Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697750704301.pdf (Ireland)
Department of Health Statement of Strategy 2021-2023 February 2021 Contents Overview of the Department of Health’s Statement of Strategy 2021-2023 Foreword by the Minister Introduction by the Secretary General Scope, Purpose and Use of our Statement of Strategy Strategic Priorities Strategic Priority 1: Manage COVID-19 and promote public health Strategic Priority 2: Expand and Integrate Care in the Community Strategic Priority 3: Make access to healthcare fairer and faster Strategic Priority 4: Improve oversight and partnership in the sector Strategic Priority 5: Become an organisation fit for the future Delivering our Strategy Developing our Internal Environment Responding to our External Environment Conclusion Appendices: I.
How the Department of Health developed its Statement of Strategy II.

Programme for Government Commitments III.

List of National Strategies IV.
Bodies under the Aegis of the Department of Health 2 4 5 6 9 10 12 14 16 18 20 21 23 26 27 27 30 42 44 Overview of the Department of Health’s Statement of Strategy 2021-2023 Vision The Department’s vision for the people of Ireland A healthier Ireland, with improved health and wellbeing for all, and with the right care delivered in the right place at the right time Mission Why the Department exists To improve the health and wellbeing of people in Ireland by: – supporting people to lead healthy and independent lives; – ensuring the delivery of high quality and safe health and social care; – creating a more responsive, integrated and people-centred health and social care service; and – promoting effective and efficient management of the health and social care service and ensuring best value from health system resources.
Functions How the Department fulfills its mission The Department serves the public and supports the Minister for Health, Ministers of State and the Government: – by providing leadership and policy direction for the health sector to improve health outcomes; – by undertaking governance and performance oversight to ensure accountable and high quality services; – by collaborating to achieve health priorities and contribute to wider social and economic goals; and – by creating an organisational environment where high performance is achieved, collaborative working is valued and the knowledge and skills of staff are developed and deployed.
s l a o G g n i r u d n E 2 Strategic Priorities What the Department will prioritise between 2021-2023 Manage COVID-19 and promote public health Expand and integrate care in the community Make access to healthcare fairer and faster Improve oversight and partnership in the sector Become an organisation fit for the future 3 2 0 2 - 1 2 0 2 Our Values How the Department works Engaging with the public and service users Respect and fair and equal treatment of all Collaboration, innovation and forward thinking Professionalism, leadership and accountability Integrity, impartiality and value for money Our Enablers Supporting the Department to acheive its strategic priorities Empowered teams and cross-functional working Data, technology and digitisation Funding, structures and infrastructure Innovation Stakeholder collaboration and alignment 3 Strengthening the strategic capabilities of the Department and sharpening its strategic focus will help to ensure that we deliver across the ambitious health agenda set out in the Programme for Government, which includes: Delivery of Care in a COVID-19 Environment Implementing Sláintecare Promoting Women’s Health A Healthier Future Mental Health A Health-led Approach to Drugs Misuse An Age-friendly Ireland Disability Climate Action.
I look forward to working with Ministers of State Rabbitte, Butler and Feighan, colleagues in the Department and partners in the wider health and social care sector as we improve Irish health and social care over the coming three years.

Stephen Donnelly, TD.

Minister for Health Foreword by the Minister This Strategy is published at a defining moment for Ireland.
Confronted with unprecedented challenges in the form of a pandemic, the Department of Health, the HSE and all partners in the health sector, the Government more broadly and the Irish public have all risen to meet the challenge.

We will continue to lead the COVID-19 public health response and to support the resilience and future preparedness of health and social care services.
We will also build on the innovation, agility and transformation displayed in the response to date to the Covid-19 emergency and will continue to advance the Sláintecare vision.

The Government sets out an ambitious agenda in the Programme for Government and is making progress to deliver this through an unprecedented investment in health and social care services.
This investment will meet specific demands of the Covid-19 response, the broader care needs of the Irish public, and importantly will fund the ambitious Sláintecare transformation agenda.

This reform programme, benefiting from such strong political consensus, will help to ensure sustainable health and social care in Ireland.

I am intent on advancing towards universal healthcare in the years ahead.
Through all of our efforts in the health and social care sector, we will ensure that the public and service users see concrete, tangible improvements in their access to services, their experiences and their outcomes.

The public and service users will be engaged at the heart of the work that we do.

4 Introduction by the Secretary General Since the onset in February 2020 of COVID-19, colleagues in the Department of Health have shown what public service means.
The organisational values described in this Statement of Strategy are lived and on display every day in Miesian Plaza and with those working from home – leadership, professionalism, integrity, accountability, innovation.

Most of all there is a shared, deep and abiding commitment to serving and delivering for the public and to supporting the Minister, Ministers of State and the Government.
This Statement of Strategy was prepared in consultation with the public, our stakeholders, our agencies, other Government departments and staff at the Department of Health.

The Strategy responds to the commitments set out in the Programme for Government and is informed by an environmental analysis, which will also influence how we go about delivering our Strategy.
The Statement of Strategy identifies a clear and select set of strategic priorities for the Department, aligned with the Programme for Government priorities and the Sláintecare long-term vision for health and social care.

Over the coming three years, we will build on our work of recent years and deliver on the vision of universal healthcare set out in Sláintecare.
We are guided by the three pillars of the Health Service Capacity Review 2018: promoting healthier lives and preventing illness (and continuing in the near term with public health protection); expanding integrated care in the community; and reforming acute hospital care.
Advancing these priorities will involve strengthening our capabilities as a Department to deliver on our core functions, as we become an organisation fit for the future, with enhanced oversight capacity, and enhanced capacity to manage risk and engage in continuous learning.
The exercise of developing and implementing this Strategy is thus an exercise in becoming a more strategic Department; a more capable Department; and a more open Department, engaging with our partners and stakeholders to listen and to encourage alignment.

The Department will also need to be the right size to continue to deliver its mandate effectively.
The response to COVID-19 has demonstrated the Department’s strong leadership of the health and social care sector, and how effectively we can collaborate across government.

We intend to continue to play a leading role in advancing important cross-government work, including on the COVID-19 public health response, the Healthy Ireland agenda to address the wider determinants of health, mental health policy, climate action, and equality and human rights.
Our mandate and our work in the Department of Health is broad, varied and profoundly important.

Over the past year the Department’s work has been more in the spotlight than ever before.

I am proud of the work colleagues in the Department have done in responding to the COVID-19 pandemic.

I would like to thank colleagues in the Department and across the health and social care system for your diligence and commitment.
Together we can look forward to implementing this Strategy to make a real difference to the public and to service users throughout Ireland.

Robert Watt Secretary General 5 Scope, Purpose and Use of our Statement of Strategy About the document The scope of the statement of strategy This Statement of Strategy sets out the direction for the Department of Health’s work for the next three years.
The development of the Strategy has taken into account the wider context within which the Department of Health operates and is mindful of the important role played by the various partners and stakeholders that contribute towards our shared vision.
Informed by our current environment, this Strategy focuses on our specific role and distinct contribution to improving the health and wellbeing of the people of Ireland and our role in ensuring that health and social care services are delivered to those who need them.

Further details about the process used to develop this Statement of Strategy are available in Appendix I.

This is a Statement of Strategy for the Department of Health; it does not seek to set out a strategy for the entire health sector.
It is the Department’s corporate strategy for the next three years.

It focuses on the breadth of work that the Department delivers, within its role and function.

All of the work of the Department of Health is carried out in service of our vision, mission and commitment to the people of Ireland.

All of the broader work of the Department of Health is represented in our published strategies, policies and is detailed through our annual business planning process.
It aligns with the commitments set out in the Programme for Government and the Sláintecare fundamental principles (figure 1).

In the context of this work, there are five strategic priorities that will provide a focus to advance our mission in the next three years.
This Strategy is written in a time of high uncertainty; therefore it is a living document which will be reviewed regularly during the period 2021-2023 to ensure it continues to be useful in directing our work and responding to changes in the environment.
6 Components of the strategy The Strategy outlines our: vision: the Department’s long-term vision for the health and wellbeing of all the people of Ireland; mission: our purpose as a Department and the contribution we seek to make; strategic priorities: priority areas that the Department will focus on for 2021-2023; initiatives: the initiatives likely to have the most impact in advancing the strategic priorities over the next three years; enablers: the supports that will make it possible to implement this strategy; values: the deeply ingrained principles that guide all our actions; and performance: metrics that will be used to assess our success in fulfilling our Strategy.
The breadth of our work The Department of Health has more than 600 employees working together across multiple units and divisions to deliver on a very broad mission and mandate.
Further information about who we are is available online at: www.gov.ie/health and https:// whodoeswhat.gov.ie/root/health/ The function of the Department of Health is to serve the public and support the Minister for Health, Ministers of State, and the Government: by providing leadership and policy direction for the health sector to improve health outcomes; by undertaking governance and performance oversight to ensure accountable and high-quality services; by collaborating to achieve health priorities and contribute to wider social and economic goals; and by creating an organisational environment where high performance is achieved, collaborative working is valued, and the knowledge and skills of staff are developed.
The Department adheres to the Corporate Governance Standard for the Civil Service.

The Department’s Corporate Governance framework focuses on its legal, regulatory, policy and service obligations and on the sets of relationships between the Minister, Ministers of State, Secretary General, the Management Board, senior management, all staff and stakeholders in determining the direction and performance of the organisation.
More information is available: gov.ie/health The Department undertakes a broad range of work in accordance with our functions.

We are a relatively small Department with significant responsibility and accountability for the expenditure of one of the consistently largest budgets among government departments.

Our work encompasses: leadership of the delivery of the COVID-19 response; policy development and driving reform based on the vision and principles laid out in Sláintecare.
This includes policy development and reform across: public health, health and wellbeing, primary and community care, social care, mental health, women’s health, acute hospital services, eligibility, and e-health and health information; governance and oversight of bodies under our aegis including the Health Service Executive; responsibility for regulatory policy, including the regulation of certain health professionals, service providers, private health insurance, medicines; leadership in patient safety policy and legislation through the National Patient Safety Office; professional leadership through our Chief Medical Officer and Chief Nursing Officer; strategic workforce planning and development and managing industrial relations at national level; investment in capital infrastructure; ensuring accountability, including through the management of a significant volume of parliamentary work, public correspondence, and media queries; delivery of a significant programme of legislation; 7 providing support for the Department’s core functions through expertise in finance, legal, HR, data protection, research, statistics and analytics, policy development, audit, programme management, bioethics; and delivery of civil service, cross-governmental and international commitments.
An analysis of our external environment has informed the approach of this Strategy and its five strategic priorities, and will inform how we advance and deliver this Strategy.

Within the next three years it is clear that the Department will need to be agile, building our capacity to plan for uncertainty, be strategic and remain responsive to our environment.
Internally, we are at a time of transition, welcoming a large number of new staff into the Department, shifting to remote working, managing significant additional responsibilities associated with the management of the COVID-19 pandemic and transferring the majority of our responsibility for Specialist Disability Services to the Department of Children, Equality, Disability, Integration and Youth (DCEDIY) in 2021.
The Statement of Strategy is owned by all of the staff of the Department of Health and will be used to guide our work.

It is the framework we will use over the next three years to strengthen our strategic focus as a Department and to measure our progress.

It will also be used as the foundation for guiding our engagement with our agencies, partners and stakeholders.

Specific processes will be put in place to ensure the delivery of the Strategy and these are outlined in the following sections.
Figure 1 Sláintecare fundamental principles There are 19 bodies under the aegis of the Department of Health, including one commercial State body.

These are listed in Appendix IV.

The largest of our agencies is the Health Service Executive which is responsible for providing public health and social care services to everyone in Ireland.
More information on the HSE, including its corporate plan, is available at https://www.hse.ie/eng/ These bodies and agencies, together with a wide range of other stakeholders, fulfil their roles in delivering health and social care services to the people of Ireland.

This statement of strategy will guide our work This Strategy is informed by the Programme for Government, the Sláintecare report and fundamental principles, extensive consultation and the current multifaceted environment.
The Department of Health operates within a complex system of determinants of health and wellbeing, working alongside, and in partnership with, a wide range of service providers and stakeholders and other Government Departments to deliver our mission.

Our environment is increasingly complex and rapidly changing.

As we have seen with the COVID-19 pandemic and response, it can present sudden threats requiring rapid diversion of attention and resources.
This Statement of Strategy has been compiled amid much uncertainty.

8 AccountabilityPatient is paramountTimely accessPrevention and public healthFree at the point of deliveryWorkforcePublic money and interestEngagementSláintecareFundamentalPrinciples Strategic Priorities Over the next three years, the Department of Health will continue to deliver across the broad portfolio of our work to fulfil our core functions.
In the context of our wider work, a number of strategic priorities have been selected to bring focus to our collective work over the next three years and enable us to measure our success.

The Department’s Strategic Priorities for the period 2021-2023 are: 1.

Manage COVID-19 and promote public health.

2.

Expand and integrate care in the community.

3.

Make access to healthcare fairer & faster.

4.

Improve oversight and partnership in the sector.

5.

Become an organisation fit for the future.


These strategic priorities were chosen in response to the health, wellbeing, and social care needs of the people of Ireland, and in the context of significant national and international change, demands and demographics.

These were chosen through an analysis of the environment, review and alignment with our wider strategic context, and extensive consultation with our stakeholders.
These priorities reinforce the commitments set out in the Programme for Government and further strengthen the Sláintecare agenda.

These priorities fulfil the following criteria: They will deliver on commitments made in the Programme for Government.

They will progress Sláintecare reforms.

They are necessary in the context of COVID-19.

They are priorities that the Department of Health, in its unique role, must respond to or lead on.
The first three priorities focus on policy and reform and are essential for the delivery of Sláintecare.

These priorities incorporate the initiatives within the Sláintecare Strategic Action Plan 2021 -2023 around improving timely access to care and addressing health inequalities.

The fourth and fifth priorities focus on strengthening the Department’s core functions to ensure we deliver on our role.

All five priorities are important in their own right but they are also interlinked.
Progressing these priorities will require significant work, allocation of resources and collaborative working across the Department of Health.

The five strategic priorities are elaborated below including key initiatives and measures of success.

9 Strategic Priority 1 Manage COVID-19 and promote public health What does this strategic priority mean?

Leading the public health response to COVID-19 and future preparedness for health protection.
Investing in, and developing, population health planning, prevention of illness and promotion of health and wellbeing.

Why this is a priority The Department will continue to play a leading role in Ireland’s response to the Pandemic.

The Programme for Government prioritises the protection public health, patients and to ensuring sufficient health service capacity.

Focus is likely to shift within the timeframe of this strategy.
However, even after the immediate impact of the pandemic has passed, the longer term impacts of COVID-19 on health will require attention.

Given current trends and the projections for Ireland’s future demands for healthcare, the capacity of the health and social care service is not sustainable unless real progress is made in preventing illness and supporting people to live healthier lives including through implementation of the cross-Government Healthy Ireland Framework.
The key initiatives for the Department that could have most impact in the next three years are Performance Metrics – How will we know that we have advanced this strategic priority?

Continue strong leadership on COVID-19 policy development, planning and management.

Vaccine uptake and COVID-19 successfully managed.

Population health planning approach in place.

Regular monitoring of health and wellbeing indicators.

Oversee COVID-19 vaccination programme implementation.
Oversee the necessary reconfiguration of services and streamlining of pathways of care due to COVID-19, and monitor and address the direct and indirect impact on services.

Strengthen public health systems planning and preparedness.

Lead implementation of the Healthy Ireland Strategic Action Plan Phase 2 2020-2025 and drive prevention, citizen empowerment and obesity initiatives.

Deliver a citizen engagement and communications programme on public health and wellbeing.
11 Strategic Priority 2 Expand and Integrate Care in the Community What does this strategic priority mean?
Keeping people well at home, or near home, by expanding and increasing primary care and social care available in the community, within an integrated model of care across all settings.

Why this is a priority The Programme for Government makes strong commitments to strengthen community-based care, including primary care and social care, and sees this as fundamental to advancing Sláintecare reforms.

Care in the community will be expanded in a way that integrates care across all relevant settings.
Enhanced integration will reduce the system’s dependency on acute hospital care through early and timely patient engagement with the primary and community care systems.

This will make it easier for people to access the care they need in a timely way, and will build on innovations that arose during the COVID-19 response.

The key initiatives for the Department that could have most impact in the next three years are Performance Metrics – How will we know that we have advanced this strategic priority?
Progress expanded and integrated community care.

Ensure the necessary investment in and development of Community Healthcare Networks and specialist teams in the community (with a focus on older persons and chronic disease).

Develop a statutory home support scheme.

Older Persons’ Care – ensure delivery of the recommendations of the Nursing Homes Expert Panel.

Ensure timely implementation of Sharing the Vision: A Mental Health Policy for Everyone.
Scale and mainstream successful Sláintecare Integration Fund projects.

Progress on targets set out in the Health Service Capacity Review (2018) including on infrastructure and workforce.

Increased investment in primary and community care as a percentage of total services delivery budget.

Higher proportion of services delivered in the community.

Greater use of technology in service delivery and citizen engagement.

Measurement of and improved performance on service user feedback.
Cross cutting initiatives required to advance Strategic Priorities 2 and 3 Implement and resource the Sláintecare Strategic Action Plan 2021-2023 to accelerate reform, specifically the programmes Improving Timely Access to Care and Addressing Health Inequalities.

Progress population health profiling, align it to health and social care needs assessment, and use it to develop a population-based resource allocation model and structural reforms.
eHealth – accelerate work on Individual Health Identifier (IHI) and Shared Care Record as well as eHealth infrastructure.

Develop and agree a plan for expanding eligibility for public healthcare services.

Enhance capacity across primary, community and acute settings, including additional infrastructure, staffing, and diagnostics in line with the implementation of the Health Service Capacity Review 2018.

Implement our national strategies to underpin a whole-of-system approach to care (see appendix III).
13 Strategic Priority 3 Make access to healthcare fairer and faster What does this strategic priority mean?

Health and social care based on need and not on ability to pay.

A whole-of-system approach to support better health outcomes through the right care delivered in the right place at the right time, importantly addressing fundamental health inequalities.
Why this is a priority The Programme for Government commits to providing fairer and more affordable care, promoting women’s health and a range of initiatives targeting marginalized groups to ensure our services meet everyone’s needs.

Improving timely access to care and addressing health inequalities are two key Sláintecare Reform Programmes.

These are more important than ever and also more challenging in the context of COVID-19 and its aftermath.
The key initiatives for the Department that could have most impact in the next three years are Faster Advance Sláintecare reforms to improve timely access to care.

Develop a multi-annual waiting list plan, encompassing measurement of time to treatment, and align workforce.

Oversee delivery of significant extra capacity in acute hospitals, including through new Elective Ambulatory Centres.

Implement hospital productivity measures in line with the Health Service Capacity Review 2018.
Implement the Sláintecare public-only consultant contract.

Further develop the National Clinical Programmes, supported by robust clinical governance structures.

Promote NPSO initiatives for patient engagement and advocacy, improved patient experience and open disclosure, complaints and incidents policy, and infection prevention and control and anti-microbial resistance.

Fairer Advance Sláintecare reforms to address health inequalities.
Develop a population-based approach to resources allocation and develop Healthy Communities, with a particular focus on deprived areas.

Develop the business case for a new system of governance and associated health system structures for Regional Health Areas.

Develop and implement key priorities within the Women’s Health Action Programme.
Support the full and effective participation of people with disabilities in society on an equal basis with others, in accordance with the United Nations Convention on the Rights of Persons with Disabilities.

Ensure the Department and agencies comply in full with the Public Sector Equality and Human Rights Duty.
Cross cutting initiatives required to advance Strategic Priorities 2 and 3 Implement and resource the Sláintecare Strategic Action Plan 2021-2023 to accelerate reform, specifically the programmes Improving Timely Access to Care and Addressing Health Inequalities.

Progress population health profiling, align it to health and social care needs assessment, and use it to develop a population-based resource allocation model and structural reforms.
eHealth – accelerate work on Individual Health Identifier (IHI) and Shared Care Record as well as eHealth infrastructure.

Develop and agree a plan for expanding eligibility for public healthcare services.

Enhance capacity across primary, community and acute settings, including additional infrastructure, staffing, and diagnostics in line with the implementation of the Health Service Capacity Review 2018.

Implement our national strategies to underpin a whole-of-system approach to care (see appendix III).
Performance Metrics – How will we know that we have advanced this strategic priority?

Reductions in waiting times and waiting lists for acute and community services.

Improved patient experience measured through National Care Experience Programme and other channels.

Trends and shifts in activity from in-patient to community and day care.

Improved access to care for socially excluded groups – including Travellers, Roma, people who are homeless, asylum seekers, refugees and people who use drugs.
Improved health outcomes and experiences for women and girls.

Progress on targets set out in the Health Service Capacity Review (2018) including on infrastructure and workforce, including workforce mix, in acute and community settings.

15 Strategic Priority 4 Improve oversight and partnership in the sector Why this is a priority The Programme for Government prioritises cross-public service collaboration and recognises the importance of regular and open engagement with all sectors of society.
Governance and oversight are core functions of the Department.

They have never been more important – to address the impact of the pandemic on health and social care, drive the Sláintecare reform agenda, and ensure value for money in public investment in health and social care.

Good governance and systems underpin and ensure the delivery of high quality and safe health and social care to patients and service users.

Oversight drives improved performance management and improved performance.
The Department will continue to collaborate to ensure the alignment of all our aegis bodies to deliver the Sláintecare vision.

What does this strategic priority mean?

Ensuring processes, governance structures and regulatory frameworks are in place in the health and social care sector, with effective oversight by the Department.

Enhancing the Department’s own internal structures, processes and governance capabilities to support better performance oversight.
Working in partnership with the HSE, and all our agencies, to deliver key strategies and reforms, including through strong performance monitoring and management, with a focus on financial control and outcomes.

Key initiatives for the Department that could have most impact in the next three years are: Performance Metrics – How will we know that we have advanced this strategic priority?

Strengthen our partnerships and ways of working with all our agencies.
Delivery of the Health System Performance Assessment Framework Strengthen the Department’s internal structures, processes, governance and oversight capabilities.
Performance management framework (internally and externally) operating effectively Value for money improving Accurate timely data available to Department, and aligned with decision making processes, through improved HSE health information systems Good working relationships with agencies, with clarity of respective roles NPSO key metrics for patient safety including measures for person-centredness, patient safety and effectiveness Strengthen financial control mechanisms and broaden the base of financial expertise across the Department; work towards multi-annual budgeting; develop a Strategic Framework for Investment in Health Infrastructure; and embed the Public Spending Code in the health sector.
Progress NPSO initiatives for patient safety including the DOH/HSE Patient Safety Communications Protocol, surveillance reporting, clinical effectiveness and audit, and regulation for quality.

Continue to enhance regulatory policy and develop legislative frameworks across the health and social care sector including of health professionals, services, service providers and products.

Complete and implement the Health Information Systems Strategy, including a data governance focus.
Develop a Health Workforce Planning Strategy and Planning Projection Model.

Annually review the oversight agreement with the HSE to ensure clarity of roles and responsibilities and to facilitate effective oversight and accountability.

Reduce avoidable state claims by improving quality delivery.

Strengthen engagement with the voluntary healthcare sector including through the Dialogue Forum.

Proactively lead and oversee climate mitigation and adaptation actions for the health and social care sector.
17 Strategic Priority 5 Become an organisation fit for the future What does this strategic priority mean?

Ensuring the Department has the right capabilities, people, structure and culture to advance our mission.

All staff are valued and empowered to contribute to the organisation’s mission.

Why this is a priority The Programme for Government emphasises the importance of efficient public services and promotes structures for talent development in Government departments.
A high performing, fit-for-purpose Department is essential to the delivery of all other strategic priorities.

The Department has important responsibilities to fulfil as an employer.

Key initiatives for the Department that could have most impact in the next three years are: Performance Metrics – How will we know that we have advanced this strategic priority?
Complete and implement the Organisational Design project, to include capability development and assessment of staff numbers required to achieve the strategic priorities.
Organisational design project implemented Right-sized organisation, with sufficient staff, with the right skill mix, to fulfill our functions Reduced staff turnover Improvements in Civil Service Employee Engagement Survey results Learning and Development targets - including the percentage of staff who have completed strategy- relevant training Develop an Innovation Strategy and governance processes.

Expand ICT to support our core functions and remote working.
Become a more strategic Department through development of enhanced planning, change management, foresight, innovation, risk and project management capabilities, within a stronger governance architecture.

Ensure we are driven by evidence through increased capability in data analytics, health intelligence, research, evaluation, and policy development methods, with support for continuous learning and improving.
Become a more open Department through increased citizen, service user and stakeholder engagement, participation and empowerment, and increased diversity of the workforce.

Implement a Department of Health People Strategy, respond to Employee Engagement Surveys, and undertake a culture audit.

Develop our HR Strategy by becoming an employer of choice, developing our approach to recruitment and retention of staff, and implementing a medium term plan for remote working.
Strengthen cross-government collaboration capability, and international and North/ South focus.

19 We will measure our success by tracking: high level performance metrics relating to the five strategic priorities, as outlined above; the delivery of our strategic initiatives; and the establishment and functioning of the processes and structures put in place to deliver the strategy.

These metrics will assist us in measuring our success as we move through the next three-year cycle.
We will also deliver an annual report against this Statement of Strategy and an annual learning exercise and refresh of the Strategy to ensure this is a living document that remains responsive to our environment.

The environmental analysis completed during the development of this Strategy presented a range of opportunities to strengthen our contribution.

Our evolving internal and external environmental contexts will also guide and shape how the Strategy is delivered.
Delivering our Strategy This Statement of Strategy will guide the Department of Health’s work for the next three years and its implementation will strengthen our strategic capacity as an organisation.
How the Department will implement and monitor the Strategy The Department will implement the Statement of Strategy through: specific implementation processes for the Statement of Strategy put in place, including clear ownership within the Department; staff engagement; organisational leadership and governance structures put in place; internal alignment with other strategic processes and with our business planning process; allocation of resources to support the delivery of the strategic priorities; external collaboration and alignment with agencies and partners; and monitoring, evaluation, accountability and learning mechanisms put in place.
20 Developing our Internal Environment Key enablers 1.

Empowered teams and collaborative working Our people are our most important asset.

In line with the Public Sector Duty and Our Public Service 2020, we are committed to a culture of respect, collaboration and innovation, where staff feel empowered in their roles and supported in the pursuit of a healthy work/life balance.
As the complexity of our work has increased, the need to collaborate both internally and externally to tackle some of society’s biggest challenges is even greater.

We will learn from and leverage best practice to strengthen our adaptability and capability through innovative, collaborative policy-making and new ways of working together.

2.

Organisational structures and resources Our capacity to deliver on our functions, and the work that is required of us, depends on adequate resourcing and organisation.
Significant internal reorganisation has taken place to ensure the delivery of immediate priorities, including the COVID-19 response, but we must also be well-equipped for the delivery of reform and our longer-term priorities.

It is essential that our organisational structure and design, and our staff complement, are fit for purpose.

We will enhance our remote working capability and work towards the Programme for Government mandate for public sector employers to move to 20% home and remote working in 2021.
This is the corporate strategy for the Department of Health over the next three years, and as such it contains a strong focus on attending to our internal environment and strengthening the Department.

This focus on strengthening our organisation is highlighted in strategic priorities 4 and 5 and is captured in our values and the key enablers outlined below, which will provide the supports that will make it possible for the Department to achieve its strategic priorities.
This focus on our organisation is necessary in order to deliver our Strategy and advance our mission.

Our Values The values of the Department will guide all of our work over the next three years.

They are the deeply ingrained principles that serve as our cultural cornerstones.
In the next three years, we will ensure our core values are shared across our organisation and embedded across all our work: A dedication to putting the people of Ireland and users of our health and social care services at the centre of all our work, engaging them in the work that we do A strong commitment to respect and the fair and equal treatment of all An open culture that encourages collaboration, innovation, and forward thinking The highest standards of professionalism, leadership, and accountability A deep-rooted ethos of integrity, impartiality, and value for money.
21 responsibility for specialist disability services to DCEDIY, while the Department of Health will continue to oversee any residual functions relating to access to health services that are retained.

The Department will continue to support the obligations in the Disability Act 2005 to include people with disabilities in mainstream services.

Further, and in line with HSE guidance, general health and social care teams will work to deliver services that are accessible to all people with disabilities.
Within the health sector, we are committed to ongoing engagement and communication with stakeholders in all aspects of our work.

As part of our mission to create a more responsive, integrated and person-centred health and social care service, we are dependent on sustained engagement to understand and deliver on the needs of the Irish public.
We are committed to working for and in partnership with the public in all we do, through collaborative policy-making, and by engaging local communities, health and social care providers (including voluntary providers) and other stakeholders through key programmes including Sláintecare, Healthy Ireland and the Women’s Health Taskforce.
As we have seen during the COVID-19 emergency, if we are to make progress on key health and social care initiatives like Healthy Ireland or Sláintecare, the Department must represent a trusted and leading voice on health in Ireland.

By engaging consistently with service users, the public, and providers and staff across the health and social care system, we will work together to deliver on our collective vision for the future.
Coherence and alignment with our agencies, partners and other key stakeholders is essential to advance the strategic priorities set out in this Strategy 2021-23.

3.

Data, technology and digitisation Advancement in health systems information, and innovations in technology and digitisation, are vital in underpinning an evidence-based approach to policy making that is person-centred and delivers on strategic priorities.
Data is also of crucial importance to government for supporting decision-making, shaping policy and facilitating the effective delivery of public services.

We will finalise and deliver on the Health Information System Strategy and additional investments in our infrastructure to ensure that we are equipped to do our work.

4.
4.

Innovation As an organisation, we are committed to embracing innovation in line with Making Innovation Real, the Public Service Innovation Strategy (2020), and Our Public Service 2030.

The COVID-19 pandemic response sparked innovation across the health system, including in the Department of Health, and the insights and lessons learned from this will be identified and built upon.

There is also broader potential for further collaboration between the health service and the enterprise sector.
We will develop an Innovation Strategy as a key enabler for the actions described in this Statement of Strategy, and will embrace innovative methods of working across our policy development and research functions in particular.

5.

Stakeholder collaboration and alignment We are part of the wider civil service and work alongside other Government Departments to serve the people of Ireland.
We work closely with other Departments to deliver the Programme for Government and play a leadership role in the implementation of specific governmental priorities including, in particular, the Healthy Ireland Framework and the public health response to COVID-19.

We will continue working in cooperation with other government departments on the wider determinants of health in order to prevent illness, and on the proposed development of wellbeing indicators.
We are committed to playing our part in the delivery of key cross-governmental initiatives, including climate action and ensuring equality.

The Department of Health and the Department of Children, Equality, Disability, Integration and Youth (DCEDIY) are working closely to ensure a smooth transfer of 22 Responding to our External Environment 3.
Changing Demographics Ireland’s shifting demographic profile contributes to the need for reform of the health system as reported in the Department of Health’s Health Service Capacity Review 2018.

The Capacity Review indicated a need for significant expansion in the capacity of the health service, as well as substantial reform in how services are delivered.

Sláintecare represents the framework for these reforms.
Our first three strategic priorities represent our commitment to the necessary policy development and reform to meet the future needs of our population.

4.

Economic Outlook Resource pressures can be anticipated as a feature of the health and social care landscape over this strategic period 2021-23, particularly in the context of the consequences of the COVID-19 pandemic and of Brexit.
The significant increase in investment in health and social care in Budget 2021 represents a real opportunity to deliver on national health and social care strategies and reform priorities.

Significant additional resources secured in Budget 2021 will drive and support the management of COVID-19 in tandem and as part of overall health service delivery and reform.

Strategic priority 4 outlines the initiatives we will take towards ensuring value for money in relation to this investment.
An analysis of our external environment has informed the development of this Statement of Strategy.

The current environment presents the Department of Health with a range of opportunities to strengthen our contribution and this Statement of Strategy provides our framework for responding.

1.
1.

COVID-19 The Department will continue to take a leading role in Ireland’s response to the pandemic, working alongside the HSE, and the broad spectrum of health and social care providers, other Government Departments and with the people of Ireland.

Nobody is unaffected by the pandemic and the consequences on our people’s health and wellbeing are not yet fully known.
Addressing the COVID-19 pandemic and its wider impact on health and service delivery will continue to be the Department’s top priority for as long as is necessary.

2.

Political Landscape The Programme for Government provides the Government’s priorities and commitments.

Those commitments relevant to the Department of Health are listed in Appendix II.
Sláintecare was drawn up with cross-party political support, representing a unique platform and opportunity for collaboration towards the transformation of our health and social care services.

The Programme for Government reiterates the Government’s commitment to Sláintecare and this Statement of Strategy outlines the Department’s role in leading on the Sláintecare programme of reform.

23 5.

Public Engagement and Trust 6.

Equality and Equity The Department of Health serves the people of Ireland.
We are committed to engaging and involving patients and people in their own health and wellbeing, and care and treatment, as well as improving citizen participation in policy-making.

This is essential to achieving our vision.

The pandemic has transformed public knowledge and perception of the Department of Health.

During the COVID-19 pandemic the impact of Government decision-making and the important role that the civil service plays has become clearer than ever before for many.
With an unprecedented investment in health and social care services in 2021, the continuing threat of the pandemic, and advancements in technology and communications, public expectation is higher than ever.

Increased awareness of the role of the Department of Health, due to our role in the COVID-19 response, presents an opportunity to build on a high level of public engagement with health issues and to further strengthen our partnership with the Irish public.
The Public Sector Duty under Section 42 of the Irish Human Rights and Equality Act 2014 outlines the Department’s responsibility to eliminate discrimination, promote equality and protect human rights of staff and service users.

The Department of Health has specific responsibilities and this Statement of Strategy emphasises our commitments through strategic priority 3 and embedding equality as one of our core values.
In particular: The Department of Health will address health inequalities in line with the reform programme detailed in the Sláintecare Strategic Action Plan 2021 -2023.

The Department of Health will continue to promote compliance with the United Nations Convention on the Rights of Persons with Disabilities in the health (including mental health) and social care sphere.
The Department is demonstrating its commitment to the Public Sector Duty through specific commitments including: a committment to undertake a Public Sector Duty Self-Assessment; engaging with bodies under our aegis to ensure that they comply with the Public Sector Duty; implementing Department of Health actions within relevant National Strategies, listed in Appendix III, many of which cover services for marginalised groups; and reporting on progress towards our commitment to the Public Sector Duty in our annual report.
24 7. International Landscape 8.

Climate Action International trends and obligations shape our environment.

There is a strong international focus on progress in the areas of Universal Health Coverage, primary health care and non-communicable diseases, as well as pandemic preparedness and global health security.
Ireland’s Sustainable Development Goals National Implementation Plan 2018-2020 sets out the Government’s ambitious response to the United Nations’ Sustainable Development Goals (SDGs) and commits Ireland to fully achieving all 17 of the Goals by 2030.
This Department of the Environment, Climate and Communications will continue to work with the Department of Communication, Climate Action and Environment and relevant partners in order to achieve the relevant SDG targets, with a focus on SDG3 Good Health and Wellbeing.

The UK’s exit from the EU will also continue to demand significant engagement, planning and agile management on the part of the Department, the HSE and other agencies.
Our policy-making is informed by international thinking and best practice and we share both our data and our experience widely through both formal and informal international partnerships and networks.

The Department is committed to a continuing contribution to shape EU processes and outcomes as they affect the citizen.
The Department will continue to contribute internationally and to learn from international best practice, including through engagement and collaboration with other international bodies such as the World Health Organization (WHO), Organisation for Economic Co-operation and Development (OECD), European Centre for Disease Prevention and Control (ECDC) and others.
Climate change represents a significant challenge to the health and social care system as we must confront both our contributions to emissions and waste production, and also the adverse health impacts threatened by air and water pollution and general environmental degradation.

These risks include rising levels of chronic disease, respiratory illness, and infectious disease, and the potential for more frequent pandemics.
As part of the Government’s vision for Universal Healthcare, the Programme for Government commits to the delivery of “sustainable care”, highlighting climate consciousness as key to achieving long-term health goals for Ireland.

The Department of Health has published its Climate Change Adaptation Plan for the Health Sector 2019- 2024.
The Department supports and aligns with cross-governmental initiatives including those laid out in the Climate Change Action Plan 2019, the Public Sector Mandate, the Sustainable Development Goals National Implementation Plan, the Climate Action and Low Carbon Development (Amendment) Bill and the Decarbonisation Strategy forthcoming in 2021.

The Department is committed to strengthening our leadership role, our oversight function in the sector, and our cross government engagement on climate action.
Our commitment will be demonstrated in this strategic cycle through: appointment of dedicated staff on climate change; adherence to the forthcoming Public Sector Mandate and direction of bodies under our aegis to adopt a climate mandate; compliance with the Climate Action and Low Carbon Development (Amendment) Bill; implementation of the Climate Change Adaptation Plan for the Health Sector (2019-2024); continued implementation of the Climate Action Plan 2019 and contribution to, and implementation of, the Climate Action Plan 2021; examination of WHO recommendations and best practice approaches to reducing waste and improving ecological practice in health care; and commitment to actions in the forthcoming Decarbonisation Strategy and compliance with reporting measures applying across the Public Sector.
25 Conclusion The Department of Health holds a unique role in a complex system.

Over the next three years, this Statement of Strategy will guide our work as we collaborate with colleagues across government, our agencies, the public and all stakeholders in the health and social care sector towards our shared vision of ‘a healthier Ireland, with improved health and wellbeing for all, and with the right care, delivered in the right place, at the right time’.
We will strengthen our organisation to develop and harness the capability of our staff, who are our most important asset.

We will remain responsive and adaptable to our national and international environment, learning from and sharing best practice.

Most importantly, we will work with and be accountable to the Irish public as we deliver on our strategic priorities, serving them in all the work that we do.
26 Appendix I How the Department of Health developed its Statement of Strategy Strategic review Review of key documents and environmental analysis Consultation Internal and external consultation Gaining buy in throughout process Analysis and Drafting Analysing research findings and consultation feedback to draft Statement of Strategy Overview This Statement of Strategy for the Department of Health has been written in accordance with the Public Service Management Act of 1997.
The Act indicates that a Department is required to submit to the Minister of the Government a strategy statement in respect of the Department i) within 6 months after the appointment of a new Minister of the Government having charge of the Department or Scheduled Office, and ii) at the expiration of the 3 year period since the last such statement was prepared and submitted.
The formation of a new Government in July 2020, and the subsequent appointment of a new Minister for Health, thus necessitated the development of a Statement of Strategy for the Department.

A project team was convened in September 2020, to develop and submit a completed Strategy document to the Minister for Health by December 2020.

In that timeframe, the project team undertook a detailed process of strategic review, consultation, analysis and drafting as described below.
The process was designed to produce a Statement of Strategy for the Department of Health that articulates the medium- term priorities of the organisation, providing strategic direction and clarity for the years 2021-2023.
A successful Statement of Strategy will be a touchstone for colleagues in developing and aligning their day- to-day work, while communicating to the public and a broad range of stakeholders the Department’s priorities for the coming period and how they fit into a long-term vision for health.

27 Strategic Review The project team undertook an extensive strategic review in the initial phases of development for this Statement of Strategy.
The objectives of this strategic review were to: learn from previous Statements of Strategy (those belonging to the Department of Health, other government departments and private sector bodies); compile relevant information from strategic documents that will inform our priorities for the coming period e.g.
Department of Health commitments to national strategies, relevant information related to the environmental context; gather important information related to the Department’s obligations as a public sector body e.g.

obligations to climate action articulated in the Programme for Government and obligations to the IHREC Public Sector Duty; and inform consultation with key stakeholders.
Documents deemed relevant to the review met at least one of the following criteria: Include elements required to be included in the Statement of Strategy as referenced in the Guidelines Major Department of Health strategies, priorities and/or obligations Government and/or cross departmental strategies, priorities, risks, or issues The project team reviewed a total of 89 documents in the initial review phase, across six types of document, summarised in the table below.
Specific attention was paid to key strategic documents including the Programme for Government and Sláintecare documents.
Total number of documents reviewed: Number of Department of Health Reports and key strategies with links to the Programme for Government Number of HSE/agency documents Number of cross departmental documents Number of international documents Number of documents informed by citizen perspectives Number of other Statements of Strategy reviewed 89 18 5 26 16 8 16 This review contributed to the Department’s understanding of its environmental context, the role of the organisation in leading the health and social care sector, the views of stakeholders and, ultimately, to the determination of strategic priorities.
Consultation Consultation was core to the development of this Statement of Strategy.
It was important to engage with stakeholders internally and externally across the health and social care system to understand: how staff view the challenges and opportunities facing the Department, and gain their input on the priorities of the Department in the medium-term; how the Statement of Strategy might best provide strategic direction for staff; and how stakeholders outside the Department, including the public and the Department’s agencies, see the Department’s role and their views on what the Department should prioritise in its role in the medium term to deliver on the long-term vision for the health and social care system.
28 Analysis and Drafting The analysis and drafting stage of developing this Statement of Strategy was an iterative process.

Gathering the information collected through the initial strategic review and consultation phases, the project team produced analyses of internal and external factors that could affect the progression of strategic priorities.
This analysis accounted for internal strengths and weaknesses as well as external factors such as the political context, advances in technology, and economic trends.

Situating the results of extensive consultation in these contexts, the project team produced multiple drafts of this strategic document, which were tested in various iterations with stakeholders including internal subject matter experts and presented to senior management for review.
Finalisation and Publication In December 2020, the Department project team for the Statement of Strategy submitted a draft to the Acting Secretary General for approval.

It was then submitted to the Minister for final approval ahead of submission to the Oireachtas, in line with the requirements of the Public Service Management Act 1997.

Ahead of publication, the Statement of Strategy was translated into Irish as per the requirements of the Official Languages Act 2003.
The Strategy and supporting documents were published on the Department of Health’s website.

Over a 6-week period, the Department engaged in a detailed consultation process.
Internal consultation included engagement with: Minister for Health, Ministers of State; Acting Secretary General and Management Board; a cross-divisional reference group, with three workshops held; Management Board’s subcommittees on risk and policy; all-staff via internal survey; internal senior management networks via workshops; and colleagues expert in areas related to strategic priorities via workshops.
External consultation included: a inter-departmental group working on Statements of Strategy was convened by the Department of Health and held 2 meetings including inputs on the Public Sector Duty from IHREC and on climate action from the Department of Environment, Climate and Communications; invitation of submissions from other government departments; public consultation via online survey which received 2555 responses; consultation with the HSE and aegis bodies – 14 submissions received; and additional consultation with external experts on risk and strategy.
These consultations formed a vital part of the development process for this Statement of Strategy, ensuring that it reflects a shared vision for the future of the health and social care service.

29 Appendix II Programme for Government Commitments Programme for Government Sub-Category Department of Health Commitment Public Finances and Taxation We will examine, in advance of Budget 2022, appropriate funding measures to support the implementation of Sláintecare.
Delivery of Care in a COVID-19 Environment Quickly identify the impact of COVID-19 on Sláintecare implementation Examine new ways to utilise community settings and create partnerships with our private hospitals to avoid placing increased pressure on the public system Ensure capacity, particularly bed and critical care capacity, for a COVID-19 rapid response and for non-COVID-19 emergencies into the longer term Prioritise the elective-only programme to treat patients and to manage the reduced capacity, as a result of COVID-19.
Maintain an intense focus on COVID-19 and follow four guiding principles: isolate, test, trace and treat, to enable a speedy reaction, should there be an increase in cases.

Continue to deploy new technologies, telehealth, and innovative ways to support vulnerable groups, as well as new pathways of care.
Ensure that patients and healthcare staff are kept informed of and fully engaged in changes in healthcare practice, due to COVID-19 Maintain ongoing monitoring of international experience and knowledge to assist in ensuring the safety of patients and healthcare workers.

We will examine international public health models, learning from best practice, and reshape our public health system, to ensure an agile and well-planned response to future epidemics.
Implementing Sláintecare The response to the COVID-19 Emergency has demonstrated that by working together, we can make progress and achieve these aims in the longer term.

It has also necessitated new ways of delivering care.

We must ensure that these new models meet demand, while taking account of lower occupancy rates and the longer time now needed to prepare for procedures.

Many of the healthcare responses to COVID-19 are important elements of Sláintecare, and we will identify how to keep the gains.
Underpinning our approach will be the provision of more health services in the community, increases in capacity, including bed, ICU and critical care capacity, and the promotion of good public health policy.

Our approach will be patient centred.

We will maintain leadership at the highest level, with the Cabinet Committee on Health, chaired by the Taoiseach, giving overall strategic direction, and overseeing the implementation of Sláintecare.
30 Programme for Government Sub-Category Implementing Sláintecare: Structural Reform Implementing Sláintecare: Fairer and Affordable Care Implementing Sláintecare: Deliver More Care in the Community Department of Health Commitment Bring forward detailed proposals on the six new regional health areas to deliver local services for patients that are safe, high quality and fairly distributed.

Finalise the new Sláintecare consultant contract and legislate for public-only work in public hospitals.
Undertake an analysis of key indicators and healthcare metrics to examine how care needs are being met or unmet, to be used as a component in the planning of future healthcare delivery.

Increase homecare hours and introduce a Statutory Homecare Scheme.

Extend free GP care to more children.

Extend free GP care to carers in receipt of the Carer’s Support Grant.

Abolish in-patient hospital charges for children.

Extend free dental care to more children.

Introduce baby boxes for all new parents.


Reduce prescription charges and the Drug Payment Scheme threshold.

Increase the income threshold on medical cards for people over 70.

Extend discretionary medical cards to those with a terminal illness.

Introduce a cap on the maximum daily charge for car parking for patients and visitors at all public hospitals, where possible.

Introduce flexible passes in all public hospitals for patients and their families.
Establish a National Medicines Agency, promoting national prescribing to reduce the cost of medicines, including via generic prescription, where appropriate, and to set a fair price for drug reimbursement.

Retain access to private health services, ensuring choice for those accessing health care.

Developing Community Healthcare Networks to support the expansion of services, based on the need and size of local populations.
Targeting an increase in opening times for unscheduled care, radiology, and diagnostic services in the community.

Strengthening general practice – implementing the contract with GPs, sustaining out-of- hours and rural services, and increasing GP training places, including for GPs with Special Interest qualifications.
Establishing a ‘Delivering Equality of Opportunity in Schools (DEIS)’ type programme for health, providing GP practices, community pharmacies and public health staff with dedicated additional resources to communities, focused on improved health outcomes and driven by strong data.

Rolling out the chronic disease management programme.

Increasing telemedicine and virtual clinics, based on the very positive usage and experience during the COVID-19 crisis.
Supporting the Dialogue Forum working with voluntary organisations to build a stronger working relationship between the State and the voluntary healthcare sector.

Commencing talks with our pharmacists on a new contract and enhancement of their role in the delivery of healthcare in the community, including via e-prescribing and issuance of repeat prescriptions.

Supporting the expansion of community ophthalmology and the wider adoption of the Sligo pilot model.
31 Programme for Government Sub-Category Implementing Sláintecare: Increase Capacity Department of Health Commitment Continue to invest in healthcare infrastructure and equipment, together with the recommendations of the Capacity Review, in line with Project Ireland 2040.

Ensure capacity for a COVID-19 rapid response, including bed and ICU capacity and for non-COVID emergencies into the longer term, by utilising some private hospital capacity, if necessary.

Open the National Children’s Hospital.


Deliver the second cath lab in University Hospital Waterford.

Conclude the governance arrangements and commence the building of the new maternity Hospital at St Vincent’s Hospital, Dublin.

Provide new radiation oncology facilities in Galway and Dublin.

Through the Design and Dignity Programme, renovate and renew eleven mortuaries across the country.

Increase capacity in our National Ambulance Service and expand Community First Responder schemes.
Work with the HSE to improve palliative care across the country, by aiming to ensure a seamless pathway for palliative care patients across in-patient, homecare, nursing home and day care services.

Implementing Sláintecare: Ehealth and ICT Invest in a modern eHealth and ICT infrastructure, in line with Project Ireland 2040 and the eHealth Strategy for Ireland.
Build on the progress already made in responding to COVID-19, by working with GPs to improve eHealth measures, and providing for the secure electronic sharing of patient information, lab results, diagnostic imaging reports, and prescription orders between medical providers.

Roll out the Individual Health Identifier programme, ensuring that patient information is accessible across different services to improve patient safety.
This will allow patients direct access to view and correct inaccurate information.

Implement an Electronic Health Record system in the new National Children’s Hospital and prepare to roll it out nationwide.

Explore the potential for introducing a 24-hour triage and health-concerns telephone and website service, which will help to direct patients into appropriate streams of care.
Implementing Sláintecare: Supporting our Healthcare Workers Recruit additional frontline community staff, including public health nurses and allied health professionals, such as occupational therapists, physiotherapists, dementia advisers and speech and language therapists.

Continue to implement the Nursing Agreement, which includes additional measures to assist with the recruitment and retention of nurses into the public health service.
Establish an expert group on nursing and midwifery to advance the nursing and midwifery professions.

Engage with radiographers, paramedics, and healthcare assistants on how their roles can be developed.

Increase the number of public-only consultants in our hospitals.

Implement the GP contract.

Transfer GP training to the Irish College of General Practitioners.
Establish a workforce planning expert unit to work with the education sectors, regulators, and professional bodies to improve the availability of health professionals and reform their training to support integrated care across the entire health service.

Require continuous professional development for all staff in the health sector.
32 Programme for Government Sub-Category Implementing Sláintecare: More Compassionate Care Implementing Sláintecare: Focus on Rare Diseases Implementing Sláintecare: Implementing National Health Strategies Implementing Sláintecare: Organ Donations Implementing Sláintecare: Sustainable Care Department of Health Commitment Enact the Patient Safety (Notifiable Patient Safety Incidents) Bill 2019, providing for mandatory open disclosure.

Enhance the patient safety role of HIQA.


Continue to support the National Patient Advocacy Service and the work of the National Patient Safety Office (NPSO) in overseeing a programme of patient safety improvements and reforms Reassess how claims for medical negligence are handled in Ireland, including the role of the State Claims Agency, so that the Irish medical negligence regime is brought into line with other OECD countries following from the Meenan Report.
Examine the potential to legislate for mediation as a first resort for disputes involving medical negligence in health care.

Introduce a package of supports for those affected by patient safety incidents, at the same time as an open disclosure, and ensure that an apology is made.

Publishing an updated National Rare Diseases Plan.

Promoting research and, in particular clinical trials, which are key to improving the prevention, diagnosis and treatment of rare diseases.
Enacting the National Research Ethics Committee Bill.

Establishing a National Genetics and Genomics Medicine Network.

Supporting the medical genetics service in Our Lady’s Children Hospital, Crumlin.

We will continue implementing the National Cancer Strategy; Trauma Strategy; National Dementia Strategy; National Maternity Strategy; Neuro Rehabilitation Strategy; National Clinical Programme for Stroke.
Enact the Human Tissue Bill, providing the legal basis for an opt-out system of organ donation and deliver a public information campaign.

Examine WHO recommendations and best practice approaches to reducing waste and improving ecological practice in health care.
33 Programme for Government Sub-Category Promoting Women’s Health Department of Health Commitment Support the work of the Women’s Health Taskforce, including the development of a Women’s Health Action Plan, to tackle a wide range of issues impacting women’s health outcomes in Ireland.

Promote an increase in the number of new mothers breastfeeding, by increasing support in our maternity hospitals and primary care centres, through access to lactation specialists and public health nurses.
Fully implement the recommendations contained in Dr Scally’s Report of the Scoping Inquiry, and all other reports into CervicalCheck Support the CervicalCheck Screening Programme and promote the uptake of the HPV vaccine.

Provide free contraception over a phased period, starting with women aged 17-25.

Enact the Assisted Human Reproduction (AHR) Bill.

Introduce a publicly funded model of care for fertility treatment.

Extend BreastCheck to those aged 69.


Implement the National Maternity Strategy, to support recruitment and training of additional key midwifery and medical staff, options for homebirth, access to dating and anomaly scanning in all maternity units, and care pathway across the maternity network.

Progress the planning, tender and design stages for the relocation of the Coombe Hospital to St James’s, the Rotunda Hospital to Connolly, and Limerick University Maternity Hospital to University Hospital Limerick.
Establish exclusion zones around medical facilities.

Note the review, as required under Section 7 of the Regulation of Termination of Pregnancy Act 2018, which will take place in 2021.

Healthier Future: Tobacco and Nicotine Ban the sale of nicotine-inhaling products, including e-cigarettes, to people under 18 years, introduce a licensing system for the retail sale of nicotine-inhaling products, and restrict the types of retailers that can sell these products.
Curb the advertising of nicotine-inhaling products near schools, on public transport, and in cinemas.

Healthier Future: Alcohol Continue to implement the Public Health (Alcohol) Act and honour our longstanding commitment to introducing minimum unit pricing in consultation with Northern Ireland.

Healthier Future: Tackling Obesity Work with key stakeholders to introduce a Public Health Obesity Act, including examining restrictions on promotion and advertising aimed at children.
Ensure that all local authorities embed actions on obesity prevention in future County and City Development Plans.

34 Programme for Government Sub-Category Healthier Future: Children's Health Department of Health Commitment Introduce planning restrictions on outlets selling high calorie ‘junk-food’ and beverages adjacent to schools.

Extend the Oral Health Promotion Programme to reach all children in primary schools.
Healthier Future: Exercise Promote more physical exercise among all sections of the community, young and old, for the long-term health and benefit of society.

Healthier Future: Screening and Immunisation Work to encourage increased participation in Physical Education in primary and secondary education.

Support SMEs to have adequate shower and changing facilities to assist workers who cycle and run to work.
Encourage close collaboration between the Departments of Education, Health and Sport and sporting organisations to encourage and enable physical activity among children, in particular at primary school.

Remain committed to protecting the nation’s health and wellbeing through immunisation, infectious disease control, and the continued support of our screening programmes.

Examine the possibility of introducing a national immunisation register.
Extend BreastCheck to women aged 69 and BowelScreen to all aged 55-74.

Make the flu vaccine available to more people, without charge.

Continue to support the National Vaccine Alliance in promoting the uptake of childhood vaccines and reducing vaccine hesitancy.

Examine the inclusion of the chicken pox vaccine in the children’s immunisation schedule.

Following completion of the work of the Health Research Board on approaches to vaccination in other countries, act on its advice and recommendations.
Mental Health Promoting positive mental health and reducing the burden of mental illness can have benefits for everyone.

The outbreak of COVID-19 in Ireland has created significant anxiety, stress and fear for many people, reinforcing the need for a range of mental health supports and services.

Mental health service users are among the most vulnerable people in Ireland; we should aim to become an international leader in supporting and caring for people with mental health needs.
Mental Health: Sharing the Vision By providing more assistant psychologists, occupational therapists, and other key workers, we will create a flexible approach and encourage more collaboration with acute services and the voluntary and community sector.

We will ensure that any new services, such as outreach, are supported by community cafes and intensive rehabilitation units.
Care will be provided to vulnerable people in a variety of in-patient and community settings Through the promotion of digital health interventions such as online training, safe talk training and new pilot telepsychiatry services, including in an emergency department, we will significantly improve access to mental health services.
35 Programme for Government Sub-Category Mental Health: Implementation Plan Department of Health Commitment We will immediately establish a national implementation and monitoring committee, which will have representatives from the statutory, voluntary and community sectors.

Work to end the admission of children to adult psychiatric units, by increasing in-patient beds, as well as examining the model of assigning these beds.
Continue to support the expansion of Jigsaw services and their existing network of early intervention and prevention services and supports.

Integrate mental health services provided by nongovernmental organisations, with a system of care that includes local statutory and community services.

Continue to resource the national roll-out of the model care for Specialist Perinatal Mental Health, with the expansion of mental health supports to be made available to both parents and parents of adopted children.
Open the new National Forensic Mental Hospital in Portrane.

Implement the Pathfinder interdepartmental unit on youth mental health.

Examine a one-door policy, a single psychological assessment tool to determine the most appropriate service.

Extend the remit of the National Treatment Purchase Fund to secure timely assessment for both child and adult psychological services.
Seek to expand social prescribing where patients are referred to non-clinical activities, as a means of positively influencing mental wellbeing.

Complete the update of the 2001 Mental Health Act, including amendments to allow young people, aged 16- 17, the right to consent to treatment for their mental health.

Publish a Traveller and Roma Mental Health Action Plan.

Examine the appointment of a Chief Psychiatrist in the Department of Health and a National Director for Mental Health in the HSE.
Increase the number of Authorised Officers to support families, in line with the Expert Group on the Review of the Mental Health Act 2001.

Examine extending the Patient Advocacy Service to support those accessing public mental health services.

Ensure that mental health services are accessible to people in the deaf community.

Promote mental health research to assist in better responding to the mental health needs of the population.
Mental Health: Suicide Prevention Work closely with the National Suicide Prevention Office to develop specific suicide prevention policies and to ensure a whole-of-government approach to suicide prevention.

Support ongoing implementation of the extended Connecting for Life, focused on reducing the loss of life by suicide and reducing cases of self-harm.
36 Programme for Government Sub-Category Health-led Approach to Drugs Misuse Department of Health Commitment Examine how we can continue to support Drug and Alcohol Task Forces in identifying local need in communities, and support targeted initiatives addressing drug and alcohol misuse.
We will ensure that a representative of the National Oversight Committee for Reducing Harm, Supporting Recovery is included in the implementation and monitoring arrangements for Sharing the Vision – a Mental Health Policy for Everyone We will implement the recommendations of the Working Group to Consider Alternative Approaches to the Possession of Drugs for Personal Use We will undertake a review of this alternative approach, to ensure that it is meeting all of its aims, following the first full year of implementation, and make any necessary changes.
Recognising the additional risk faced by people who use drugs, specific actions have been taken to support increased and improved access to opioid substitution services during COVID-19.

We will seek to retain these measures to reduce waiting times in accessing these services.

Examine the regulations and legislation that apply to cannabis use for medical conditions and palliative care, having regard to the experience in Northern Ireland and Great Britain.
Convene a Citizens’ Assembly to consider matters relating to drugs use.

Build on recent initiatives at junior and senior cycle and support secondary schools in introducing drug and alcohol awareness programmes, particularly in relation to the hazards of casual drug use.

Examine approaches to identifying at-risk young people and vulnerable groups to interrupt their potential trajectory into problem drug and alcohol misuse.

Increase and support drug-quality testing services, particularly at festivals.
Recognise that women can face barriers to accessing and sustaining addiction treatment, arising from an absence of childcare or the presence of domestic violence, and develop targeted interventions aimed at responding to their needs.

Expand services for pregnant and post-natal women affected by substance use, and their children.

Examine the potential for an information campaign on the health impacts of steroid use, particularly on young men.
Create a path for people in rehabilitation from drug addiction to access education and training facilities in their local areas.

Re-establish the Galway City Community Based Alcohol Treatment Service.

Progress the National Clinical Programme for Dual Diagnosis and work to develop joint protocols and referral pathways.
Support the Drug Related Intimidation Reporting Programme, developed by the National Family Support Network, in partnership with An Garda Síochána, to respond to the needs of drug users and families facing the threat of drug-related intimidation.

Establish a 24-hour helpline, based on the FRANK helpline in the UK providing advice and assistance to people who use drugs and their family members.
Develop health and social interventions, based on an inclusion-health approach to target people who are homeless and in addiction.

Ensure in-reach supports and pathways to access to treatment for homeless, Traveller and new communities.

Increase the number of residential treatment beds for those stabilising, detoxing, and/or seeking drug-free services.
37 Programme for Government Sub-Category Department of Health Commitment Age Friendly Ireland: Commission on Care Age Friendly Ireland: Home and Community Care Support Significantly increase support for step-down accommodation to prevent high-risk single people and families from exiting treatment into homelessness.

Reduce the number of lives lost through overdose by opening a pilot medically supervised injecting facility in Dublin City.

Support the roll-out of access to, and training in, opioid antidotes.
Ensure a ‘Good Neighbour’ policy for drug treatment centres to address any concerns held by local residents and businesses alike.

Legislate against the coercion and use of minors in the sale and supply of drugs.

Continue to resource harm reduction and education campaigns aimed at increasing awareness of the risks of drug use and the contribution of drugs to criminality.
Learning from COVID-19, we will assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens.

We will establish a commission to examine care and supports for older people.

Expand community-based care, bringing it closer to home, in line with the Sláintecare Implementation Plan.

Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality, regulated home care.

Increase homecare hours.


Expand Community Intervention Teams to prevent unnecessary hospital admissions and to support the timely discharge of patients to their homes.

Ensure that community services assign a case manager for older people with chronic conditions to assist them with accessing the care they need.

Develop the role of advanced nurse practitioners in older person services and chronic disease management.

Increase the availability of step-down facilities.


Support eHealth and the increased use of assistive technologies, supporting people to live independently.

Deliver a ‘Carers Guarantee’ proposal that will provide a core basket of services to carers across the country, regardless of where they live.

Increase access to talk therapies and improve access to specialist expertise, when it is required, in line with Sharing the Vision – a Mental Health Policy for Everyone.
Develop a plan aimed at tackling loneliness and isolation, particularly among older people, as outlined in the Roadmap for Social Inclusion.

38 Programme for Government Sub-Category Age Friendly Ireland: Delivering Choice Age Friendly Ireland: Long- term Residential Care Age Friendly Ireland: Enhancing Dementia Care Department of Health Commitment Embed ageing in place options for older people into the planning system, as the county and city development plans are redrawn this year.
Drawing on the Housing Need and Demand Assessments, develop demographic reporting tools and population projections to gain a better national understanding of the needs and location of housing options for older people.

Increase the provision of smaller homes in developments, ensuring that older people can remain living in their communities, close to essential services and facilities.
Task local authorities to work with Approved Housing Bodies, co-operatives, private developers, and Age Friendly Ireland on the development/redevelopment of older-person housing.

Maintain support for the Housing Adaptation Grant Scheme.

Promote active retirement and positive ageing initiatives to tackle social isolation.

Explore a new digital skills for citizens grant scheme, focusing on one-to-one training.
Ensure that older people who are at greater risk of fuel poverty and the respiratory illnesses associated with air pollution be prioritised in climate action and climate mitigation plans.

Encourage book clubs for older people to tackle loneliness.

Work with the Nursing Home Expert Panel, which has been tasked with examining and advising on the ongoing COVID-19 response.

Examine ways to improve integration with the health service and clarify clinical governance arrangements for nursing homes.
Support the Nursing Homes Support Scheme (The Fair Deal) to provide assistance when staying at home may no longer be an option.

Enact legislation implementing the revised Nursing Homes Support Scheme arrangements for farmers and business owners.

Ensure that no Nursing Homes Support Scheme resident is charged for services they do not use.

Examine extending the remit of the Patient Advocacy Service to residents of long-term residential care facilities.
Champion a whole-of-life approach to care and caring responsibilities.

Ensure that the best possible safeguards are in place to protect our friends and family in nursing homes.

Implement the National Dementia Care Strategy.

Ensure that home support is adaptable and responsive to the needs of those with dementia.

Increase the number of dementia advisers.

Investigate the possibility of establishing a dementia village along the lines of Hogeweyk, in the Netherlands.
Finalise a code of practice on Advanced Healthcare Directives, allowing for full commencement of the legislative framework.

39 Programme for Government Sub-Category Age Friendly Ireland: End-of- life Care Department of Health Commitment Increase the number of specialist palliative care beds countrywide over the next five years, ensuring that there will be a hospice serving every region in the country.

Open new units in Mayo, Waterford, and Wicklow in 2020.
Progress plans to build units in Drogheda and Cavan, and a further in-patient unit planned for the Midlands.

Support Community Specialist Palliative Home Care Teams in all HSE areas, fund designated home care packages, and resource specialist palliative care provided in hospices.

Increase resources for the Children’s Palliative Care Programme.
This will be supported by consultants with a special interest in children’s palliative care and children’s outreach nurses to coordinate care for children with lifelimiting conditions and their families.

Publish a new Palliative Care Policy for Adults by mid- 2021 to update the 2001 policy.

This will reflect the many developments in end-of life care and international best practice and better interact with children’s palliative care.
Complete the research being carried out in association with the Irish Hospice Foundation into the cost of bereavement and funeral poverty in Ireland.

This research will inform our approach to determining any further interventions or supports the State can provide to alleviate any hardship associated with loss and bereavement.

Disability Prioritise early diagnosis interventions and access to services.

Improve and change services through better implementation and collaboration.
Ensure that the most effective interventions are provided for each individual, to guarantee the best outcomes.

Seek to reduce the waiting times for assessment of need under the Disability Act 2005, through the full-year provision of additional therapy posts.

Fully implement the new standard operating procedure for assessment of needs for all applications.

Fully complete the establishment of the Progressing Disability Services for Children and Young People (0- 18 years) Network Teams.
Integrate access to mental health supports as part of disability service provision.

Continue with the successful decongregation programme and complete a further move of more people with disabilities from congregated settings to homes in the community, with the necessary supports.

People with disabilities and their families have been impacted by COVID-19 in many ways, whether from a move to delivering services online, or a reduction in services, to feelings of isolation.
A renewed focus on how we provide services is needed.

Work with all stakeholders to see how services and resources can be delivered.

Reduce and provide a pathway to eliminate the practice of accommodating young people with serious disabilities in nursing homes.

Work towards implementing the most recent Disability Capacity Review.
We are committed to the introduction of personalised budgets, improving the provision of services for people with disabilities through a range of options, including service brokers, and empowering people to choose the supports that most meet their needs.

This will be based on the experience of the pilot schemes.
40 Programme for Government Sub-Category Disability: Residential and Respite Care Disability: Day Services and Supports Disability: Autism Spectrum Disorders Department of Health Commitment Additional residential places and new emergency residential placements.

Additional appropriate residential places for people currently living in respite care, as an emergency response to their needs.

Further intensive transitional support packages for children and young people with complex/ high support needs.
Additional respite nights for people with disabilities.

Work to expand adult day services and supports, throughout the country, for adults with physical and sensory disabilities, intellectual disability, and autism.

Deliver increased home support and Personal Assistance hours.

Implement the National Autism Plan and keep it under regular review.

Implement a programme of awareness-raising to provide a better information resource for children and parents about available supports.
Deliver a campaign to create awareness of the challenges, needs and experiences of people with autism spectrum disorder.

Build capacity and competence amongst key professionals working with people with autism, including a national training programme for clinicians.
Cross- departmental The Programme for Government commits to the full implementation of the ‘One Health’ Strategy, placing particular focus on the connections between human, animal and environmental health and encouraging the optimal use of animal health products Cross- departmental We will continue to work with colleagues across Government, delivering on our role in achieving a better quality of life for all.
We will continue to work with colleagues across Government, delivering on our role in reigniting and renewing the economy.

We will continue to work with colleagues across Government, delivering on our role in pursuing and implementing a Green New Deal.

We will continue to work across Government, delivering on our role in achieving balanced regional development.

We will continue to work across Government, delivering on our role in achieving a New Social Contract.
Work in this area includes: Review and update the National Carers’ Strategy.

We will continue to work across Government, delivering on our role in building stronger and safer communities.

We will continue to work across Government, delivering on our role in providing better opportunities through education and research.

We will continue to work across Government, delivering on our role in building a shared island.
We will continue to work across Government, delivering on our role in ensuring that Ireland is at the heart of Europe and Global citizenship.

We will continue to work across Government, delivering on our role in reforming and reimagining our public life.

We will continue to work across Government, delivering on our role in ensuring the effective functioning of Government.
41 Appendix III List of National Strategies List of Health Strategies The following is a non-exhaustive list of national health strategies as reflected in documents such as, among others, the Programme for Government, Budget 2021, and Implementing the Public Sector Equality and Human Rights Duty.

For up to date publications, please see the Department of Health website.

1.

A Healthy Weight for Ireland: Obesity Policy and 19.

Organ Donation and Transplant Initiatives Action Plan 2016-2025 2.
A Trauma System for Ireland: Report of the Trauma Steering Group 3.

Connecting for Life: Ireland’s National Strategy to Reduce Suicide 2015-2024 20.

Paediatric Model of Care 21.

Reducing Harm, Supporting Recovery: a health- led response to drug and alcohol use in Ireland 2017-2025 22.

Sharing the Vision: A Mental Health Policy for 4.

COVID-19 Nursing Homes Expert Panel: Final Everyone Report 5.
Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Ireland 2018 6.

Healthy Ireland Framework 2019-2025 23.

Sláintecare Consultant Contract 24.

Smile agus Sláinte – National Oral Health Policy 25.

Taskforce on Staffing and Skill Mix 26.

The Women’s Health Taskforce 7.

Housing Options for our Ageing Population: Policy 27.

Tobacco Free Ireland Statement 8.

Ireland’s National Action Plan on Antimicrobial Resistance 2017-2020 9.
Model of Care for Ambulatory Gynaecology 10.

Model of Care for Infertility 28.

Health Service Capacity Review 2018 29.

National Clinical Programme for Stroke 30.

National Strategy & Policy for the Provision of Neuro-Rehabilitation Services in Ireland 31.

Paediatric Services (including New Children’s 11.

National Ambulance Service Strategic Plan 2016- Hospital) 2020 32.

Report of the National Advisory Committee of 12.

National Cancer Strategy 2017-2026 Palliative Care (2001) 13.
National Carers’ Strategy 14.

National Dementia Strategy 15.

National Maternity Strategy – Creating a Better Future Together 2016-2026 16.

National Physical Activity Plan for Ireland 33.

Palliative Care for Children with Life-Limiting Conditions in Ireland - A National Policy 34.

Safeguarding Vulnerable Persons at Risk of Abuse National Policy & Procedures: Incorporating Services for Elder Abuse and for Persons with a Disability 17.

National Positive Ageing Strategy 35.


Sláintecare Implementation Strategy 18.

National Sexual Health Strategy 2015-2020 42 Cross Governmental Strategies The Department of Health is a partner in the delivery of multiple cross-governmental strategies, some of which are listed below.
The items marked below with an asterisk are those National Strategies highlighted by the Irish Human Rights and Equality Commission as representing State commitments to human rights and equality (noted in Implementing the Public Sector Equality and Human Rights Duty).

1.

Better Outcomes, Brighter Futures: The National Policy Framework for Children and Young People, 2014-2020 2.

Comprehensive Employment Strategy for People with Disabilities 2015-2024 3.

DCEDIY School Inclusion Model 4.


Making Innovation Real - the Public Service Innovation Strategy 5.

National Digital Strategy 16.

The Global Island: Ireland’s Foreign Policy for a Changing World 17.

The Migrant Integration Strategy 2017-2020* 18.

The National Action Plan for Social Inclusion 2018-2021* 19.

The Quality Customer Services Initiative* 20.

First Five: A Whole-of-Government Strategy for Babies, Young Children and their Families 2019-2028 6.
National Disability Inclusion Strategy 2017-2021* 21.

Wellbeing Policy Statement and Framework for Practice 2018-2023 7.

National LGBTI+ Inclusion Strategy 2019-2021 8.

National LGBTI+ Youth Strategy 2018-2020 9.

National Strategy on Children and Young People’s Participation in Decision-Making 2015-2020 10.

National Strategy for Women and Girls 2017- 2020* 11.

National Traveller and Roma Inclusion Strategy 2017-2021* 12.

National Youth Strategy 2015-2020 13.


One World, One Future: Ireland’s Policy for International Development 14.

Our Public Service 2020 15.

Public Sector Duty 43 Appendix IV Bodies under the Aegis of the Department of Health 1.

Dental Council 2.

Food Safety Authority of Ireland 3.

Health and Social Care Professionals Council (CORU) 4.

Health Information and Quality Authority 5.

Health Insurance Authority 6.

Health Products Regulatory Authority 7.

Health Research Board 8.


Health Service Executive (HSE) 9.

Irish Blood Transfusion Service 10.

Medical Council 11.

Mental Health Commission 12.

National Cancer Registry Ireland 13.

National Paediatric Hospital Development Board 14.

National Treatment Purchase Fund 15.

Nursing and Midwifery Board of Ireland 16.

Pharmaceutical Society of Ireland 17.

Pre-Hospital Emergency Care Council 18.

Safefood 19.

Voluntary Health Insurance Board 44 45