The HSE published its 2024 National Service Plan (NSP) on 14 February. The NSP outlined the health and social care services which will be provided within the HSE’s allocated budget of €23.5 billion for 2024. This record allocation to the HSE is 4.6% above the 2023 budget and double the 2016 budget.

The HSE said the additional budget represents:

• €162.8 million investment in new service developments, including enhancing mental health and disability services;
• €834.7 million to fund increased costs of providing the existing level of service; and
• The implementation of the six new Health Regions.

The HSE says the aims of the 2024 NSP are to:

• Improve access to urgent and emergency care;
• Prioritise waiting lists;
• Continue to enhance mental health and disability services; and
• Build on existing partnerships to develop and improve services.

On publishing the NSP, HSE Chairman Ciarán Devane said the creation of the Health Regions will strengthen the governance and responsiveness ability of the HSE, and that a priority for 2024 is improving the infrastructure of the HSE in terms of technology and eHealth.

Pharmacy

With regard to the Ministerial Expert Taskforce to Support the Expansion of the Role of Pharmacy, the HSE states that it will; “work closely with the DoH (Department of Health) and other stakeholders to operationalise and implement the agreed recommendations of the Expert Taskforce”. Other commitments affecting pharmacy are to; “continue engagement on the expanding role of pharmacy, ensuring that the supporting processes (contractual and administrative) are maximised; review the potential for streamlining controls and validations within PCRS, while maintaining good governance; and complete a clinical review of medicines suitable for an over-the-counter GMS Scheme, and develop proposals for this scheme including proportionate control mechanisms.”

The NSP also commits to enhancing clinical expertise and enabling a sustainable professional workplace of healthcare professionals, including pharmacists, “through commencing a viable infrastructure to facilitate clinical practice placements and postgraduate development”.

Medicines budget

Savings under the medicines budget are also deemed a priority, with a focus on: “providing funds to reinvest in new drugs and to progress medium to long-term structural reform in respect of medicines expenditure”. The NSP says that a review of medicines expenditure will be undertaken, to identify “key trends, primary drivers of expenditure, and the penetration rates of generics and biosimilars across community, hospitals and national schemes”.

The HSE’s plan for 2024 also seeks to establish the following Medicines Management Programme work streams “for efficiency generation”:

• Ongoing best-value biological programme to include best-value medicines process for generic medicines on the High Tech Arrangement;
• Implementation of a reimbursement application system for continuous glucose monitoring sensors and publication of a preferred product(s) evaluation;
• Identification of preferred high-protein oral nutritional supplement products;
• Further analysis of non-medicine items (ostomy/urostomy products) and analysis to identify other areas for potential efficiencies; and
• Testing and formalising of new acute and community key performance indicators (KPIs) relating to medicines expenditure sustainability to be included formally in National Service Plan

‘Productivity Task Force’

The Department of Health’s Productivity and Savings Taskforce, which was established in January 2024, was also referenced in the NSP. When announcing the establishment of the Taskforce, Health Minister Stephen Donnelly TD highlighted that the health budget had doubled since 2016, and said that “we will have to develop innovative and sustainable means” of meeting the demands posed by the health needs of our ageing population. The NSP says; the “Task Force will be of particular benefit in identifying productivity measures for short (one to two year) and medium term (three to five year), all of which will be an aid to the future funding models for the health service.” Among the areas highlighted for further savings measures are the full cost recovery of public-in-private; and procurement, stock management and usage of various goods and services, including medicines, aids and appliances, and PPE. GP diagnostics and “other digital options to reduce costs of service delivery” were also cited.

iSIMPATHY

Also cited in the NPS was the possibility of exploring funding opportunities in support of iSIMPATHY. iSIMPATHY was a €3.1 million EU funded project that ran across the three jurisdictions of Northern Ireland, Scotland and the border areas of the Republic of Ireland from October 2019 until March 2023. The iSIMPATHY project gave itself the objective of transforming “the approach to optimisation of medicines through the delivery of medicine reviews to over 6,000 patients taking multiple medicines, and in delivering training to 120 GPs, hospital doctors, and pharmacists”. It had a specific focus on embedding a single approach for polypharmacy management as well as establishing the value of cross-border working in this field.

The HSE’s National Service Plan, contains a number of objectives for 2024 under the HSE’s EU and North South Unit. This Unit “works on behalf of the organisation to promote health co-operation with providers on a north-south, east-west and all-island basis to ensure better outcomes for people, especially those living in border and remote areas”. A commitment under this Unit for 2024 is to: “Explore possible funding opportunities in support of iSIMPATHY (implementing Stimulating Innovation in the Management of Polypharmacy and Adherence through the Years) etc.”.

The HSE’s 2024 National Service Plan is available at hse.ie > About the HSE > Publications.