Latest news with #Sláintecare
Euractiv
5 days ago
- 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
6 days ago
- 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
6 days ago
- 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.
Irish Independent
25-06-2025
- Health
- Irish Independent
Just one in six eligible for free GP card have availed of it, Health Minister to tell committee
The minister will make her first appearance before the committee to consider further revised estimates for the Department of Health in 2025. She will point out that that "through Medical Cards and GP Visit Cards about 2.3m people have access to free GP care. When the income thresholds were increased to the median income, we estimated 430,000 to be newly eligible. The take up has only been 72,500." She is saying there are different reasons for the lower uptake and is urging people who are eligible to apply for the GP visit card. She will also to point out how increased investment in the health service has not been matched by productivity levels in hospitals. "Over the last five years we have increased real expenditure in our hospitals by approximately 36pc above inflation,' she will say. "This includes an average increase of 18pc more staff on the ground. At the same time, we can see that activity in our hospitals - inpatients, day cases, outpatients and emergency department presentations - has increased on average 12pc over the same time period. "This shows activity on average has fallen behind investment. This average also masks considerable variation in performance. "For example, one of our model four hospitals only saw a 3pc increase in overall activity from a 36pc increase in workforce and a real expenditure increase of 42pc. "In contrast, another model four hospital saw a 22pc increase in overall activity from a 40pc increase in workforce and 46pc increase in real expenditure." The minister will say: "I have a higher expectation of performance in return for public investment because every cent invested must produce a result that responds to the demands we face. ADVERTISEMENT "This isn't about efficiency for the sake of metrics, though those are vital, this is about making everyone's life easier when they have to engage with the healthcare system. "This is about ensuring that when you need an appointment, you get it within the Sláintecare model." She will point to "unparalleled increases in investment over the last five years'. The five-day working week over seven days for hospital staff is a "key priority", she will say. "This is not only about consultants, many other staff in community and across hospitals are needed to operate our services on a seven-day basis. "This is a key reform goal for me, and I am delighted that there has been agreement between the HSE and all staff representatives on moving to working across seven days. This agreement means up to 10pc of staff, in addition to consultants, will be rostered over weekends. "I am now focused on ensuring that the HSE delivers these changes and the public can access the services they need at the time they need them." She will tell the committee that "a key area of focus for 2025 underpinning increased efficiency and performance is the digitisation of our services. "It is no exaggeration to say that staff have been trapped in a work environment of pen and paper for many years. "We are increasing our investment in digital health in 2025 by €100m."
Irish Examiner
18-06-2025
- Health
- Irish Examiner
Demand for GP visits to grow 30% in next 15 years, with extra 1,200 doctors needed, report finds
Demand for GP visits is expected to increase by as much as 30% in the next 15 years, with an extra 1,200 doctors needed to keep pace, new research has found. The Economic and Social Research Institute (ESRI) said healthcare reforms may reduce the pressure on hospital services in the medium term, but this will 'inevitably increase the demand for general practice service in the coming years'. 'However, the lack of nationally representative and accessible data on general practice presents a major challenge for effective capacity planning,' its report said. 'It remains unclear whether current measures will be sufficient to meet future demand.' Funded by the Department of Health, the ESRI was asked to research a range of scenarios around population growth and ageing, the pace of health ageing and policy reforms, and the impact all that would have on demand for general practitioners and general practice nurses. It found rising demand for GP services in the future would be largely driven by population growth and, to a lesser extent, the ageing population. Ireland's population is expected to increase from 5.3 million in 2023 to between 5.9 million and 6.3 million by 2040. Meanwhile, the share of the population under 25 is expected to fall, while the population over 50 will increase. While everyone uses GP services, their utilisation tends to increase with age. The ESRI estimated GP consultations would grow from 19.4 million in 2023 to between 23.9 million and 25.2 million by 2040, which is a rise of between 23% and 30%. This will mean between 943 and 1,211 new GPs will be needed across Ireland by 2040, relative to a headcount of 3,928 in 2023. Furthermore, an extra 761 to 868 general practice nurses will be needed. Dr Sheelagh Connolly, lead author of the report and associate research professor at the ESRI, said the findings offer policymakers 'evidence on the scale of workforce expansion needed to meet future demand'. She highlighted Sláintecare reforms as reorientating care towards primary and healthcare settings, such as extending GP visit cards to children under eight, but with the consequence of increasing demand on such services. 'There is already some evidence to suggest that general practice is struggling to meet existing demand,' the report said. 'The recent increase in training places for GPs — from 258 in 2022, to 285 in 2023 and 350 in 2024 — should help increase the number of GPs in the coming years.' However, it added the number of GPs would need to be regularly monitored over time to ensure supply keeps pace. Reacting to the research, minister for health Jennifer Carroll MacNeill said it provided 'valuable insights' into the demand for care from general practice for our growing and ageing population. 'It will inform the Government's efforts to collaborate with general practice to enhance its capacity as a core component of healthcare," she added.
