Health service productivity issues are significant and require addressing, according to the UK’s Health Minister, Stephen Donnelly. The statement follows a report indicating that hospital activity is not keeping pace with government funding levels. Donnelly announced plans to save nearly £430 million this year through the implementation of various productivity measures.
On Monday, the Health Department stated that it aims to achieve considerable savings of around £424 million by 2024 (£554 million when considering a full year’s saving). The targeted savings will come from reduced spending in several areas including medicine expenditure, non-pay costs, procurement expenses, long-term residential care for the elderly, and management consultancy costs.
This move is aimed at lowering the financial risks faced by the health sector in 2024. However, these savings will not compromise the delivery of safe and high-quality patient services. The department also aims to save £34 million by cutting down on external consultancy expenses in the health service.
To increase efficiencies and improve productivity, the department plans to implement ‘mandated central referrals per region per speciality’, where GPs would refer patients to a team of specialists instead of individual consultants.
The department also proposed a shift in handling waiting lists by implementing mandated out-sourced and technology-enabled solutions for patients waiting over 12 months without an active plan, including a remote consultation project in dermatology.
Additionally, the proposal entails reducing the number of patients who miss their appointments. This involves the introduction of ‘mandated patient-initiated reviews’ across all apt settings and specialities, ensuring the appointment is initiated by the patient, caregiver, or family member rather than being automatically scheduled.
The proposal introduces new processes to avoid repetitive scans for patients as ordered by GPs and hospital doctors. It also suggests the implementation of additional clinics and the optimal use of clinical infrastructure during late evenings and Saturdays.
On Monday, Mr Donnelly unveiled a fresh examination of the effects of multi-billion euro financial injections and extensive staff recruitment on hospital productivity. Despite a health budget surge of over €8 billion and a 30% swell in staffing between 2016 to 2022, Mr Donnelly disclosed that hospital activity wasn’t maintaining sufficient momentum.
He noted that despite an influx of 2,500 doctors, 5,600 nurses, and 3,700 administrative and supportive staff, there was an underwhelming increase of less than 10% in hospital activities during the same timeframe.
According to the newly issued report by the Irish Government Economic Evaluation Service (IGEES), there was a considerable disparity across all sectors between the expenditure and workforce available, in alignment with the growth in separate or ‘composite’ activity metrics – a sum of in-patients, out-patients, day cases, and emergency visits adjusted by unit costs for each domain.
The report stated a significant variance in most instances, with the growth in composite activity either behind workforce growth by two times, or lagging behind actual expenditure growth by up to three times over the same timescale.
Mr Donnelly explained that an assortment of elements, inclusive of infrastructure and technology, could be contributing to this scenario. Without attributing blame, he remarked that the data lucidly showcased considerable productivity challenges that demand conquering, assisted by clinicians and management teams.
However, there’s hopeful news according to Mr Donnelly, who announced that health results in Ireland have been on an upward trajectory with waiting lists having been reduced consistently over the previous two years. He revealed a substantial decrease in the quantity of patients who had been waiting longer than the Sláintecare designated 10/12 weeks – a decline of a considerable 11% was reported in 2023 from its peak during the pandemic (170,000).
He assured that this was a positive trend, and expressed their intentions of working assiduously to affect further reductions in waiting times in 2024 – underpinning the importance of optimising productivity in the health sector whilst enhancing patient outcomes and access.