Healthy Ireland: Health Service Reform and Models of Care

Dr. Stephanie O’Keeffe, National DirectorHealth and Wellbeing, HSE

October 9th 2014

Saolta University Health Care Group Conference

Overview

• Health Reform and Population Health

• Healthy Ireland

• Health Service Role and Priorities

• Saolta University Health Care Group leading the way…..

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Healthy Ireland:A Framework for Improved Health

& Wellbeing 2013-2025

• Improved health and wellbeing one of four pillars of reform in Future Health: A Strategic Framework for Reform of the Health Service 2012-2015

• Future Health and Healthy Ireland underline commitments at national level and service wide to reform our services and systems toward a renewed focus on chronic disease prevention and improved health and wellbeing

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Why: Health Check

•EU goal +2 years of healthy life expectancy & reduction in health inequalities•Life expectancy has improved but… obesity and predicted increases in chronic diseases and cancers stand in the way•Population Growth•Population Ageing +65s and +85s

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Health Check• Half of people over 50 have one chronic disease, 11%

have more than one (TILDA).• 20% to 40% increase expected in major chronic

diseases by 2020.• Three quarters of deaths in Ireland are due to three

chronic diseases – cancer, CVD and respiratory diseases, which are largely preventable.

• Death rates: social class gradient100-200% higher in lower SES. This pattern is true for cancers and CVD and markedly so for respiratory disease.

Health Check Trends

• Diet and nutrition• Smoking• Alcohol• Physical Activity• Hypertension• Mental wellbeing

+ Ageing population

꞊ Chronic disease ↑

Healthcare sustainability?

Systemic risks – systemic solutions

The approach: Expansion of policies and governance for health HIAP

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Healthy Ireland Goals

• Goal 1: Increase the proportion of people who are healthy at all stages of life  

• Goal 2: Reduce health inequalities 

• Goal 3: Protect the public from threats to health and wellbeing 

• Goal 4: Create an environment where every individual and sector of society can play their part in achieving a healthy Ireland

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Framework of Actions

•Governance and Policy

•Partnerships and Cross-Sectoral Working

•Empowering People and Communities

•Health and Health Reform

•Research and Evidence

•Monitoring, Reporting and Evaluation

Health Service Priorities in 2014:• Reform: Being accountable for ensuring the health

service plays its part in Health and Wellbeing agenda • Building workforce capacity for the prevention agenda

• National Integrated Clinical Strategy and Programmes will incorporate disease prevention, early detection and self care in new integrated models of care

• National model of self care for people with chronic conditions

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Health Service

•Publishing a 3 year Health Services implementation plan for Healthy Ireland with Cross-Divisional commitments

– Hospital Group plans– Community Healthcare Organisation/ISA plans– Specific actions to improve health and wellbeing among our staff– Address HIQA standards 4 .1: the health and wellbeing of service users

are promoted, protected and improved and Standard 1.9: service users are supported in maintaining and improving their own health and wellbeing

– Work toward a more robust set of performance indicators, aligned to national Outcomes Framework