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Permanent Secretary sets out priorities for addressing pressures in NI health system

Department of Health Permanent Secretary Peter May has emphasised that massive efforts are being made across health and social care to get through this winter.

Alongside this work to mitigate current pressures, action is also needed for the longer term to put the health and social care system on a sustainable footing. This will involve collective action across the system, significant changes to services, and sustained additional investment.

Mr May said:

“I pay tribute to the intensive efforts being made at all levels across our Health and Social Care system to meet the current challenges. I am very conscious of the scale of the pressures and their relentless nature. I also want to make clear that we cannot keep asking our teams to go through this. We cannot accept the fact that too many people are waiting in distress, discomfort and pain for care.

“The problems we are seeing across health and social care are mirrored across these islands. There is no quick or simple solution, nor is there a single lever that can be deployed to turn the situation around. There are, however, a series of individual measures that need constant attention and which together can at least mitigate the pressures in the here and now. Every percentage point improvement we can achieve on ambulance turnarounds and delayed discharges makes a difference to patients.

“We also have to plan ahead for future winters and to reduce the time people have to wait for treatment. We can make improvements which will benefit both patients and those who work in health and social care.”

The Permanent Secretary added:

“It is important to emphasise that, despite all the serious pressures, our health service is still open and caring for people to the very best of its ability. If you need health care, whether that is at an Emergency Department or from your GP, please don’t be put off seeking it. You will be triaged to help make sure those most in need are treated quickest and staff will always try to keep any delays to a minimum.”

Priority areas in planning ahead for the future include:

* Increasing domiciliary care and wider social care capacity to meet increasing levels of need. This will require sustained investment in staffing – building on additional allocations totalling £45million in past two years to enhance pay and conditions of social care staff. Maintaining close co-operation between the HSC system and the independent care sector is another key requirement as is work to improve current contracting arrangements. The Department’s public consultation on the future of adult social care identified an estimated 80% increase in demand for social care by 2040 due to demographic change.

* Focus on community-based care to help people live healthier lives and reduce the need for acute hospital attendances and admissions. This will include enhancing GP support to care homes so only those who would benefit from going to hospital do so. Investment in primary care is also vitally important including the continued roll out of the Multi-Disciplinary Teams model, with Physiotherapists, Social Workers and Mental Health Practitioners working alongside GP practice teams and enhancing community nursing and AHP teams. Focusing on community-based care will also include engaging with older people and their families, enabling choice about their treatment and care settings in the final stages of their lives.

* Rebuilding and reconfiguration of acute hospital services. This must include sustaining investment in staffing and freeing up resources through reduced reliance on agency and locum use. Reconfiguration of hospital services is taking place with the establishment of specialist surgical centres.  Creating centres of excellence and moving away from the concept of every hospital providing every service will both improve the quality of treatment patients receive and increase the numbers who can be treated. In relation to reforming urgent and emergency care services, the public consultation held last year detailed a series of initiatives including the roll-out of additional urgent care centres and a regional Phone First model.

Mr May concluded:

“Some but by no means all of these measures will require both additional investment and political leadership. As has been said before, funding is not the sole solution for health and social care but there is no solution without it. It is also inevitable that some difficult choices will be required on budgetary priorities.”


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