Dáil Éireann Debate, Tuesday - 20 October 2009
251 Deputy Richard Bruton asked the Minister for Health and Children the key performance indicators used by the Health Service Executive and those used by her Department to monitor the performance of the mental health services; the trends in these indicators over the past three years; and her views on whether these indicators represent an adequate set of performance measures. [36731/09]
View answer258 Deputy Joe McHugh asked the Minister for Health and Children her views on whether new performance indicators along with supporting up to date data should be developed and published by the Health Service Executive to enable accurate monitoring of the national mental health budget; and if she will make a statement on the matter. [36823/09]
View answerI propose to take Questions Nos. 251 and 258 together.
The annual HSE National Service Plan, which sets out the quantum of services to be provided in any financial year by the HSE for the resources allocated to it, is the primary vehicle through which my Department monitors and evaluates the performance of the Executive. Significant progress was made in the National Service Plan 2009 in terms of incorporating more explicit links between funding, staffing and services and the development of an improved set of activity measures, performance indicators and deliverables in key service areas, which are matched with timescales. These improvements form a framework for achieving greater clarity at an individual service unit level within the HSE on performance expectations regarding service delivery, staffing levels and funding. My Department has an agreed monitoring framework with the HSE and receives detailed comprehensive monthly reports on all aspects of progression of the National Service Plan, including information on activity measures and performance indicators. These Performance Reports are published on the HSE’s website each month following approval by the HSE Board.
Policy for the development of mental health services is outlined in ‘A Vision for Change', the report of the expert group on mental health policy. The aim is to migrate from the traditional institutional based model to a patient-centred, flexible and community based mental health service, where need for hospital admission is greatly reduced, whilst still providing in-patient care when appropriate. The performance measures and associated targets in the mental health area for 2009 are published as part of the National Service Plan 2009 and are included for ease of reference in a table. Examples of measures include (i) the number of child and adolescent mental health teams and (ii) the number of inpatient places per 100,000 population. The August Performance Report advises that the number of child and adolescent mental health teams has increased from 47 teams at the end of December 2008 to 54 at the end of August 2009. The National Service Plan target is 55 by end 2009 and there is an ultimate target of 99 teams as specified in ‘A Vision for Change'. The number of inpatient places per 100,000 population stands at 28.5 at the end of June (following an end December 2008 outturn of 30.7), against a full year target of 25.
Some of the measures outlined in the National Service Plan were included for the first time in 2009 with a view to the development and progression of the data by the end of the year. My Department is working on an ongoing collaborative basis with the HSE to further develop and refine performance measures across all service areas, including mental health, to ensure that they are as robust and meaningful as possible and reflect key priorities and international best practice as well as being comparable both within the EU and further afield.
Last week I received the first biannual report against the HSE Corporate Plan 2008-2011 which charts progress against desired medium and longer term objectives and priorities as set out in the Corporate Plan and implemented annually through the National Service Plan. This will facilitate the Department and the HSE in mapping performance trends across the health sector, including mental health, to inform future strategic and annual service planning. My Department and the HSE are also working under the auspices of a joint performance information group to streamline and simplify collation and presentation of information which will provide more capacity for better use and analysis of data. The continued development of HealthStat by the HSE is also part of our ongoing co-ordinated approach to monitoring and measuring health service performance at national level. These developments will facilitatea clearer link between information and action at all levels of the health system, from operational management to short and medium term planning to long term policy and strategy development.
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Mental Health National Service Plan Indicators, 2009 |
Projected Outturn 2008 |
Expected Activity/Target 2009 |
|
Performance Activity |
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|
Admissions |
||
|
Total number of admissions to acute inpatient units (adults and children) |
16,230 |
15,905 |
|
No. of readmissions as a % of total admissions |
70% |
68% |
|
Total number of involuntary admissions |
1,387 |
1,372 |
|
Child & Adolescent Mental Health |
||
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No. of Child & Adolescent Mental Health Teams (as outlined in a Vision for Change) |
47 |
55 |
|
No. of new child/adolescent referrals received by Mental Health Services |
— |
|
|
Total number of child/adolescent patients seen by a member of the CAMH teams (new and existing) |
— |
New measures for collection in 2009 |
|
Total number of new child/adolescent referrals assessed |
— |
|
|
Performance Indicator |
||
|
Acute Units |
||
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a) Number of inpatient places per 100,000 population |
30.7 |
25 |
|
b) First admission rates to acute units (that is, first ever admission), per 100,000 population |
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|
Annual rate |
105.6 |
105.6 |
|
Quarterly rate |
26.4 |
26.4 |
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c) Inpatient readmission rates to acute units per 100,000 population |
||
|
Annual rate |
266.2 |
260.3 |
|
Quarterly rate |
70.1 |
66.6 |
|
d) Rate of involuntary admissions per 100,000 population (Quarterly rate) |
8.2 |
Reduce by 1% |
|
Median length of stay in inpatient facilities |
12 |
12 |
|
Children & Adolescent Waiting List |
||
|
Waiting times for assessment and treatment by CAMH Teams |
— |
To be progressed in 2009 |
|
Overall number on waiting list; No. and % seen (<3 months; 3-6 months; 6-9 months; 9-12 months, >12 months) |
— |
Target to reduce waiting times in 2010 using 2009 data as base position |
|
% of new versus existing child/adolescent patients seen by a member of the CAMH team |
— |
To be progressed in 2009 |
|
No. of repeat deliberate self harm presentations at ED |
— |
To be progressed in 2009 |
