Northern Ireland is on the right path to developing a health and social care service which will be sustainable into the future.
That was the central message from Health Minister Edwin Poots today as he briefed MLAs on progress in taking forward transformation in health and social care.
During an extensive statement to the Assembly entitled ‘Taking Forward Transformation’, Mr Poots told members of measures being employed to tackle the challenges facing health and social care.
The Minister told MLAs: “We have a growing and ageing population, a growth in chronic conditions, a growth in demand, and an over-reliance on hospital beds. All of this is set against a backdrop of economic and financial constraint. Given the challenges ahead, the way we work now is not going to work well in the future. This is not a criticism – it is a statement of fact. That is why I want to take this opportunity today to report on what we said we would do, what we have done, and what we are going to do.”
During the course of his broad-ranging statement, the Minister updated members on the latest developments right across the HSC including Transforming Your Care (TYC), Connected Health, finances, performance developments and the initiation of public facing accountability meetings.
He told MLAs: “Throughout the transformation process it is essential that we hold true to the core principles of the NHS. The principles are that health services are generally free at the point of delivery, based on individual need, not ability to pay; funded by taxation; and are available without prior restriction on which cost-effective treatments or therapies individuals should receive. Thus the best available cost effective services will be provided for all citizens. These principles remain a fixed point in the transformation process.”
The Minister told Assembly members that many financial challenges remain. He said: “My Department, the Health and Social Care Board (HSCB) and the Trusts have been working closely to identify opportunities for delivering both cash-releasing and productivity improvements. Some £139million of saving opportunities have been identified at this stage and these monies are being retargeted to those areas in health and social care where priority is greatest.
“However, this still leaves a significant funding gap. While I am committed to identifying and implementing saving opportunities, this must not be at the cost of quality of services. I have therefore made a bid in this year’s June Monitoring Round for £55.2million including £28million for Transitional Funding to support Transforming Your Care and savings initiatives.”
£26million of this bid was for elective care to improve waiting times in hospitals.
The Minister said that TYC is still the primary tool in delivering the change required to making Health and Social Care sustainable. He highlighted the work that has been done to form Integrated Care Partnerships (ICPs) and to develop new health centres in Newry and Lisburn which allow easier access to services under one roof.
He said: “ICPs are looking to improve quality of care, access to care and pathway redesign so as to improve outcomes for those most in need. They will help keep patients out of hospital who do not need to be there and help to ensure patients conditions are managed better locally. The health centres are exciting developments which will complement the provision of existing centres such as those in Banbridge, Portadown and Holywood Arches.”
Turning to collaboration with the community and voluntary sector, the Minister told the Assembly that £250,000 is being invested in a partnership with Marie Curie into Delivering Choice Programme which is a whole system approach to the design and delivery of palliative care.
The Minister then briefed Assembly members on learning disabilities saying that evidence from engagement shows that day opportunities and alternatives to traditional day care provision are increasingly important to people with a learning disability.
He went on to say: “The HSCB is reviewing how changes to day opportunities and day centres for those with learning disabilities will be implemented across the region. This will ensure that there is a consistent regional framework, and full and meaningful engagement with clients, and their families and carers, and with staff. Services would then be designed locally within this framework. It is estimated that the programme for redevelopment of day services and day opportunities may take up to five years to complete in some areas.”
On residential care, the Minister said: “I expect all future Trust proposals to be part of the new HSC Board oversight arrangements, yet with local consultation and engagement as part of the decision making processes. I want to assure Members that the future of statutory residential care homes will be considered on a case by case basis, recognising that we must do what is in the best interests of the current residents.”
On acute services, Mr Poots explained how GPs can arrange for ill patients to be admitted to hospital directly and thus avoid the need for vulnerable patients to be admitted through Emergency Departments. He spoke of the work being carried out by the Trusts, including the Ambulance Service, to avoid unnecessary hospital stays.
He also said he has approved bridging funding of £18million to ensure that Trusts have sufficient time to bring in new working models of care under wider acute service reconfiguration.
Addressing the issue of performance the Minister noted that there had been decreases in the number of people waiting for outpatient appointments but added: “While the majority of people attending hospital receive a safe and effective service, no-one can deny that the hospital system is under pressure.”
The Minister restated his belief that the services must be transparent and accountable and that is why he had organised the first Public Facing Accountability meeting with the Northern Ireland Ambulance Service for this evening (Tuesday).
During his comprehensive statement, Mr Poots told MLAs that another £1million has been invested in memory services after a similar amount was invested last year.
He highlighted the opening of a range of new services including the new molecular pathology and Northern Ireland Biobank which supports people with cancer, and the new Health Centre in Downpatrick. He also highlighted the new surgical unit at the Royal Victoria Hospital and the new Emergency Department at Antrim Hospital which he said would open soon. And he told the Assembly that in the last year he has had the privilege of cutting the first sod at both the £4.7million extension to the Bluestone Unit at Craigavon Hospital and the £232million new ward and acute services block at the Ulster Hospital.
He went on to outline progress in the development of a new percutaneous coronary intervention service model which allows heart attack patients to bypass emergency departments and go straight to catheterisation laboratory for appropriate treatment immediately.
Mr Poots also took the opportunity during his statement to update assembly members on the latest position on Paediatric Congenital Cardiac Services (PCCS) saying: “I have received the PCCS working group’s recommendation which involves building on the existing service provided by the Dublin paediatric cardiac surgery centre for the Belfast Trust. I met with the Republic’s Minister for Health, Dr James Reilly to discuss flexibility in the location for the future delivery of this service. I asked him to give consideration to a two-centre model potentially providing PCCS services in both Belfast and Dublin. Consideration of this proposal is continuing at official level. My overriding priority is to ensure the delivery of safe and effective services for vulnerable children.”
The Minister reminded MLAs that he is committed to improving the performance of the Northern Health and Social Care Trust following the recent report from the Turnaround and Support Team.
On e-health, Mr Poots detailed the great progress that has been made in this area to not only help service delivery through innovation but also in driving economic growth.
In conclusion, the Minister said: “I stand by the commitment I made when I came to office – that I would not shy away from the tough decisions in order to ensure that the health service provides for every single person who needs it. It is in the interests of the community that we transform our health and social care services. But in so doing, we must ensure that existing services continue without disruption. I am confident that we are on the right path to developing a health and social care service which will be sustainable into the future – one which focuses on meeting the needs of our local communities and individual patients and service users.”