The COO, Yvonne O Neill, Orla Treacy and Liam Woods joined meeting at 4.00pm
The Performance Profiles and Operational Services Reports for September and October 2021 and the OSR Dashboard Project Report was circulated to the Committee prior to the meeting for their review. The Performance Profile provides updates on key performance areas across the four domains of the National Scorecard for Community Healthcare, Acute Hospitals and National Services, Quality and Patient Safety and Finance and Human Resources and the Operational Service Report 2021 (OSR) provides the results of the performance of Healthcare Services based on expected levels of activity/targets as per National Service Plan 2021.
The COO informed the Committee that in the short term, it is likely that challenges arising from winter and the 4th wave of the pandemic will impact on performance and there is also capacity challenges in both the public and private sector. It was noted that for the remainder of 2021, there will be ongoing efforts made to prioritise services and redeploy staff to COVID-19 related work services, and vaccination programmes (Flu, COVID-19 primary vaccination and booster doses). It was further noted that there will likely be ongoing COVID-related staff absences, including in relation to Long Covid.
The National Director Community Operations provided an update on the performance of Community Services. She noted that a key lesson learnt from the cyber-attack has been the vulnerability of the data collection / performance-reporting process in Community services. This has highlighted the requirement for the proposed Integrated Community Case Management System (ICCMS) which has been included in the National Service Plan for 2022.
The Committee considered the other challenges in Community Services including the backlogs of care caused in part by patients delaying seeking treatment over the course of the pandemic and the increase in waiting lists as a result of staff being redeployed as part of the pandemic response.
The National Director Community Operations reported that Community Intervention Team referrals, physiotherapy access within 52 weeks, access to Palliative Inpatient Beds and Community Adult Mental Health Service referrals within 12 weeks are all performing better than their expected target for 2021. In relation to the Children’s Disability Networks (CDN), it was noted that 85 CDNs have been established across each of the nine CHOs to improve access to services in the Disability sector. It is planned that the remaining six will be in place by year end.
The National Director Acute Operations provided an update on the performance in acute hospital services. He reported that Emergency Department attendances have risen. Factors contributing to the increase in ED attendances include the impact on GPs of their participation in vaccination programmes and of the gradual return of patients to EDs as lockdown measures had eased and vaccination levels increased. The Committee requested detail on the higher numbers attending ED, including how much of this increase is Covid-related and how much is non-Covid related.
The Committee noted that NCCP is reporting an increase in referrals for cancer services especially in relation to breast, prostate and lung cancer cases and this increase compounded by existing backlogs is having an impact on performance against NSP targets with some locations being below targets. The COO informed the Committee that improvement plans are in place to address these performance issues on Cancer services also noting there has a been improvement in service at UL and University Hospital Waterford.
The number of urgent Colonoscopy breaches is down as the waiting list action plan is being successfully implemented across hospital groups and improvements have been identified in service performance in surgical and emergency medical re-admission within 30 days of discharge and Ambulance response time and turnaround delays escalated within 60 minutes.
The Committee discussed the Child Health Developmental Assessment Performance. It was noted that to assist with performance, administrative staff have been redeployed to assist and support Public Health Nurses (PHNs), targeted recruitment of PHNs required to address the increased demand for public health nursing services and an increase in the number of places for PHN training.
The Committee discussed the implementation of the Winter Plan and the key areas of focus aimed at enhancing community capacity, decreasing acute hospital demand through the prioritisation of Primary Care and Community Services and advancing the goals of Sláintecare as well as mitigating the impact of COVID-19. The COO agreed to provide a summary Winter Plan Implementation update report to the Committee for consideration at their next meeting.
It was noted that as part of the HSE Access to Care Plan the HSE has put a procurement framework in place to allow Acute Services to purchase procedures from private providers. The Committee discussed projections for the future use of private capacity in response to the COVID-19 Omicron variant. It was noted that the Service Plan has Access to Care funding that can be used to contribute to tackling increased Covid-19 related demands.
The update report in relation to the OSR dashboard project circulated prior to the meeting noted that phase 2 has been extended and work was ongoing to finalise the dashboard.