The HSE’s latest income and expenditure position at 30 April 2019 shows a revenue deficit of €116.2m which represents 2.3% of the available budget. The main drivers of the deficit are acute hospitals, PCRSand demand led schemes, disability services, and the treatment abroad scheme.
The HSE National Service Plan (NSP) is an important accountability instrument in use by the Department in determining how the HSE is performing against its targets as it captures in a clear and quantified way the range of health and social care services to be provided by the HSE for the allocation it has received. It establishes links between funding, staffing and services and it incorporates activity measures, outcome-based performance indicators and deliverables in key service areas, which are matched with targets and timescales.
The Department provides oversight of the performance of the HSE in relation to the delivery of the services set out in the NSP. The mechanism for this oversight includes the ongoing monthly performance management process in place between the Management Board in the Department and the HSE Leadership (now the HSE Executive Management Team) where the HSE reports monthly to the Department on the performance of the health system against the agreed targets set out in the NSP.
As part of the monthly performance cycle, the HSE provides an update on the application of its Performance and Accountability Framework. This includes the submission of an Escalation report which provides detail on services which are in escalation for the month in question and the actions being carried out to mitigate these. Services in escalation are those which are experiencing significant performance issues.
The latest escalation report is for April 2019 and currently the HSE are reporting 7 areas (6 in acute hospitals and 1 in social care) which have been escalated to the National Performance Oversight Group. Improvement plans and support measures are in place to monitor the ongoing performance of the different areas in escalation.