Mr. Paul Reid:

I thank the committee for its invitation to discuss the implementation of Sláintecare, in particular the issue of regionalisation. I wish to provide the committee with a summary update on three of the areas that we are progressing in Sláintecare's implementation: RHAs; scheduled care; and the enhanced community care programme.

Since the last committee meeting on Sláintecare, the Department of Health and the HSE have continued to progress the implementation of RHAs actively. The Department of Children, Equality, Disability, Integration and Youth has also been involved in this work. The detailed system and RHA design and the associated implementation plan, which sets out the key enabling work streams, and their objectives, milestones, activities and risks are being developed between the HSE and the Department of Health. In addition to fortnightly meetings between the Department and the HSE, working groups have been established to examine clinical corporate governance and accountability; finance, including population-based resource allocation; digital and capital infrastructure; people and development; change, communications and culture; and programme co-ordination. Six different stakeholder engagements have already taken place, with further engagements planned. In July, there will be further workshops with a wide range of stakeholders across the system at national, regional and local levels. Before the end of July, regional workshops are planned for engaging with managers, clinicians and local leadership teams.

Tackling waiting lists is a key priority for the HSE and is included as one of six key priorities in the HSE Corporate Plan 2021-2024. The corporate plan commits to delivering significant reductions in waiting lists and waiting times, working towards achieving the following Sláintecare maximum waiting time targets by 2026: ten weeks for a first outpatient appointment; 12 weeks for an inpatient or day case procedure; ten weeks for a GI scope; and ten days for diagnostics. The 2022 waiting list action plan has been jointly developed by the Department, the HSE and the NTPF and is being overseen by a waiting list task force, which is co-chaired by Mr. Watt and me. The action plan sets out the following December 2022 maximum waiting time targets to ensure progress towards the Sláintecare targets: 98% of patients waiting for their first outpatient appointments will be seen within 18 months and 100% will be seen within 36 months; 98% of patients waiting for an inpatient or day case procedure will be treated within 12 months and 100% will be treated within 24 months; and 100% of patients waiting for GI scopes will be treated within 12 months.

The action plan is supported by dedicated funding of €350 million, including €150 million allocated to the NTPF and €200 million allocated to the HSE. The plan focuses on delivering significant additional activity in 2022 and building capacity within the system to address recurrent capacity gaps sustainably. The plan commits to delivering 100,000 additional outpatient department appointments, 28,000 additional inpatient or day case procedures, 8,000 additional GI scopes and 30,000 additional diagnostics. Detailed plans to deliver this activity have been developed.

Engagement continues across the delivery system, including with the NTPF, to identify all opportunities to deliver additional activity in 2022. The plan seeks to progress longer term reform in order to address sustainably the recurrent capacity gaps that were identified in 2021 through a comprehensive waiting list demand and capacity analysis. Significant planning has been undertaken to develop solutions and outline the requirements necessary to address the capacity gaps.

Investments in the healthcare budget for strategic reform initiatives such as enhanced community care are having a significant impact. The programme was allocated €240 million for the establishment of 96 CHNs, including 30 CSTs for older people and another 30 for people with chronic diseases, to provide integrated services for people nearer to home. To date, more than 2,000 staff have been recruited or are at an advanced stage of recruitment, with more than 1,700 additional posts to be recruited for in 2022. Eighty-one of the planned 96 CHNs, 21 of the CSTs for older persons and 11 chronic disease teams have been established to date.

From 2019 to 2022, an investment of €210 million has been made available through the GP agreement to support eHealth and other modernisation initiatives and the roll-out of chronic disease management, CDM, programme to more than 430,000 people. In early 2021, direct GP access to radiology services was implemented with five private providers, with approximately 140,000 radiology tests undertaken in 2021, which has assisted in reducing the demand on hospital services. More than 94,000 scans have been carried out up to May 2022. All of these developments in community services are being delivered with increased collaboration and partnership with voluntary providers.