The document summarizes the key points made by Tony O'Brien, Director General of the Irish Health Service, at the 10th National Health Summit on reforms to the Irish health system. It outlines that the health service faces increasing costs and demands, and must achieve €600 million in savings in 2014. Key reforms discussed include establishing integrated models of care, workforce modernization under public agreements, and transforming healthcare delivery from an industrial model to one utilizing information technologies. The aim is to provide more efficient, higher quality care that is safer, timely and as close to home as possible.

1. 10th National Health Summit
Choices for our Health Service
Mr. Tony O’Brien
Director General of the Health Service
Wednesday 19th February 2014
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2. Irish Health Services
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Health & social services for 4.6m people
€13.6bn gross spend (includes Child & Family)
Almost 100,000 employees (largest employer in country)
550,000+ inpatient cases & 750,000 day cases
10m + home help hours
15m + GP consultations
• €600+m planned savings in 2014

3. Upward Pressure on Demand and Costs
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 Overall Affordability of Healthcare?

4. National Service Plan 2014
• Key areas are:
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Service Delivery
Quality and Patient Safety
Service Reforms
Financial Outlook and Challenges
• Financial Challenge include:
– From 2008, total reduction to HSE gross budget is
€3.92bn (26%) includes savings of 619m
– Expenditure reduction targets 2014
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5. Service Developments 2014
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6. Risks to Delivery of Service Plan
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7. Patient Safety & Quality

8. Open Disclosure

9. Aim of Reform
To help people remain healthy and to provide effective safe high quality
healthcare and personal social services to the people of Ireland
(Future Health, Nov 2012)

10. 3. Equal
Care
Reformed
Health
Service
A Single Tier UHI
System
2. Higher
Quality Care
Clinically Lead, Rigorous
Performance
Management
1. A New Model of
Care
Treatment at the Lowest Level
of Complexity that is Safe,
Timely, Efficient and as Close to
Home As Possible

11. Reforming Healthcare Services
• Structural, financial, service and health & wellbeing reform
• Develop an integrated portfolio of reform programmes
• New Directorate established – July 2013
• Sustained emphasis on quality and patient safety
− New Patient Safety Agency
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Integration of health and wellbeing
Integrated models of care
Performance assurance
Strategic human resource management
eHealth and Information and Communication Technology
Strategy
• Establishment of Child and Family Agency – 1st Jan 2014
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12. Transformation from Industrial Age Healthcare
to Information Age Healthcare
Industrial Age Healthcare
Information Age Healthcare
Individual Self-care
Person
Transformation
Through
Cost-Effective Use
of Information &
Communication
Technologies
Community
Primary
Secondary
Tertiary
Friends & Family
Community Networks
Professionals as Facilitators
Professionals as Partners
Professionals as Authorities
Source: Adapted from Malaysian Telemedicine Blueprint
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13. Challenges for Healthcare
Cost vs Quality
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14. Changing Role of Patients
Patient
ePatient
Passive Role
Active (engaged role Role
Information given
Seek out information (Internet)
Top down delivery
Partner in delivery
Paternalistic Medicine
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Participatory Medicine

15. Public Service Agreement
Haddington Road Agreement 2013-16
A central pillar to the overall economic strategy of
Government, with a focus on productivity, cost
extraction and reform
• Key Opportunities:
− Workforce restructuring
− Reviews of rosters, skill mix, productivity & staffing levels
− Reductions in overtime/allowances/agency staff spend
− Nursing/Midwifery Graduate Programme
− Support Staff Intern Scheme
− Grade rationalisation
− Increased use of redeployment
− Strengthening Performance Management
− Assurance Group established
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16. Medicines Management & Generic Prescribing
Statins:
SIMVASTATIN
PPI:
LANSOPRAZOLE
ACE inhibitor: RAMIPRIL
ARB:
CANDESARTAN

17. New Scorecard
QUALITY
Quality,
Access & Resources (to
include Finance):
The basis of the new
balanced scorecard
ACCESS
Safe,
high quality,
patient centred
services
RESOURCES
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18. Ultimately: Outcomes for All
Faster
Fairer
Access to
Hospitals
Free Access to GP
Care
Affordability
Improved
Health and
Well being
Improved
Quality
and Safety
More
People
Cared for
in their
Homes
Better
Management
of Chronic
Illness
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19. Conclusion
• Dual challenge of reducing costs while improving patient
outcomes
• Continued demographic pressures and increasing
demand
• Patient safety is paramount and a central theme of Health
Reform
− Although care costs, poor quality care costs more
• We will continue to establish:
– Integrated models of care across all services/care groups
– Workforce modernisation within the context of the Public
Service Agreements
– Reformed services to provide effective, safe high quality
health and personal social services to the population of
Ireland
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