Dáil Éireann Debate, Wednesday - 31 March 2021
993. Deputy Alan Kelly asked the Minister for Health the status of Sláintecare workstream 1 in relation to providing co-ordinated care, in the right place and at the right time, with a specific emphasis on prevention of health deterioration for individuals living with spina bifida and hydrocephalus; and if he will make a statement on the matter. [16764/21]
Amharc ar fhreagra1238. Deputy Róisín Shortall asked the Minister for Health the status of the implementation of Sláintecare workstream 1 in relation to measures (details supplied). [17629/21]
Amharc ar fhreagraI propose to take Questions Nos. 993 and 1238 together.
Workstream 1 of Sláintecare refers to Service Redesign and Supporting Infrastructure. It focuses on providing the right care, in the right place, at the right time, where the patient/service user is paramount and strong emphasis is placed on prevention and public health.
Significant progress has been made in implementing this workstream. The development of an interagency multi-annual 5-year plan to integrate all five Capacity-Access workstreams (namely Healthy Living, Enhanced Community Care & Capacity, Enhanced Acute Care & Capacity, Scheduled Care and Unscheduled Care) is underway having been impacted by the re-assignment of key service and clinical staff to COVID-19. This work has now been factored into the development of the National Service Plan 2021 and the Slaintecare Implementation Strategy and Action Plan 2021-2023 currently being finalised.The 2021 Budget funding of €1.235 billion provides the opportunity for delivering Sláintecare at pace, and is intended to be the first major step towards achieving the appropriate capacity of the health service in terms of both beds and community-based services as set out in the Health Service Capacity Review, 2018.
Key areas of progress also include the development of the Healthy Ireland (HI) Strategic Action Plan which is currently undergoing review and approvals process. It sets out Healthy Ireland’s strategic actions for the next phase of the HI Framework (2021 -2025), aligned with the Programme for Government ambitions. The Sláintecare Healthy Communities Programme, an area-based approach to improving health and wellbeing at community level with a particular focus on areas of deprivation, is progressing well, with wide-ranging stakeholder engagement underway and targeted health and wellbeing services identified. Other elements that have progressed include the publication of healthy eating guidelines for young children and the “Keep Well” campaign to support resilience in individuals and communities, in line with the Government plans for COVID-19 Resilience and Recovery, focused on keeping active, staying connected, switching off, eating well and minding your mood, including significant investment of resources to support implementation of a range of initiatives under these themes, in partnership with a wide group of stakeholders.
An Enhanced Community Care Model including the development of a Community Healthcare Network multidisciplinary model through a learning site approach, Integrated Care Hubs for Older People and People with Chronic Diseases to provide specialist care in a community setting, building on the GP Agreement and the National Clinical Programmes for each of the four major chronic diseases (diabetes, asthma, COPD and heart failure) was also rolled out.
The value of eHealth, ICT and health information systems was demonstrated throughout the pandemic. Through rapid development and deployment of systems and technology, several thousand staff were set up to work remotely where they could continue to support frontline healthcare workers, telehealth solutions were deployed for GPs and outpatient clinics, paper prescriptions were replaced with electronic copies thus reducing non-essential contact with GPS and practice staff, ICU systems were deployed and upgraded, patient assessment hubs and other Covid facilities were fitted out and connected, the Covid Care Tracker used by contact tracing teams to record data on patients referred for test was developed and deployed. The Covid Tracker App was developed and became the first such app that worked across borders. Since December, the national covid vaccination system was developed an deployed and mass vaccination sites and other facilities have been connected to the health network and fitted out with kit to support vaccination teams.
Investment in EHRs continues. Building on the successful deployment of an EHR at St James Hospital in 2018 and Maternity & Newborn EHR systems in our larger Maternity Hospitals, the National Childrens Hospital are in the final stage of selecting their preferred product and the deployment of these complex systems will represent and multi annual exercise in preparation for commissioning of the site. In the meantime the National Forensics Hospital and National Rehabilitation Hospital are deploying EPR systems with other sites taking a more stepwise approach to deploying modular components of EHRs.
The Sláintecare Integration/Innovation Fund continued to support initiatives testing and scaling how services can be delivered and that support the delivery of integrated care and the shift to community care in new and innovative ways, helping to reduce and prevent hospital visits.
Full details of progress made in 2019 can be found in the Sláintecare Action Plan Year-end Report 2019. A report on implementation in 2020 is being finalised and will be published shortly.
In terms of disability services, HSE Disability Services provide personal and social supports based on the needs of the individual, rather than the provision of services based on a specific diagnosis or condition. Services for people with disabilities include day and respite services, adult day services, residential services.
The HSE also provides a range of assisted living services including Personal Assistant and Home Support Services to support individuals to maximise their capacity to live full and independent lives. PA and Home Support Services are provided either directly by the HSE or through a range of voluntary service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.
Services are accessed through an application process or through referrals from public health nurses or other community-based staff. Individuals' needs are evaluated against the criteria for prioritisation for the particular services and then decisions are made in relation to the allocation of resources. Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria, and the level of resources available. As with every service there is not a limitless resource available for the provision of home support services and while the resources available are substantial, they are finite. In this context, services are discretionary and the number of hours granted is determined by other support services already provided to the person/family.
