Mr. Paul Reid:

I thank the committee for the invitation to meet to discuss progress with the implementation of Sláintecare. The Chair has already introduced my colleagues so I will not do so again. Members will recall that I previously provided updates on the main elements of Sláintecare progress at the February meeting. As members will be aware, in addition to the mid-year report, an end-of-year progress report for 2021 has also been developed and we are close to finalising with the Department the Sláintecare action plan for 2022.

I would like to focus on the following aspects of Sláintecare progress today: the multi-annual waiting list plan; Regional Health Areas; enhancing community care programme; and the Sláintecare integration fund.

On multi-annual waiting lists, a critical objective of Sláintecare is to reduce waiting lists. Since the last update provided, the 2022 waiting list action plan was launched on 25 February. The plan allocates €350 million to the HSE and NTPF and details 45 actions to reduce and reform waiting lists. The immediate focus of the plan is on the delivery of activity to reduce active waiting lists for acute scheduled care by 18% this year, which would bring the number of people waiting to their lowest point in five years. In addition, the 2022 plan focuses on 15 high-volume inpatient and day-case procedures, including cataracts and hip and knee replacements, so that every person waiting over six months for one of these procedures, and who is clinically ready, will receive an offer of treatment.

The 2022 plan also lays the foundations for longer-term reforms in areas such as patient care pathways, key service reforms and data and information. This is the first year of a multi-annual programme of reform to achieve the Sláintecare targets whereby no person waits more than ten weeks for their first outpatient appointment and 12 weeks for their inpatient or day-case procedure. Consistent with this, each hospital group has been set a target that by December 2022, 98% of all patients on our waiting lists will wait less than 18 months for their first outpatient appointment and 12 months for their procedure.

Of course, it is important to note that there continues to be challenges in the area of scheduled care, as Mr. Watt noted in his opening statement, with the most recent surge in both ED attendance and Covid cases. We will continue to work closely with hospitals to ensure appropriate supports and plans are in place to deliver the 2022 waiting-time targets. We are also working closely with CHOs to tackle long community waiting lists. I will continue to brief members on progress in relation to these key areas.

Since the February update, we have continued to work with Departmental colleagues to take forward planning for the introduction of RHAs. The focus of this planning work has included detailing the vision and objectives for RHAs, and the identification and scoping of key implementation work streams. At this time, the work streams identified as part of the wider work programme are as follows: programme co-ordination; corporate and clinical governance and accountability; population-based resource allocation; finance; digital and capital infrastructure; people and development; and change, communications and culture.

In early March, a workshop was held involving the senior management teams from the HSE and the Departments of Health and Children, Equality, Disability, Integration and Youth to provide an update on the position with RHAs and to consider, scope and refine the key implementation work streams. Similar workshops are being arranged in the coming weeks for CHOs and hospital groups. The HSE board will also be playing a lead role in overseeing the RHA agenda as it progresses. A detailed implementation plan is being developed by the Department and the HSE with input from the RHA advisory group. This will be finalised in 2022. Transition to RHAs will take place during 2023 and, by quarter 1 of 2024, the expectation is that RHAs will be fully operational.

The developments under the enhanced community care programme, ECCP, continue at pace with 51 community health networks, 15 community specialist teams for older persons and four community specialist teams for chronic disease management now established. Some 21 community intervention teams are now operational, with national coverage secured. The GP diagnostics programme has facilitated 139,000 scans of various modalities in 2021 with a further 38,000 provided to the end of February 2022. Crucially, key leadership roles have been and are being recruited which include 84 network managers, 82 assistant directors of public health nursing, 35 GP leads, 52 operational leads for community specialist teams and 54 consultants. An individual population health profile has also been created for each of the 96 community health networks, containing standardised data on the demographics and health status of each community health network.

Members will recall that budget 2019 provided €20 million for the establishment of a ring-fenced Sláintecare integration fund to support service delivery which focuses on prevention, community care and integration of care across all health and social care settings. This fund supported 123 projects and over 100 projects have now been mainstreamed into the healthcare system. Overall, these projects have resulted in over 15,000 reduced referrals to scheduled care, more than 19,000 acute inpatient bed days avoided, and more than 8,000 patients removed from waiting lists.

My commitment, and that of my colleagues and members of the HSE board, to Sláintecare reform is clear. This was demonstrated over the past couple of years whereby, despite major challenges caused by the pandemic and the cyberattack, significant Sláintecare reform and innovation was delivered across our health and social services as outlined in the mid-year and end-of-year progress reports. I look forward to the publication of the Sláintecare action plan 2022 so that we can continue to report on and monitor progress of the reform programme. As we progress and report on Sláintecare initiatives, we are hopeful that we will build trust and confidence in the Sláintecare programme of reform itself so that it is seen s delivering upon promised reform and improvements to Ireland’s health and social care services.