HSE publishes 2023 Annual Report: Reforming our System to Deliver Better Care

Last year the HSE provided health services to more people in hospitals and in the community and oversaw the introduction of the reform of the organisation to ensure people get the right care, at the right time and in the right place.

The HSE has today, (Friday, 26 July) published its 2023 Annual Report and Annual Financial Statements highlighting the broad scope of work and activity carried out during the year and includes information about HSE reforms, operations, budget, key challenges, governance and performance.

In the context of population increase of over 97,000 people in 2023, the HSE delivered health and social care services to an ageing population (increase of 37% for people aged 65 years and over since 2014) and with life expectancy now at 84.3 years for women and 80.5 for men.

2023 was a challenging year also due to budgetary, recruitment and digital transformation requirements needed to bring about the reform of the health service.  The HSE will continue to work with staff, patients and service users to build on the improvements made last year.

We continued to see a reduction in waiting lists for scheduled and unscheduled care despite increased presentations by implementing the Waiting List Action Plan. The Urgent and Emergency Care Plan saw a reduction on the numbers of people on trolleys (down 8% on 2022 and down 22% during the second half of the year) despite unscheduled care presentations increasing from 1.25 million to 1.69 million, an increase of 35%, since 2017.

2023’s HSE budget was €21.6bn.  Healthcare costs increased significantly in recent years with inflationary increases and the rise in energy and other related healthcare costs affecting spend last year.

Commenting on the 2023 annual report, HSE Chairman Ciarán Devane said:

“Our health service is continuing to deliver outcomes that are in many instances among the best in Europe. The quality of healthcare in the community services and hospital care provided by the HSE and our partners is recognised by the public, with Ireland reporting the highest self-perceived health status in the European Union.

A challenge now facing us is to ensure such positive trends for people’s health persist while working collectively to address known service capacity deficits impacting access to services and quality of care”.

In 2023, significant progress on change and reform in the health service was made with the establishment of the six Health Regions to facilitate comprehensive integrated, person-led, community-first health and social care through the alignment of acute and community-based services.

HSE CEO Bernard Gloster said:

“Structural change is not the main goal of this reform. We are doing this to ensure that people experience just one health service, which provides whatever care they need at the right time and in the right place.

While we continue to face significant challenges, there have been many achievements in 2023. While more patients have come on waiting lists as anticipated, we also took far more people off than we had targeted to do. By the end of the year, we reduced the volume of the waiting lists by approximately 2.7%, and the average length of wait was brought down to seven and a half months”.

Highlights from the HSE 2023 Annual Report

Our Population

It is estimated 5.3 million people live in Ireland, this is an increase of over 97,000 people in 12 months:

• there were 54,493 births in 2023
• the most recent estimate of life expectancy in Ireland is 80.5 years for males and 84.3 years for females
• according to the Healthy Ireland Survey 2023, 86% of the population said that their quality of life is good or very good with just 5% of the population saying that their quality of life is poor or very poor

Acute Services

• 3.65 million new and return outpatient attendances - this is 7% above 2022 activity and 8% above 2023 target
• 1.36 million new ED attendances - this is line with 2022 activity and 1% above 203 target
• 1.7% of surgical re-admissions to the same hospital within 30 days of discharge - this is in line with 2022 performance and 15% above 2023 target
• 86.6% of people waiting <15 months for first access to Outpatients Department Services
• 95.9% of all attendees at ED who are in ED < 24 hours

Community Healthcare

• 1.61 million persons covered by medical cards as at 31 December - this is 3% above 2022 activity and 1% below 2023 target
• 95,962 total Community Intervention Teams referrals - this is 14.5% above 2022 activity and 18% above 2023 target
• 45,424 day only respite sessions accessed by people with a disability - this is 60% above 2022 activity and 86% above 2023 target
• 89.4% of children aged 24 months received measles, mumps, rubella (MMR) vaccine - in line with 2022 performance but 6% below 2023 target
• 3.54 million home support hours delivered to persons with a disability, 5% above 2022 activity and 13% above 2023 target
• 92.8% of urgent referrals to Child and Adolescent Mental Health Teams responded to within three working days

Human Resources

In 2023, we expanded our workforce with a further 8,240 WTEs. Medical and dental staff levels increased by 1,064 WTEs, the number of nursing and midwifery staff increased by 2,628 WTEs, the number of health and social care professionals increased by 1,064 WTEs and the number of staff working in other patient and client care increased by 1,213 WTEs.

Finance

The HSE was allocated a budget of €21.6bn for 2023, an increase of approximately €1bn on the previous year. The capital budget allocated to the HSE in 2023 was €1,157m of which €140m was reserved specifically for ICT projects.