HSE underperforms in a number of areas

The HSE has admitted it is underperforming in areas such as emergency department (ED) trolley waits, the setting up of new primary care teams, and staff absenteeism.

In a new report from the HSE measuring its performance from January to June of this year against targets set in its 2008-2011 corporate plan, the HSE says in 23 of the 30 targets it is performing at a level of 70% or greater, but it is below par in its performance in the remaining areas.

On ED trolley waits, the analysis shows that only 13 out of 31 hospital A&Es are meeting the HSE's own six-hour target for waits.

The HSE report analyses the average time from registration to discharge from ED for people who are eventually admitted to hospital.

The figures show that  Beaumont, St James's  the Mercy in Cork, Loughlinstown, Blanchardstown, Our Lady of Lourdes in Drogheda, Galway University and Naas Hospitals are substantially in excess of the target waiting time.

The average A&E waiting time for admitted patients in Beaumont, the figures show, was inexcess of 24 hours.

The HSE report says delayed discharges are significant in two of the hospitals that have long waiting times for patients being admitted through A&E.

On staff absenteeism, the report shows that rates have dropped in the first six months of this year and now stand at 4.6%. The HSE says it intends to engage in "absence-preventing activities and strategies on a proactive basis."

On the setting up of the long-promised new primary care teams intended to offer more care to patients outside the hospital setting, the HSE says there are now 112 such teams operating across the country with a target of 210 to be up and running by the end of the year.

Primary care teams are listed as one of the areas requiring "focused attention".

The HSE report shows that the hospital service is not meeting the set target of having public patients making up 80% of patients being treated in hospitals. In June, the level of public versus private patients was around 76% to 24% when it should be 80% to 20%.

The report says the high volume of emergency work in hospitals limits the ability to reach the public/private targets. It points out that emergency admissions to hospitals have increased from 66.3% in June last year to 66.8% in June 2009.

It adds that it is worth noting that hospitals do not have control over the numbers of patients presenting as an emergency, nor can they control their decision on public/private status should these patients be admitted.

The report says non-emergency (elective) patient numbers have now dropped to only 33.2% of total patients in hospitals.

The report says the HSE is performing well in terms of symptomatic breast cancer services, following the reorganisation of these services.

On the HSE's value for money programme , the report states that under this heading, "net cost avoidance" of €249 million is projected for this year, with €484 million having been saved last year.

However, the HSE warns that there is now significantly reduced scope for further cost efficiencies in 2010.

"It will be extremely challenging for the system to maintain the previous year's cost reductions, and manage the rate of cost growth while delivering services within the resulting base," the report states.

The HSE's assessment of its performance shows that it scored well in areas such as childhood vaccination rates, reducing MRSA rates, and handling complaints.

It said other areas that needed working on included breastfeeding rates, caesarean section rates and disability assessments. Ireland has the lowest breastfeeding rate among 29 OECD countries.

It said there were also worrying trends on smoking rates among younger people. The report notes that the tobacco industry continues to attract around 50 new young smokers per day in Ireland.

The report says the HSEe is performing below par on surgical services for treating undescended testicles in boys.

The assessment report does not, however, contain performance measurement of outpatient and inpatient waiting lists or of patient safety data.

[Posted: Thu 29/10/2009]