Latest news with #Sláintecare
Irish Examiner
3 days ago
- Health
- Irish Examiner
HSE's most vulnerable patients cared for by temporary staff as agency spend surges to €726m
The most vulnerable patients in the HSE — including those with a disability, older people, and those using mental health services — are increasingly being cared for by temporary agency staff, startling new figures show. Staff shortages are so acute that the HSE has warned that at times it is unable to fill vacancies even with temporary staff as agencies are struggling to recruit health workers. A shortage of accommodation is among the reasons blamed. The figures reveal for the first time which patients are being left to the care of temporary staff amid criticism of the high spend on agencies — which came to over €726m last year alone. Most agency spend is on hospitals and services for older people Hospital spending on agency staff topped the table at €304.7m last year, followed by the €118.9m spent on older people's services. A further €106.3m was spent on agency staff for mental health services and €77.9m in disability services. Data for 2021 to May 2025 shows in each of these critical areas, the spending increased year on year. The spending on agency staff for older people's services almost doubled from €64.5m to €118.9m last year. Despite pledges to rein this in, this sector appears to be on track for a new record with some €52.1m spent already by May. Mental health and disability services People using mental health or disability services face long waiting lists as demand grows and these figures indicate temporary staff are being used to plug those gaps. Four years ago, disability services spent €40m on agency staff, last year it had jumped to €77.9m and, by May this year €37.2m was already spent. In 2021, the mental health division spent €71.5m on temporary workers. Last year it was €106.3m, and by May it had reached €48.5m. Agency bills are also ballooning in those areas which are expanding under Sláintecare plans to move healthcare out of hospitals to local communities: The Health and Wellbeing division, for example, spent €34.8m four years ago on agency staff, but last year the bill hit €324.3m and by May it stood at €106m. Even agencies struggle to hire staff HSE corporate finance general manager Sarah Anderson said hiring and keeping 'key staff is a constant challenge and impacts adversely on the ability to maintain safe and effective services'. She warned: 'At times the HSE have been unable to fill a vacancy even via agency. The agencies have indicated that they are experiencing difficulty in recruiting themselves due to a lack of availability and also accommodation availability and costs. There is a global health workforce challenge, she said, with agencies also covering sick leave, maternity leave, or filling-in during recruitment. The figures were released to Sinn Féin health spokesman David Cullinane. 'Wasteful over-reliance on agency spending has long been an area identified for savings, yet we are still seeing year-on-year increases despite the Government's health productivity and savings taskforce,' he said. Pay and numbers strategy 'This increase is coming at the same time and, in my view, is directly related to the Government's arbitrary recruitment limits under the pay and numbers strategy.' This sets limits on staffing numbers and costs. It has been much criticised by health unions. Mr Cullinane warned: 'These staff are needed to provide essential services but they cannot be recruited directly, so the HSE is paying a premium price for agency workers instead.' He called for 'an ambitious and realistic workforce plan', saying 'strict targets to significantly reduce runaway agency spending' are also needed. Sinn Féin will propose this in an alternative budget, he added, describing the taskforce and strategy as 'sticking plaster solutions'.
Irish Examiner
07-07-2025
- Health
- Irish Examiner
Children waiting up to 13 years for primary care assessment
Children have been waiting as long as 13 years for a primary care assessment within the HSE, as new figures throw a spotlight on just how long waiting lists can go. Previously, the HSE had bracketed all children who had been waiting for longer than one or two years into one overall cohort when detailing the length of time that they were waiting. The new figures, delivered to Social Democrats TD for East Cork Liam Quaide in response to parliamentary questions, show that close to 19,000 children aged up to 17 have been waiting for longer than two years for an initial psychology, occupational therapy (OT), or physiotherapy assessment. For the first time clarity is given as to just how long waiting lists in some parts of the country have extended to, including: A child waiting 13.6 years for a psychology appointment in Dublin North West A patient waiting 9.7 years for an occupational therapy assessment in Dublin North A wait of 8.7 years for an OT assessment in Meath The figures show that of the four disciplines in question psychology is the worst affected. Mr Quaide, a clinical psychologist, said that the crisis in primary care services has 'flown almost entirely under the radar', in contrast with the scrutiny applied to similar issues seen with the HSE's network of Children's Disability Network Teams (CDNTs). 'The core of this crisis is a failure by successive governments to invest in staff over many years. It stems from a political ideology that views the staffing of our essential services purely as a cost, not as an investment,' he said. The HSE said it "recognises the need to address waiting lists, and this is reflected in our commitment to developing the provision of community services through the newly established Health Regions, in line with Sláintecare". A spokesperson said: "This involves a significant restructuring in how services are delivered to ensure that integrated care is provided equitably and efficiently for those who need it. "In 2023, the rate of referral for therapy services grew by 7% nationally, and increased by a further 1% in 2024. The increased referral rate is particularly notable in physiotherapy, psychology and audiology. "Numbers seen in 2024 are comparable with 2023, however, the rate of referral, remains a challenge Children's services by their nature are more complex in presentation and require more attendance compared to services for adults. "It should be noted that when children transfer from specialist disability services to primary care, waiting time is calculated from the date of the original referral. Read More
Euractiv
27-06-2025
- Health
- Euractiv
Ireland's Sláintecare health reform risks mission creep, needs clearer vision
'Sláintecare can mean almost whatever we want it to mean,' said Professor Steve Thomas of Trinity College Dublin. 'There's a danger of mission creep,' he warned. Thomas, who helped draft the original Sláintecare report, said the reform risks losing coherence. At a healthcare policy conference on 25 June, Prof. Thomas called for a clearer vision of universal healthcare. 'We're still debating eligibility and entitlement eight years on,' he said. 'We need to pin down as quickly as possible our vision.' Sláintecare, Ireland's national healthcare reform programme, was launched in 2017 in response to long-standing issues in the country's health system. It aims to create a universal, single-tier health service where access to care is based on medical need rather than ability to pay. While digital health transformation is gathering pace, policymakers, clinicians and economists think the reforms must be more ambitious. They agree that digital advances must deliver better patient outcomes and improved value for money through a more robustly connected, data-driven healthcare system, but the system remains slow to change and fundamentally dysfunctional. Prof. Thomas urged policymakers to leverage crises as catalysts for reform. 'COVID was quite helpful in getting extra resources into the health system,' he said. 'But we must protect our workforce. We're expecting a lot from them.' Sláintecare, the country's flagship universal healthcare reform programme, still lacks a unifying vision in a shifting economic and digital landscape. The path forward is fraught with challenges, including fragmented systems, workforce shortages and demoralisation, and a lack of public engagement. From analogue to AI Ricardo Sampaio Paco, Service Improvement Lead at St James's Hospital, offered a compelling case study of how digital tools can transform hospital operations. 'At St James's Hospital, 80% of the discharges in the past were occurring after three in the afternoon,' he said. This bottleneck created a 'ripple effect' that delayed admissions and strained emergency departments. To address this, the hospital implemented a visual management system that digitised patient flow data and enabled real-time decision-making. 'It's now possible to see … for every patient what their estimated discharge is, the clinical criteria for discharge, the discharge destination and required onward care,' Paco explained. 'You can have this within five seconds after you get in contact with the screen.' The results were striking: a sharp reduction in late discharges, increased surgical throughput, and improved frailty assessments. 'We're now the best hospital for hip fracture care in Ireland,' Paco said, citing a leap from 7% to 70% compliance with national standards. General practice, the digital bedrock While hospitals are making strides, Dr Mike O'Callaghan, Clinical Lead at the Irish College of GPs, stressed that general practice remains the 'foundational' layer of Ireland's digital health ecosystem. 'General practice is where a lot of the volume happens,' he said, noting that GPs handle over 21.5 million consultations annually. 'Continuity of care is continuity of records and vice versa.' O'Callaghan warned against creating new digital silos. 'If everybody's in charge and there's patient information everywhere, then no one is in charge,' he said. 'We need to have a central repository of all this stuff so that we're all on the same page - including the patients.' He also highlighted the importance of maintaining and curating electronic medical records. 'It's not good enough to build a big, shiny system. You need to make sure that it's being maintained, because that's how patients are kept safe.' Telemedicine 2.0 Dr Victor Vicens, Chief Medical Officer at Abi Global Health, argued that traditional telemedicine has failed to deliver on its promise. 'Basically, what it did was put a camera in front of a doctor,' he said. 'The basic unit, which was doctor time, was not changed.' Abi Global Health is using AI to triage cases, allocate healthcare professionals, and monitor consultation quality. 'Next-generation telemedicine is omnichannel, on-demand and up to three times less costly,' Vicens said. 'This leads to better financial results and better health outcomes.' The economist's view Dr Jonathan Briody, a health economist at the Royal College of Surgeons in Ireland, framed digital health as a fiscal imperative. 'Digital health is not an optional thing anymore,' he said. 'It's integral to modern service delivery and group patient outcomes.' He pointed to the success of virtual wards, such as the one at St Vincent's Hospital, which has treated over 500 patients and saved nearly 4,000 bed days. 'Each hospital bed that we free by a safe virtual consultation provides another bed for someone who needs it,' he said. With the Health Service Executive's 2025 budget reaching €27 billion, Briody emphasised the shift toward value-based healthcare. 'We're measuring success not by the euro spent or services provided, but by the outcomes achieved per euro.' Trust, data and the public Despite the momentum, speakers acknowledged that public trust and digital literacy remain significant barriers. 'Patients are shocked when I can't see their medicines,' said O'Callaghan, referring to the lack of interoperability between GP and out-of-hours systems. 'Patients actually think our digital infrastructure is more cooked than it is.' Briody added that many patients are unaware they own their health data. 'They're shocked to learn that their data belongs to them. We're just mining it for them.' Vicens argued that public confidence hinges on transparency and evidence. 'Getting more confidence from the systems relies on doing what science has always done – publishing, providing reliable results, and reliable sources of evidence.' Inclusion and equity Digital exclusion was another recurring theme, particularly for older people and refugees. 'Six in ten older people in Ireland are not comfortable online,' said Vicky Harris, Head of Programmes at Age Action. 'Digital First, not Digital Only. Ensure quality services are maintained offline as well as online.' Dr Hanna Balytska, a Ukrainian doctor now working in Limerick, described how language barriers and outdated communication methods - such as postal letters - led to missed appointments among refugees. 'They always keep their telephone number. They always keep their email,' she said. 'So that's why even in English, if we send something in English, they can translate it.' Community care, the next frontier Margaret Curran, General Manager at Caredoc, showcased the SMILE programme, which uses wearable devices and remote monitoring to manage chronic conditions. 'It showed a 41% reduction in ED attendances, 44% reduction in bed night stays, and 87% reduction in unscheduled urgent GP visits,' she said. Curran emphasised the programme's cost-effectiveness. 'To manage 600 high-need patients, we have 4.5 whole-time equivalent triage nurses,' she said. 'It really pays for itself very early on.' Michelle O'Hagan, a community pharmacist in Tallaght, called for greater integration of pharmacy services. 'We are the cornerstone of healthcare,' she said. 'We can offer more clinical skills and reduce hospital admissions.' Ireland's digital health transformation is at a critical juncture. The tools, talent and political will are increasingly in place. But to deliver on the promise of Sláintecare, better care, better access, and better value, policymakers must ensure that digital innovation is inclusive, coherent, and grounded in the lived realities of patients and providers alike. The foundation of the new health era in Ireland has to be a highly effective, data-driven system. Without it, an ageing population and chronic disease will drain and break Ireland's capacity to care for its citizens, damaging the economy and democracy. By Brian Maguire
RTÉ News
27-06-2025
- Health
- RTÉ News
31 enforcement actions issued to safeguard mental health patients
Thirty-one enforcement actions were issued last year to safeguard mental health patients and residents in 20 centres nationwide. The Mental Health Commission's Annual Report for 2024 highlighted deficiencies in some Health Service Executive facilities that inspectors say must be addressed by the executive's leadership. ''Closer attention by the HSE to underperforming approved centres would transform the national picture," said Mental Health Commission CEO John Farrelly. In 2024, overall compliance across HSE-funded adult centres was just under 81%, while independently run adult centres achieved 88.5% compliance. There was an increase in the number of high and critical non-compliances in 2024 compared to previous years. 366 non-compliances were recorded in total with critical non-compliances concentrated in a few HSE-approved centres. Six facilities achieved 100% compliance including Aidan's Residential Healthcare Unit; Ashlin Centre; Carraig Mor Centre; Grangemore Ward, St Otteran's Hospital; and St Patrick's University Hospital. Those achieving 70% overall compliance or below with regulations include Acute Psychiatric Unit, Tallaght University Hospital (70%); Units 2, 3, 4 and Unit 8 (Floor 2), St Stephen's Hospital, Cork (66.67%); Department of Psychiatry Letterkenny University Hospital (63.33%); Elm Mount Unit, St Vincent's University Hospital (62.07%); Acute Mental Health Unit, Cork University Hospital (60%); and the Central Mental Hospital, Portrane (56.67%). Examples of non-compliances may include lapses in individualised care planning, risk management, staffing, and premises. The HSE welcomed the publication of the Mental Health Commission (MHC) Annual Report. It acknowledged that, in some areas, compliance with regulations for premises, staffing, risk management and care planning remain areas of concern. As part of Sláintecare, the HSE said that a new regional structure will improve how services are run in each area and provide a consistent quality of care across the country. The HSE budget for mental health for 2025 is €1.458bn, 5.4% of the overall HSE budget this year. Restrictive practices are also declining in favour of a more rights-based approach for mental health patients and residents. "The decline in the use of coercive and restrictive practices represents one of the most notable human rights advances in mental health care in Ireland in recent times," said Inspector Professor Jim Lucey. "These advances demonstrate how regulation can drive important human rights improvements and result in key behavioural change in the way services are delivered." The Mental Health Commission is an independent statutory body that aims to foster and promote high standards of care and good practice in the delivery of mental health services. It also ensures that the interests of those involuntarily admitted are protected under the Mental Health Act 2001.
RTÉ News
26-06-2025
- Health
- RTÉ News
31 enforcement actions taken to safeguard mental health patients
31 enforcement actions were issued last year to safeguard mental health patients and residents in 20 centres nationwide. The Mental Health Commission's Annual Report for 2024 highlighted deficiencies in some HSE facilities that inspectors say must be addressed by the Executive's leadership. ''Closer attention by the HSE to underperforming approved centres would transform the national picture," said the Chief Executive of the Mental Health Commission, John Farrelly. In 2024, overall compliance across HSE-funded adult centres was just under 81%, while independently run adult centres achieved 88.5% compliance. There was an increase in the number of high and critical non-compliances in 2024 compared to previous years. 366 non-compliances were recorded in total with critical non-compliances concentrated in a few HSE-approved centres. Six facilities achieved 100% compliance including Aidan's Residential Healthcare Unit; Ashlin Centre; Carraig Mor Centre; Grangemore Ward, St Otteran's Hospital; and St Patrick's University Hospital. Those achieving 70% overall compliance or below with regulations include Acute Psychiatric Unit, Tallaght Hospital (70%); Units 2, 3, 4 and Unit 8 (Floor 2), St Stephen's Hospital, Cork (66.67%); Dept of Psychiatry, Letterkenny University Hospital (63.33%); Elm Mount Unit, St Vincent's University Hospital (62.07%); Acute Mental Health Unit, Cork University Hospital (60%); and the Central Mental Hospital, Portrane (56.67%). Examples of non-compliances may include lapses in individualised care planning, risk management, staffing, and premises. The HSE welcomed the publication of the Mental Health Commission (MHC) Annual Report. It acknowledged that, in some areas, compliance with regulations for premises, staffing, risk management and care planning remain areas of concern. As part of Sláintecare, the HSE said that a new regional structure will improve how services are run in each area and provide a consistent quality of care across the country. The HSE budget for mental health for 2025 is €1.458bn, 5.4% of the overall HSE budget this year. Restrictive practices are also declining in favour of a more rights-based approach for mental health patients and residents. "The decline in the use of coercive and restrictive practices represents one of the most notable human rights advances in mental health care in Ireland in recent times," said Inspector Lucey. "These advances demonstrate how regulation can drive important human rights improvements and result in key behavioural change in the way services are delivered." The Mental Health Commission is an independent statutory body that aims to foster and promote high standards of care and good practice in the delivery of mental health services. It also ensures that the interests of those involuntarily admitted are protected under the Mental Health Act 2001.
