Review of acute hospital services in the Mid - Health Service Executive

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Review of acute hospital services in HSE Mid-West An action plan for acute and community services In summary, these national transformation priorities are setting a direction of travel in which more care is provided at home or as close to home as possible, and that when patients do need acute hospital services, they will receive high quality care that is integrated with local services and provides best value. Review of acute hospital services in the Mid-West The HSE commissioned Horwath Consulting Ireland Ltd and Teamwork Management Services Ltd to undertake a review of acute hospital services in the HSE Mid-West, using recognised international best practice as the comparator. We were asked to conduct our study on an independent ‘fact-finding’ basis, as opposed to undertaking a process of ‘formal’ consultation with all interested parties. Our primary objectives of this review, therefore, are to: • Assess the appropriateness or otherwise of current acute hospital services in the Mid- West; • Define what these services need to look like in the future if they are to be in a position to deliver services in line with international best practice standards; • Determine the optimal supporting governance structure for these acute services; and • Draw up an action plan to move safely from today’s model of care to the best practice model of care. Review of PCCC and its interface with acute care To ensure full integration of the acute and the community aspects of the HSE Transformation Programme, the original brief was extended to examine those elements of the PCCC services that directly relate to the acute hospital sector. We are now also required to report on: • Estimating the future resources that PCCC will need if they are to reach their full potential for helping patients avoid acute admission to hospital or be safely discharged from hospital at an earlier stage in their recovery; and • Identifying the PCCC actions required to achieve their full potential, and integrating these actions into the overall action plan for delivering the new strategy for acute services in the Mid-West. 9
Review of acute hospital services in HSE Mid-West An action plan for acute and community services Our understanding of the current acute services in the Mid-West has been informed by familiarisation visits to all existing hospitals delivering acute care, by fact-finding interviews with a range of relevant healthcare bodies and organisations, by demographic and hospital discharge (HIPE) data for patients resident in the Mid-West and also those patients from outside the area using Mid-West hospitals, published healthcare reports, policy documents provided by the HSE, and by written submissions from the hospitals themselves and interested parties. For the PCCC component of our review, our understanding was gained through a combination of planning meetings, workshops and visits to selected representative PCCC centres and community hospitals. Our recommendations in this report therefore take into account: • Our conclusions from our fact-finding programme, supplemented by the written submissions; • Our latest studies into the evidence from international best practice; • Our understanding that the HSE has already adopted a new acute healthcare strategy in line with international best practice and is currently proceeding to implementation, starting in the North East; and • The assumptions and pre-conditions that need to be fulfilled in order to deliver the optimal configuration of acute hospital services. We are pleased to take this opportunity to thank everyone who took part in this review for their constructive, open approach to the task in hand. Their support and contributions to our work are much appreciated. We recognise that the detailed changes proposed are substantial and challenge current working practices. They are designed to have a far reaching beneficial impact for patients through the provision of safe, sustainable, cost effective and high quality services across all the service sectors, from pre-hospital to tertiary care. In the next section, we describe why and how the future clinical models of acute and community care are being developed for Ireland. 10
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Current service delivery Regional s
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Centralising specialist acute servi
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Critical care network Review of acu
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Tele-medicine Review of acute hospi
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