Ms Mary Day:

I thank the chairperson and members for the opportunity to address the committee this morning. I am CEO of the Ireland East hospital group. I am joined by the clinical director for the Group, Mr. Kevin O'Malley.

The establishment of hospital groups provides a unique opportunity to deliver integrated models of care and to bring research and innovation to the core of the clinical service delivery model. The Ireland East hospital group, IEHG, was established in January 2015 and is the largest and most complex of the hospital groups. Comprising 11 hospitals, six of which are voluntary and the remaining five of which are statutory, the Ireland East hospital group spans eight counties and four community health organisations and has a gross annual expenditure of in excess of €1 billion.

The Ireland East hospital group's ambition is "to be the national leader in healthcare delivery, with a strong international reputation, improving the quality of healthcare and better patient outcomes through education, training, research and innovation for the 1.1 million people we serve". To achieve this ambition, we have developed a ten-point framework programme, which will see the IEHG established as an independent hospital group, with an academic health sciences centre as its core.

Over the past two years, the group has established a management team to run the largest hospital group; prioritised developing integrated pathways across the continuum of care between the acute, primary, community and continuing care services; focused on developing a robust quality and patient safety function to ensure high quality safe care is delivered; developed our first clinical academic directorate in cancer as a move towards an academic health sciences centre model; introduced an unscheduled care transformation programme to improve patient throughput in our emergency departments, EDs, and enhance patient experience; and created additional surgical and outpatient capacity in the group by ensuring model 2 hospitals carry out higher volumes of low acuity work, thereby freeing up capacity in the model 4 hospitals.

We now want to build on the positive start and make meaningful changes to the delivery of care in order that every patient within the IEHG can receive the same access to high quality safe care, regardless of where he or she lives. To develop and fulfil our ambition further, we need to have primary legislation which will enable the IEHG to become an independent hospital group with its own board operating under the HSE's commissioning arm and with fully accountability to the Oireachtas. Hospital groups, if properly constituted, will enable the acute hospital sector to integrate with the primary, continuing and community care sectors in a manner not previously achieved; ensure that we can meet the needs of the local population within a quality and safety framework that delivers high quality safe care; develop operating models that ensure smaller hospitals are aligned with academic teaching hospitals, thereby improving the quality of care to all our patients; optimise the use of resources, by ensuring care is delivered in the most appropriate location; and bring research and innovation to the core of service delivery, ensuring bench-to-bedside developments become a reality. Our link with University College Dublin is also vitally important to our work with generations of doctors, nurses and other health professionals who are graduates of UCD providing excellent services in our hospitals.

Patient care is at the centre of everything we do. To that end, the IEHG has developed a quality risk and patient safety directorate, which will develop a comprehensive risk management system which incorporates clinical and non-clinical risks. Another key element of our quality framework is to conduct a safety survey to enable us to assess comprehensively the practices and procedures behind the numbers.

A core objective of the IEHG is to develop an academic health sciences centre, where education and research contribute to patient care and well-being. Internationally, such centres have scored well ahead of non-academic centres for patient outcomes and safety and improved staff recruitment and retention.

In delivering this objective we have developed a clinical academic cancer care directorate, which allows us to combine the strength and scale of our clinical cancer services at the Mater and St Vincent's hospital along with the cutting edge research of UCD to enhance the care given to cancer patients, to improve their life expectancy, and to deepen our understanding of cancer. This will be the largest cancer care centre in the country, caring for more cancer patients than any other hospital group.

To meet the needs of the patients we serve, it is vital that primary care and acute hospitals work closely together. We have a GP on the group management team and we have endorsed the concept of local integrated care committees to improve the links between hospitals, community and primary care sectors. Such committees have already been established in Kilkenny, Wexford, Mullingar and Loughlinstown in Dublin, and work is under way in Navan.

Clinical integration with the communities we serve is also vital. The IEHG has a dedicated work programme on integration with primary, community, continuing and home care entities. The main aim of this is to ensure the needs of patients are aligned as seamlessly as possible across the continuum of care, with a special emphasis on managing the frail elderly patient pathway.

My opening statement is just a snapshot of who we are, what we do and what our ambitions are in the Ireland East hospital group. The written submission we made to the committee gives a much broader overview, including our work in unscheduled and scheduled care, genetics, human imaging and education and training.

I thank the committee for its time this morning. Mr. O'Malley and I would be happy to answer any questions the committee may have.