Medical News

An overview of the HSE National Service Plan 2018

By December 22, 2017 No Comments

Prescription charges will reduce from €2.50 per item to €2 and the monthly cap is also set to decrease, from €25 to €20 per month, with a total investment of €42.6m next year.

This was claimed in the HSE National Service Plan 2018,  released on Wednesday, December 20th 2017, following its approval from Government.

Furthermore, the plan has stated that the drug payment scheme family threshold will lower from €144 per month to €134 per month.

The National Service Plan outlines the type and volume of health and personal social services that are to be provided in 2018, within the funding available.

The 2018 budget of €14.5 billion represents an overall increase of €608 million (4.4 per cent) compared to the 2017 allocated budget allocation. Some new 2018 investments will include €9m to support the expansion of paediatric and adolescent orthopaedic services and €15m towards mental health.

An investment of €25m will be put into primary care to support the GP contract, GP training, diagnostics, therapies, nursing, Advanced Nurse Practitioner appointments and community nursing and €10m has been set aside for respite care, with the aim of providing support to 400 individuals with a disability and their families next year.

A total of €40.2m will also be invested in acute hospital services to improve access to critical care services, along with investment in services for people with Spina Bifida and spinal conditions.

Women and infant health services have been targeted for development, particularly through increased scanning and gynaecology services.

In addition, it has been claimed that cancer services nationally will receive a total of €5.5m, which will allow for the expansion of services such as radiotherapy treatment.

This funding will go towards cancer drugs and ongoing care for those who are surviving cancer too, as the number of patients now surviving their cancer following improved treatments and services is growing.

To tackle our ageing population, the HSE will invest in services for older people, stating that there will be a continued emphasis on maintaining individuals in their own homes so that they can have as much independence as possible.

Next year will also feature an additional investment of €32m in additional home support, transitional care, and bed capacity in rehabilitation settings.

A further €9m is being provided for Intensive Home Care Packages (IHCPs), an ongoing investment from a joint agreement between Atlantic Philanthropies, the DoH and the HSE.

The Nursing Homes Support Scheme (NHSS) has anticipated that they will support 23,334 people in residential care at year end with a budget of almost €962m.

In relation to Primary Care, an additional investment of €25m will allow for the expansion of Community Intervention Team support and OPAT support (IV care in patients’ homes), predicted to provide an additional 4,682 referrals.

Access to Occupational Therapy Services will be expanded through the GP out of hours service and the commissioning of 15 additional primary care centres, with an investment of €10m.

The HSE has stated that €6.5m ha been set aside for “those individuals whose needs are broader than just the health and support services”, with an apperent €1.5m due to be invested in homeless services, while €1m will contribute to funding primary care services for refugees in emergency reception and orientation centres.

The National Ambulance Services will be on the receiving end of €2.75m with the aim of increasing the recruitment and training of additional paramedic staff; the expansion of aeromedical services; the implementation of a clinical hub. The investment will further support the National Transport Medicine Programme.

Although the additional level of funding is welcome, the HSE has acknowledged the financial challenge of the growing cost of delivering core health and social services in 2018.

The Health Service Executive has estimated that there will be a financial challenge within the operational service areas of approximately €346m, due to Ireland’s older population, increased demand for services, rising costs of workforces, new and existing drugs, and regulatory requirement costs, and the fact that our current health services model and design are “no longer fit for purpose and cannot meet the needs of our citizens now and into the future”.


Mr Tony O’Brien, HSE Director General commented on the plan: “For several years we have been aware of the need for a shift in health service delivery in order to move from the more traditional focus of treatment and cure, to that of prevention and treatment, when required.

He continued: “The challenges referenced in this service plan are recognised fully in the recent Sláintecare report, which signals a new direction of travel in relation to eligibility, delivery, and funding of health and social care in Ireland into the future.

Commenting on the cost pressures the HSE is facing, Mr O’Brien added: “As we seek to grow our service levels to a greater extent than our resources are growing, we must continuously strive for operational efficiencies.

“This is the sign of a mature and ambitious health system that is doing everything it can to deliver the maximum volume of services to patients and service users within the budget we have to work with”.

To mitigate the estimated operational financial challenge for 2018, the HSE has developed a comprehensive Value Improvement Programme which will come into effect from the beginning of 2018.

This is a single over-arching programme with three broad priority themes; improving value within existing services, improving value within non-direct service areas, and strategic value improvement.

Value will be judged in terms of improvement of services and service user experience alongside evidence of economy, efficiency and effectiveness.


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