THE HEALTH Service Executive (HSE) is to review employment levels for clerical/administrative staff as well as nurses and put in place new work practices for laboratory personnel as part of a revised plan for the implementation of the Croke Park agreement.
The revised plan for the health service, which was submitted to the Department of Finance in recent days, also states that the HSE wants significant reforms to the operation of the ambulance service including the elimination of existing restrictive practices.
It also reveals that as part of changes to mental health services, 42 beds at St Dympna’s hospital in Carlow and St Canice’s hospital in Kilkenny will be closed with the relocation of all residents to community facilities.
The Government has asked all departments to draw up revised action plans for the implementation of the Croke Park deal on public service pay and reform in the light of the Budget last month and spending cuts for this year.
The revised plans are expected to be considered by the national body charged with the implementation of the agreement at a meeting later this week.
Large parts of the revised action plan for the health service is identical to the commitments set out in an earlier document drawn up last October. However there is a new section on clinical care programmes targeted for this year in areas such as acute medicine, emergency medicine, critical care, elective surgery, outpatients and chronic diseases.
The plan states, for example, that the number of new dermatology and neurology outpatient attendances should increase by 30 per cent this year. It also says a new emergency medicine programme will aim to improve safety and quality of patient care and waiting times.
“This will be achieved through the use of emergency care networks in a new national emergency care system and the development of clinical guidelines for the top 20 emergency conditions, eg pain management, abdominal emergencies, head injuries, etc.”
Among the targets for chronic diseases is to reduce asthma deaths by 100 lives over five years and 500 lives over 10 years by establishing a national network for guideline-based asthma care.
The action plan also says “appropriate escalation measures” will be adopted to move patients to wards when emergency departments experience an increase in demand.
In a letter to the Department of Finance setting out the plan, the secretary general of the Department of Health, Michael Scanlan, said the real value of the agreement would be the extent to which the HSE would be able “to continue to provide the required quantum and quality of services with greatly reduced resources and, thus, at much lower cost”.
The revised plan says the HSE wants new working arrangements for medical laboratory staff to begin from the start of next month. It says the initial focus of the medical laboratory reforms will be on the requirement for an extended working day/week and changes to the existing call system.
It says a review of radiology diagnostic services will focus on increasing output with no additional cost by extending the working day and increasing efficiency within the existing day.
“This will need to be achieved by the introduction of more efficient work practices, more efficient scheduling and reporting of radiology diagnostics, reviewing the ratio of staff required and same-day diagnostic reporting for acute medicine.”
The document says the planned review of clerical administration staffing levels, which will examine the current management and administrative structures, will be considered in the light of the numbers who left under the recent redundancy programme.
“Management will also be reviewing existing nurse staffing levels,” according to the plan.
