectives and activities. [20315/02]

Richard Bruton

Question:

550 Mr. R. Bruton asked the Minister for Health and Children the key performance indicators of the agencies which his Department funds; the performance in respect of these for the past five years; and if these agencies publish a commentary on these performance indicators linking them to objectives and activities. [20330/02]

I propose to take Questions Nos. 549 and 550 together.

My Department is committed to the use of performance indicators as a means of managing its work. The health strategy "Quality and Fairness" outlines the largest expansion in services in the history of the Irish health system. A vision has been set out across the full range of care areas for how the system can develop not just in the short-term but over the next decade to deliver high quality care for all. The strategy sets out four goals which encompass the major conclusions from the strategy consultation process and analysis in terms of overall direction for the future:

– Better health for everyone

– Fair access

– Responsive and appropriate care delivery

– High performance.

These are in turn broken down into 12 specific objectives. The strategy's action plan translates these objectives into 121 clear, achievable tasks, complete with target dates and allocation of responsibility. In line with the commitment given in "Quality and Fairness", I have established a strategy implementation unit in my Department to drive implementation of the strategy at national level.

The strategy implementation team has responsibility for the preparation of an annual report for the Cabinet sub-committee on implementation of the strategy and is currently engaged in compiling the necessary information for preparation of this important report. I expect to report to the Cabinet sub-committee before the end of the year. I also intend to produce an end of year report showing those areas where progress on the implementation of the health strategy has been made and I will provide a copy of this report to the Deputy as soon as it becomes available.
The Deputy may also wish to note that I am reconvening the National Consultative Forum on 11 November this year to consider progress reports on the implementation of the strategy and to comment on priorities in the light of progress and emerging trends. Performance indicators are an integral part of the Department's business plan and are used in reviews of progress as part of the managerial process. Copies of the 2001 and 2002 business plans are available on the Department's website.
My Department is currently preparing its statement of strategy for 2003-05 as are all other Departments in line with the provisions of the Public Service Management Act, 1997. This statement will contain key performance indicators which will be reported against in future annual progress reports. Performance indicators also feature in the performance management and development system which is currently being embedded in the Department.
Under the Programme for Prosperity and Fairness, a set of performance indicators was devised to measure progress in relation to modernisation objectives and payment of the final 4% of the pay award was linked to satisfactory progress on these indicators. The indicators for the Department of Health and Children were agreed by the Civil Service quality assurance group which was set up under the PPF to monitor progress. The Department submitted a report in May 2002 to the Civil Service quality assurance group. Progress was deemed to have been satisfactory and the final 4% was awarded to departmental staff as a result.
The agencies which my Department funds use a range of performance indicators. The key performance indicators are those which are under development jointly by the health boardsauthority and my Department in relation to the annual health board-authority service plans. These performance indicators set out to cover five domains, effectiveness, efficiency, health improvement, equity-access and service user satisfaction-experience and are used by both my Department and the health boards-authority in relation to service plans.
Because these joint performance indicators are developmental in nature and have only been instituted in the past two years it is not possible to provide a report on performance in respect of the past five years. In addition at the present stage in the development of this set of key performance indicators data definition and data quality issues have yet to be adequately resolved to allow for the publication of a worthwhile commentary by health boards effectively linking them to objectives and activities. With regard to other agencies which my Department funds I am having the information on relevant key performance indicators collated and will respond to the Deputy as soon as possible.
The key performance indicators concerned in relation to health board-authority annual service plans are listed below.
Health Promotion – Performance IndicatorsPercentage of primary schools in each health board designated as health-promoting.
Percentage of post-primary schools in each health board designated as health promoting.
Percentage of primary schools in each health board working towards this designation.
Percentage of post-primary schools in each health board working towards this designation.
Percentage of post-primary schools with at least one health-related policy agreed and published.
Percentage of band 1 hospitals that are full members of the health promoting hospitals network.
Percentage of band 2 hospitals that are full members of the health promoting hospitals network.
Percentage of band 1 hospitals that are associate members of the health promoting hospitals network.
Percentage of Band 2 hospitals that are associate members of the health promoting hospitals network.
Number of days of professional/staff training provided this year (excluding conferences).
Number of professional staff trained, by discipline, in Health promotion principles and practices this year.
Overall Health Indicators – Performance IndicatorsThe percentage of mothers who are breastfeeding on discharge from public hospitals.
The percentage of mothers who are breastfeeding at three months.
Percentage of target number of programmed inspections of food premises by high risk category carried out in 2002.
Percentage of target number of programmed inspections of food premises by medium risk category carried out in 2002.
Percentage of target number of programmed inspections of food premises by low risk category carried out in 2002.
Percentage out-turn of target number of food samples as specified in the national food sampling plan.
Number of premises in each of the 12 categories as specified in the Tobacco (Health Promotion and Protection) Regulations 1995 S.I. No. 359 of 1995.
Standardised survival rates for breast and colorectal cancer to five years.
Percentage of live births to females aged 15-19 per 1,000 population, who are aged 15-19 years.
Primary Care – Performance IndicatorsNumber of GMS GP Practices in your health board region (excluding subsidiary contract holders);
(a) Providing services as single-handed practices.
(b) Operating formal out-of-hours rotas.
(c) Providing services as recognised GP partnerships.
(d) Providing services as recognised GP co-ops.
(e) Employing a practice manager.
(f) Employing a practice nurse.
(g) Employing a practice secretary.
(h) Employing a practice manager, practice nurse and practice secretary.
(i) With female doctors working full-time.
(j) With female doctors working part-time.
Percentage of GMS GPs holding primary immunisation contracts (excluding subsidiary contract holders).
Percentage of known Private GPs holding primary immunisation contracts (excluding subsidiary contractors).
(a) Percentage of GMS GP practices with a computer.
(b) Percentage of GMS GPs who have undertaken the ICGP IT training course.
Percentage of dispensing doctors in the health board region.
Percentage of pharmacies making pharmacy claims electronically through the GMS.
Dental and Orthodontic ServicesNumber of public water fluoridation schemes in the health board region.
Percentage of public water fluoridation schemes, monitoring results within statutory limits.
Percentage of school children screened in designated classes within national schools.
Number of patients currently in receipt of orthodontic treatment.
Number of patients who have completed orthodontic treatment.
Acute Services – Performance IndicatorsSuccess in achieving waiting times targets (<12 months for Adults), for in-patient admissions for the following target specialties – ENT, orthopaedics, cardiac surgery, general surgery, gynaecology, ophthalmology, plastic surgery, urology, vascular surgery.
Success in achieving waiting times targets (< 6 months for Children) for in-patient admissions for the following target specialities – ENT, orthopaedics, cardiac surgery, general surgery, gynaecology, ophthalmology, plastic surgery, urology, vascular surgery.
Percentage of new patients seen in out-patient department within 13 weeks of referral by general practitioner.
Waiting times for out-patient department appointments by speciality; percentage seen within 13 weeks of referral by GP.
Waiting times for out-patient department appointments by speciality, percentage seen within 26 weeks of referral by GP.
Waiting times in out-patient department (Percentage seen < 60 minutes).
Percentage of patients, by speciality, who have been seen by a consultant at their first out-patient department clinic appointment.
Percentage of patients over 65 years of age, assessed as clinically fit for discharge 12 or more hours ago, who are still in hospital awaiting appropriate placement
Percentage of patients under 65 years of age, assessed as clinically fit for discharge 12 or more hours ago, who are still in hospital awaiting appropriate placement.
Average Length of Stay (ALOS) (with changes on previous year for set of diagnostic related groupings (DRGs).
Is Triage available in accident and emergency 24 hours a day?
(a) Waiting times in accident and emergency for triage.
(b) Waiting times in accident and emergency for consultation.
(c) Waiting times in accident & emergency for admission.
Number of times in the last year the hospital transfusion committee has convened.
Ambulance Services – Performance IndicatorsPercentage of (emergency) calls for which a patient report form has been completed by ambulance personnel.
Percentage of (agreed response) calls for which a patient report form has been completed by ambulance personnel.
Percentage of ambulances (emergency response vehicle) with a defibrillator monitor.
Percentage of ambulance personnel who have completed approved standard training per pre hospital emergency care council.
Mental Health – Performance IndicatorsSuicide rate per 100,000 population by: (a) Male (b) Female (c) Age (d) County of residence.
Number of individuals presenting with parasuicide per 100,000 in accident and emergency, assessed by the mental health services (acute hospital services).
Percentage of those individuals presenting with parasuicide who have been assessed and are referred for further intervention (mental health services).
Number of community residential (adult mental health service) places per 100,000 population for high support.
Number of community residential (adult mental health service) places per 100,000 population for medium support.
Number of community residential (adult mental health service) places per 100,000 population for low support (split by HB).
(High: 24 hour supervision by trained staff; medium: day staff provision; low: visiting staff) – provided by health board – provided by other.
Number of day centre attendances per 100,000 population.
Number of day hospital attendances per 100,000 population.
Number of out-patient attendances per 100,000 population by diagnosis (based on ICD diagnostic groups).
Percentage of admissions to the acute mental health service with a primary diagnosis of alcohol disorder.
Number and rate of people per 100,000 population attending community based alcohol programmes.
Number of in-patient places by 100,000 population.
Admission rates to acute units, per 100,000 population.
First admission rates to acute units (that is first ever admission), per 100,000 population.
Occupancy rates of acute units (bed days).
In-patient re-admission rates to acute units per 100,000 population.
Average length of stay.
Percentage of people within acute units awaiting placement in a rehabilitative setting appropriate to their needs.
Number of people within intensive care units awaiting placement in arehabilitative setting appropriate to their needs.
Rate of people admitted involuntarily (specify) per 100,000 population.
Rate of new long-stay inpatients per 100,000 population.
Rate of new long-stay clients in community settings per 100,000 population.
Number of suitable long-stay patients transferred from old psychiatric hospitals to more appropriate care facilities in the community by discharge destination:
(a) home.
(b) private nursing home.
(c) community residential place.
(d) learning disability centre.
(e) community nursing-elderly care centre.
(f) centre for physically disabled.
List methodologies used to involve consumers in the development and assessment of services.
Child and Adolescent Health – Performance Indicators
Percentage of mothers of new born children contacted by a public health nurse within 48 hours of hospital discharge.
Number of boys aged 0-5 years with undescended testes undergoing orchidopexy as a percentage of all boys aged 0-16 years with undescended testes undergoing orchidopexy.
Percentage of children under 16 years admitted to hospital with a primary diagnosis of asthma who require hospitalisation for longer than 72 hours per 10,000 population under 16 years of age.
Children under 16 years admitted as day cases for myringotomy (insertion of grommets) as a proportion of all children under 16 years of age admitted for these operations.
Children under 16 years admitted as day cases for Hernia repair as a proportion of all children under 16 years of age admitted for these operations.
Children under 16 years admitted as day cases for squint correction as a proportion of all children under 16 years of age admitted for these operations.
Percentage uptake of DTaP/DT/hib/polio and meningococcal C vaccinations at 12 months of age.
Percentage uptake of DTaP/DT/hib/polio and meningococcal C vaccinations at 24 months of age.
Percentage uptake of MMR at 24 months of age.
Percentage uptake of child health core screening programme as outlined in Best Health for Children (1999).
(a) Developmental Screening.
(b) Audiology Screening of Primary School Children.
(c) Vision Screening of Primary School Children.
Child Care – Performance Indicators
Percentage of children in:
(a) Residential care.
(b) Foster care.
(c) Foster care with relatives.
for whom a written care plan, as defined by child care regulations 1995, has been:
Drawn up prior to placement.
Reviewed within two months of placement.
Reviewed every six months for the first two years.
Reviewed annually.
Percentage of children in care (a), (b), (c) who have an allocated social worker.
Number of children awaiting a foster care placement, who are not already in a foster care placement, at the end of the reporting period.
Percentage of approved foster carers with an allocated link social worker.
Percentage change in the availability of approved foster carers since the last reporting period.
Number of new approved foster carers recruited during the reporting period.
Number of foster carers who left the service during the reporting period.
Number of operational pre-school centres, which were notified in accordance with the pre-school regulations 1996.
Percentage of operational pre-school centres, which were notified in accordance with the pre-school regulations 1996 and were inspected in accordance with the regulations.
Percentage of inter country adoption first assessments completed during the year, within 18 months of receipt of application.
Percentage of child protection case conferences held, where the invited parent-guardian of the child was in attendance.
Older Persons – Performance IndicatorsThe number of re-admissions for the same complaint/ condition, by speciality:
(a) orthopaedics.
(b) medicine.
(c) surgery.
(d) gynaecology.
(e) ophthalmology.
(f) ENT.
to acute hospitals within:
one week of discharge.
one month of discharge.
per thousand admissions of those aged over 65 years.
The number of patients, over 65 years on the waiting list for:
(a) Cataract surgery.
(b) ENT surgery.
(c) Orthopaedic Surgery.
The number of cataract procedures completed on:
(a) a day case basis.
(b) an in-patient basis.
Percentage uptake of influenza vaccine among the GMS population aged over 65 years.
Number of people aged over 75 years in continuing residential care, i.e. health board and other nursing home care as a percentage of the total population over 75 years.
Percentage of people over 65 years of age who were in receipt of the following services during the reporting period:
(a) Home help services.
(b) Hours of Home Help service provided.
(c) Day care.
(d) Respite care.
Physical and Sensory Disability Services – Performance Indicators
Percentage of clients who have applied to health board-voluntary sector, or have otherwise been identified for inclusion on the physical and sensory disability database who have been interviewed.
Number of people who have applied to the health board-voluntary sector for a personal assistant.
Percentage of those assessed by the health board-voluntary sector as being in need of a personal assistant.
Percentage of people who require additional hours.
Percentage of personal assistants who have received training.
Percentage of agencies or residential service employers for people with physical and sensory disabilities that employ a methodology to seek the views of the person in residential care, their parents, family members and-or advocates.
Intellectual Disability Services – Performance Indicators
The percentage of people with an intellectual disability in resi dential care for whom a written person centred plan is in place.
The percentage of people with an intellectual disability (by organisation) in residential care including group homes who have been vaccinated against Hepatitis B.
The percentage of people with an intellectual disability (by organisation) who declined the vaccination
The percentage of staff (by organisation) in residential services for people with an intellectual disability who have been vaccinated against hepatitis B.
The percentage of staff (by organisation) who declined the vaccination.
The percentage of clients on the intellectual disability database assessed as requiring day services for whom funding has been received who are receiving the service.
Percentage of these clients requiring a further day service.
The percentage of clients on the intellectual disability database who are assessed as requiring residential services for whom funding has been received and who are receiving the service.
Percentage of these clients requiring further residential services.
The percentage of clients who have been assessed as needing to be transferred from psychiatric hospitals and large institutional settings for whom funding has been received.
Percentage of agencies providing intellectual disability services that employ a methodology to seek the views of the person in residential care, their parents, family members and-or advocates.
Addiction Services – Performance IndicatorsThe percentage of all drug misusers (including under 18s) who are assessed within three working days and offered treatment as deemed appropriate not later than one month after assessment.
Percentage of drug misusers under 18 years of age who are assessed within three working days and offered treatment as deemed appropriate not later than one month after assessment.
Services for Travellers – Performance IndicatorsPercentage of key health board personnel who have completed cultural awareness and sensitivity training programmes, which have been developed in partnership with traveller organisations.
Services for Homeless Persons – Performance IndicatorsPercentage of homeless people presenting to:
(a) Out patients.
(b) Accident and Emergency Departments.
(c) Community Welfare Services.
(d) Homeless Hostels with medical cards.
Percentage of homeless people with an addiction problem who are provided with a range of services addressing all their needs in a holistic manner.
Services for Asylum Seekers – Performance IndicatorsPercentage of asylum seekers offered screening and the percentage accepting screening.
Percentage of asylum seekers who completed screening process for the following: – hepatitis B, HIV, TB, polio and varicella zoster virus (chickenpox).
Number and percentage of asylum seekers for whom vaccination status to date has been determined.
Percentage of asylum seekers met by a community welfare officer of the board within five working days of the asylum seeker's arrival in the board's functional area.
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