Mr. Paul Reid:

I thank the committee for the invitation to discuss a range of Sláintecare programmes, and the issue of recruitment, retention and staff training, including the National Ambulance Service. The Chair has introduced my colleagues in the room and those participating by video link so in the interests of time, I will not do so again. Beginning with the enhanced community care programme, its objective in line with Sláintecare, is to deliver increased levels of healthcare locally with service delivery reoriented towards general practice, primary care and community-based services. The programme has been allocated €240 million for the establishment of 96 community health networks, 30 community specialist teams for older people and people with chronic diseases, to provide integrated services for people nearer to their homes. To date 2,300 staff have either been recruited or are at advanced stage of recruitment. A total of 90 of the planned 96 community health networks, 21 of the community specialist teams for older persons and 17 chronic disease specialist teams have already been established. National coverage for the 21 community intervention teams has been achieved and a volunteer-type model in collaboration with ALONE is being rolled out, with 6,000 people now supported through this coordinated support mechanism.

A sum of €25 million has been provided to deliver increased access to diagnostics for GPs, with 160,000 additional tests provided this year to date. On the regional health areas, the HSE is continuing to take forward this key reform programme, working closely with the Department. As outlined by Mr. Watt, phase one of regional health areas implementation is focused on high-level planning and design, in particular the service delivery model for the health and social care system and the organisational arrangements needed to deliver integrated care models. Comprehensive communication and engagement processes are being progressed, including in recent weeks and as recently as yesterday. Meetings continue with staff and with the voluntary dialogue forum and six major regional health events across community health organisation, CHO, hospital group staffs and other stakeholders throughout the country in Cork, Limerick, Sligo, Kilkenny, Tullamore and Dublin.

Addressing waiting lists is a key priority for the HSE. Hospital groups have been supported to deliver additional in-year activity in 2022, with non-recurrent funding provided to deliver additional outpatient appointments, additional inpatient day-case procedures and additional scopes and diagnostics. Additional longer term investment proposals have been submitted to the Department to support the implementation of 37 modernised scheduled care pathways and a number of hospital group priority investments to address recurring capacity gaps. In the year to date the number of long waiting patients in outpatients has reduced by 19%, inpatients and day cases by 12%, and GI scopes by 65%. Securing further progress on waiting list and waiting times will be a key priority for the HSE for the remainder of this year and beyond.

I will move on to emergency departments and our winter plan. We continue to face significant levels of demand for unscheduled care services. This year to date total emergency department attendances have increased by more than 5% compared to the same period in 2019, with attendances for outpatients aged 75 years and older increasing by 13%. Emergency admissions have also increased, in particular for the over-75s. The HSE is working very closely with the Department of Health to prepare for the winter plan 2022-23. Key areas of focus will be enhancing the local injury units; overtime for staff to support out-of-hours services; transitional care funding; aids and appliances; complex packages of care; utilising private capacity; enhanced nurse staffing in emergency departments; enhanced consultant and registrar staffing in emergency departments; seasonal vaccinations; and communications to support public awareness.

Key areas of focus will be enhancing the local injury units, overtime for staff to support out-of-hours services, transitional care funding, aids and appliances, complex packages of care, utilising private capacity, enhanced nurse staffing in emergency departments, enhanced consultant and registrar staffing in emergency departments, seasonal vaccinations and communications to support public awareness.

On recruitment, retention and training, an area in which the committee is particularly interested, the HSE is working on a range of actions to ensure the effectiveness of our recruitment efforts. Short-term actions are focused on hard-to-fill posts, including recruitment and retention of Irish trained graduates, extended international recruitment campaigns, an easy-to-use, streamlined application process, widening of the skills list and overseas relocation packages. Medium to longer term actions are focused on increasing domestic supply and working towards greater self-sufficiency. In the year to date, HSE staffing levels have increased by some 2,700 whole-time equivalents. In the period since the beginning of 2020, the HSE workforce has grown by more than 15,000 staff.

As the largest employer in the State, the HSE has an extensive and broad offering of training and development programmes delivered both nationally and locally. These programmes are tailored for both clinical and non-clinical staff. Nationally there are over 300 programmes available via HSeLanD. A further 410 are available under leadership learning and talent management programmes and further programmes are delivered by the HSE leadership academy. There is also a range of profession-specific programmes delivered across the country.

The National Ambulance Service college delivers training to staff through education and competency assurance officers, both within the college and across the service. Sixty-two new paramedics qualified from the National Ambulance Service college in August 2022. The National Ambulance Service continues to actively recruit new staff throughout the year and in March 2022 launched a rolling advertising campaign for qualified paramedics, student paramedics and intermediate care operatives. To date, this has secured 161 new recruits.

The processing of the pandemic special recognition payment continues to receive priority across all hospitals and community services. Some 123,000 employees have received the payment, 85,000 of whom are in HSE statutory organisations and 38,000 in section 38 organisations. The HSE is working with the Department of Health to take forward the payment of recognition awards to staff working in other organisations included within the organisation types covered by the Government decision.