Performance Verification Process

Phase 4 Agency Reports: Secretary General’s Observations

St. James’s Hospital

General

St. James’s Hospital, Dublin is a voluntary hospital funded through the HSE Eastern Area. It maintains strong links with the other DATH Hospitals. For Phase I & 2 the PVG decided unanimously that payment as warranted. For Phase 3 payment was warranted with comment.

The summary overview submitted with the report provides a brief overview of the context for the report.

Enhanced Customer Service

The report is good in the areas of initiatives taken to enhance the client experience, easy discharge and complaint handling. Good co-operation with NTPF is also reported. The report contains good progress in the areas of skill mix and multi disciplinary team working. New services have opened in Haematology and Oncology Day Services and GEMS Outpatients, and Medical Day Services opens in April 2005, which will result in increased capacity and greatly enhance services for clients.

Industrial Relations

There has been no strike action or threatened strike action, or work to rule in the period under review. The Hospital remains committed to maintaining a progressive employee relations environment through Partnership.

Performance Management

The Hospital is not a national pilot site but as part of the national rollout, three sites have been identified to commence Team Building Performance Management.

The Key Performance Indicator Reports continue to be a vital management tool. SJH has won a Derek Dockery Award for innovation in the Health Service, organised by the ERHA.

On an organisational basis, the hospital has a range of benchmarks and indicators to monitor performance with set service standards in place. New initiatives have also been reported in this area.

Modernisation/Equality

Numerous examples are reported in relation to modernisation. The hospital continues to play a lead role in systems implementation.

The figure has not been provided for the employment of people with disabilities, however, a working group has been established to develop an understanding of employment levels after advice was sought from the Equality Authority.

Value for Money

The report outlines good progress continuing on previously reported issues and a number of new initiatives, details of savings are included in the report. Staff redeployment is common practice throughout the hospital.

The hospital is running marginally above its employment ceiling, as previously reported, reliance on additional agency nurses has not been resolved as yet.

Staff Training & Development

Training has been provided to a number of staff under most of the categories outlined in the report. Training budget is only 1% of payroll, costings for each training course have also been supplied in the report.

Summary

The hospital continues to show good progress under all headings.

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St. Johns Hospital, Limerick

General

St. Johns Hospital is a voluntary hospital located in Limerick. For Phase I & II St. Johns was included with the report for the MWHB. It was decided by the PVG that a separate report was warranted for Phase III. The hospital has approximately 318 staff in wholetime equivalence terms. The PVG decided unanimously that payment was warranted for phase 3.

The summary overview submitted with the report provides a brief overview of the context for the report.

Enhanced Customer Service

Departments where existing extended hour’s initiatives have been expanded are continuing to work well. The report is good in the areas of initiatives taken to enhance the client experience and complaint handling.

Progress in the areas of skill mix is being made, and multi disciplinary team working is well established.

There is full co-operation with the NTPF.

Industrial Relations

Industrial relations are positive and there has been no strike action or threatened strike action. A good communication network has contributed to a positive industrial relations environment.

Performance Management

Three Departments have been identified for roll out of the team based performance management, and roll out has commenced. Performance indicators are being introduced across all departments as part of the accreditation process.

Modernisation/Equality

The accreditation process is ongoing and continues to promote changes. The hospital reports that 2.5% of staff are considered to have a disability.

Value for Money

The report outlines good progress continuing on previously reported issues. As with several other agency reports, this section would benefit from greater detail around timescales and saving achieved or expected.

Staff Training & Development

APPM Funding was made available to the hospital in late 2004, the training given for this period is outlined in the report. A total of 1.08% was spent on training and development in 2004, this did not include the cost of in house training.

Summary

Progress has been made in all areas with initiatives in place which enhance the customer experience.

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St. Vincent’s Hospital

General

St. Vincent’s Hospital, Dublin is a voluntary hospital funded through the HSE Eastern Area. The hospital is a co-founder of St. Vincent’s Health care Group, the purpose if which is to exploit economies of Scale in conjunction with St. Michael’s Hospital and St. Vincent’s Private Hospital.

In phase I & 2 of the performance verification process, the PVG unanimously decided that payment was warranted with comment. In phase 3, payment was warranted with qualification, however it should be noted that due to an oversight, this information relating to the areas highlighted for attention and addressing the same, was not furnished to the hospital until March 2005.

Enhanced Customer Service

Staff have participated in development of operational policies for a number of departments, which will provide an enhanced and seamless level of services to customers.

The existing initiatives in relation to extended hours continue to operate. Good progress is also reported on new initiatives aimed at improved customer service. The hospital has also commissioned a survey of patients regarding their perception of the quality of care and service to identify areas which may need improvement.

The Hospital is actively participating with the NTPF, and is a pilot site with the other DATHs hospitals working with the NTPF in the development of a National Patient Treatment Register.

Several examples are included in the area of the report dealing with multidisciplinary team working.

Industrial Relations

There has been no strike action or threatened strike action in the hospital. One issue reported refers to the Craft group of unions who have not engaged locally in relation to the change and modernisation agenda. One meeting with the Officials from the various unions resulted in preconditions being set down by the craftworkers.

The sections of the report dealing with the HR / Union interface and the working of partnership, provide good evidence to support the existence of a positive environment.

Performance Management

St. Vincent’s are not a performance management pilot site, however, four areas have been identified for piloting the performance management initiative in 2005, and more departments are being examined to identify more areas for roll out.

Customer service standards are well covered in the report. A “Pre Accreditation Advanced” status has been granted and the recommendations from the peer review survey have been incorporated in to the relevant Quality Improvement plans. There is evidence of strong focus on Partnership.

Modernisation/Equality

The hospital continues to work collaboratively with the wider health system and as part of the St. Vincent’s Healthcare Group. Significant progress has been made on the final draft of operational policies.

The report is very strong in the areas of equality / diversity and the processes in place to work with unions and staff to introduce and progress new initiatives. The number of people employed with a disability exceeds the target at 3.31%.

Value for Money

The report contains details of the continued rollout of management information systems, and other VFM initiatives are listed in the report outlining the savings made. Several new initiatives are also reported.

Redeployment of staff is reported, and an example given relates to the Medical Records/ Patient Services support services, where many staff are dual trained so that they can cover areas as required.

Staff Training & Development

The report contains good evidence of a range of training programmes provided and the detail required. The training budget is 1.05% of payroll.

Summary

This is a competent report with good progress reported across the examples in each area.

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South Infirmary – Victoria Hospital, Cork

General

South Infirmary – Victoria Hospital, Cork (SI/RV) is funded through the HSE Southern Area but retains its voluntary hospital status. In the first phase of the performance verification process the SI/RV was included with the HSESA for assessment purposes, however it was decided by PVG Chairperson that a separate report was warranted given the hospitals voluntary status. Payment was warranted in the second phase of the process and for Phase 3, payment was warranted with comment. A corporate overview was included with the Phase 3 & 4 reports; however, the report struggles to adhere to the required format.

Enhanced Customer Service

There are a number of significant examples of improved customer services in the report. The Hospital is currently undergoing an Accreditation Process.

A number of new skill mix initiatives have been mentioned in the report and multidisciplinary team working is evident.

Industrial Relations

There has been no strike action at the hospital.

The report notes two issues – one is being dealt with under the auspices of the National Joint Council and the other has been referred to the Labour Court.

The Partnership Committee is now up and running at the Hospital, and its structure will be revised in May 2005 in response to a request from Unions with regard to possible expansion of representation on the Committee.

Performance Management

The SI/RV is not a pilot site for PM. The Hospital has adopted a range of performance indicators and the Human Resources Department will be a pilot Department site under the National Team Based Performance Management System, with training taking place in early 2005.

Modernisation/Equality

There is significant evidence that Reform is being actively embraced, and the Hospital is currently undertaking the process of Accreditation.

The employment of persons with a disability at the Hospital currently stands at 3.03%.

Value for Money

The report contains evidence of a VFM focus. Several initiatives have been implemented and numerous new initiatives are also mentioned under this heading.

Staffing numbers are monitored closely and redeployment of staff is ongoing in response to work demands.

Staff Training & Development

2% of payroll is devoted to Training and Development. Training was provided to staff in respect of all categories outlined in the Progress Report.

Summary

The report is comprehensive with strong examples in most areas although it could benefit from being more concise.

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National Federation of Voluntary Bodies

General

The NFVB is an umbrella grouping for 61 voluntary bodies providing services with an intellectual disability. The NFVB’s agencies provide 85% of service provision the ID sector and employ around 15,000 staff. The report is therefore

Improved Customer Service The report builds on initiatives and identifies several areas where extended hours, increased activity, reduced waiting times, improved communications, patient advocacy are adding to improved customer services.

Industrial Relations

There has been no substantive IR action taken, however, one instance of nursing staff working under protest. Overall a positive IR environment is reported with the rollout of partnership groups continuing to 9 of the 61 organisations. THE NFVB is currently considering the feasibility of an overarching partnership body.

Performance Management

Progress appears good in this area with the experiences of the Pilot Site at Galway County Association being rolled out throughout the GCA and lessons from the experience are being disseminated to other NFVB organisations.

Modernisation /Equality Some slow but steady progress is evidenced under this heading with good communications on change also shown.

Value for Money

The implementation if new IT systems is helping information flow and thus assisting decisions on VFM. Good staff co-operation is reported – particularly on redeployments thus utilisation available recourses to best effect.

Staff Training & Development

Good progress reported with the NFVB being perhaps the only Health Service organisation achieving the national 3% target of payroll.

Summary

This report is much improved since the phase 3 submission. Good inter-linkages between the constituent organisations are reported. There is enhanced customer care and good management of the implementation of new developments.

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Mercy Hospital, Cork

General

The Mercy Hospital is an independent hospital with a status similar to that of the DATHs. It maintains strong links with the SHB, through which its funding is channelled. In the first phase of the performance verification process The Mercy was included with the SHB for assessment purposes in phase 1 of the Performance Verification process. However, it was decided by PVG Chairperson that a separate report was warranted for Phase 2 and subsequent phases. Payment was warranted with comment on the 3rd Phase.

This report has been submitted with “tracking changes” shown. This makes reading of the report very difficult.

Improved Customer Service The report identifies areas where extended hours initiatives are progressing well. Two new additional initiatives in this area have also been reported.

The report is good in the areas of initiatives taken to enhance the client experience and complaint handling. The hospital and its staff remain committed to the NTPF process.

The report contains good progress in the areas of skill mix and multi disciplinary team working.

Industrial Relations

There has been no strike action or threatened strike action. Management and unions ensure all processes outlined previously continue to work smoothly. The Partnership Committee has now been formulated and has had its inaugural meeting.

Performance Management

The rolled out performance management process is being piloted in two departments of the hospital.

Customer service standards will publish its performance against its service standards in Annual Reports.

While there is no evidence in the report of a formal partnership process in the hospital there is some evidence of management / union interaction.

Modernisation/Equality

The first annual review of hospital policies and procedures is being prepared and will be discussed through the Partnership Committee. The hospital has entered the IHSAB Accreditation programme.

While the figure for people with a disability employed in the hospital is approx. 1%, local disability groups have been contacted to investigate the promotion of employment of disabled people.

Value for Money

The report outlines good progress continuing on previously reported issues and some new initiatives. As with several other agency reports, this section would benefit from greater detail around timescales and saving achieved or expected.

Staff Training & Development

A group of staff are preparing an in house training package dealing with aggression and violence in the A & E. Minimal training has been provided for staff due to the financial situation of the hospital. Budgets for training have not yet been agreed with the HSE for 2005.

Summary

Good progress is being made with the resources available in all categories.

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Mater Hospital

General

The Mater Hospital, as one of the Dublin Area Teaching Hospitals (DATHs), is required to submit a stand alone report separate from the ERHA or any of the area health boards. In the first phase of the performance verification process the PVG unanimously decided that payment was warranted with comment. For both phase 2 and 3 the decision was that payment was warranted.

The Hospital have not provided a separate corporate overview with their report.

Enhanced Customer Service

Several new initiatives in this area are reported and initiatives already in place are proving successful. Good examples are also given of initiatives to improve the customer experience. In the area of skill mix good progress has been made and some new initiatives included.

Several good examples are included in the area of the report dealing with multidisciplinary team working. Good progress is also reported on new initiatives aimed at improved customer service.

Industrial Relations

I.M.O issues have been mentioned, however, they are being dealt with at a national level. Another issue which is outlined in the report is being progressed through the appropriate channels.

The sections of the report dealing with the HR / Union interface and the working of partnership again provide good evidence to support the existence of a positive environment.

Performance Management

The national performance management pilot site in the Maters Pathology Department has been successfully completed. Seven additional departments are now engaged in the next phase of the roll-out of The National Programme.

Customer service standards and their evaluation methods are well covered in the report.

Modernisation/Equality

The report contains good evidence of the continued success of previously reported initiatives and a number of new initiatives in this area. The report is also very strong in the areas of equality / diversity. Examples where steps have been taken to improve facilities and accessibility for people with disabilities are included in the report.

The figure of 1.8% of people with a disability is considered unreliable due to difficulties in sourcing comprehensive data.

Value for Money

The report contains details of the continued rollout of VFM initiatives, which include joint tendering and purchasing of products through group purchasing contracts with other large hospitals. Several new initiatives are also reported.

Staff Training & Development

The report contains good evidence of a range of training programmes provided and the detail required.

Summary

This report is once again strong with a strong corporate sense overall.

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Health Service Executive Western Area

General

The report has a comprehensive executive summary which points to development under all the main headings to be considered by the PVG. The report provides comprehensive update on all initiatives together with details of further developments under all headings. In all 3 Phases, payment was warranted with comment.

Improved Customer Service Once again this is a strong area of the report with new initiatives being introduced to complement the initiatives already in place.

Industrial Relations There has been no strike action initiated and the three areas mentioned where there is disagreement has been referred through the appropriate channels.

The partnership process is actively continuing in all areas providing many positive outcomes.

Performance Management

The Paediatric Department of the University Hospital Galway is a pilot site and is concentrating on three main performance areas.

Modernisation/Equality

There are a number of new examples of processes in support of reform process with further advances in areas already reported on in previous phases. Strong detail is also given in relation to equality / diversity agenda.

The reported figure of 1.17% is under the national 3% target for the employment of persons with a disability. This information is not routinely collected and one reason provided in the report is that staff do not necessarily wish to have a disability flagged.

Value for Money

The report is strong on VFM with initiatives cited through many service areas. Activity in Community and Hospital services exceeded planned levels whilst remaining within budget. Continued progress is cited in this area with implementation of many initiatives well underway.

Staff Training & Development

1.17% of payroll is devoted to Training and Development. There is an obvious understanding shown in the report for the importance of Training and Development and a five year plan is now in place to deal with this topic.

Summary

The WHB's report is strong and well focused with good examples of initiatives in multiple areas.

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Health Service Executive Southern Area

General

In Phase 3 (as for Phases 1 & 2), the PVG unanimously decided that payment was warranted for the HSE Southern Area.

The report contains a brief introduction which highlights continued progress for the phase, including the incorporation of key elements of Sustaining Progress into the Service Planning process.

Improved Customer Service

Once again this is a strong area of the report. Extended hours have bedded-in and further extension of hours is being explored. Improved services are evidenced in primary / community care. Patient services are being furthered and best practice guidelines have been introduced and continued in several areas.

The rollout of both skill mix initiatives and multidisciplinary team working is well reported with good progress evident. Staff up-skilling and training is facilitated encouraged, with a view to enhance customer service.

Good examples are also given of new initiatives since the last report together with further progress on the earlier initiatives reported.

A wide range of examples of changes in work practices to improve customer service are provided.

Industrial Relations

There was an unofficial 8 hour stoppage of Catering Assistants and Cooks at Cork University Hospital. The Branch Secretary of SIPTU engaged in negotiations for the staff to return to duty on resolution of the issue concerned. Local discussions commenced immediately and staff returned to duty. Follow-up meetings have been held to facilitate issues that may arise.

INO members are working under protest at present in Clonakilty Community Hospital. This issues are currently before the LRC and members are being balloted on the proposals arising out of the LRC hearing.

The report is very strong on the area of partnership at both a regional and local level.

Performance Management

St. Mary’s Orthopaedic Hospital is a pilot site for performance management. Five sub-groups have been involved and continue to make steady progress.

In 2004, Recruitment was a national pilot site for Team Based Performance Management and is now fully operational within this Department, and is being rolled out to 10 sites since January 2005.

Customer Service and organisation performance standards are well reported over a large number of service areas/locations.

Modernisation/Equality

There are a number of examples of processes in support of the health strategy. The equality and diversity agenda continues to hold a prominent position in the roll out of best practice HR practices.

In relation to the employment of persons with a disability the Southern Area exceeds the target of 3% with returns of 3.9%.

Value for Money

The report is again strong on VFM. Continued progress is cited in this area with implementation of many initiatives well underway.

Reports relating to staff numbers/WTE’s are circulated in order to monitor employment ceilings before approval is granted to fill vacant posts.

The report also details instances where re-deployments and staff flexibility were required to meet service demands.

Staff Training & Development

The report details numerous training activities under each of the required headings. The T&D expenditure is 1.37% of payroll, however, a Clinical/non-clinical breakdown has not been provided as requested. .

Summary

The report is strong in most areas and progress has been made. However, the HSE Southern area has been unable to reach agreement on the National Change Agenda with the Unions representing Craft and General Operational Grades.

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Health Service Executive South Western Area

General

The unanimous decision in relation to the first phase in respect of the ERHA was that payment was warranted but qualified. The decision in respect of phase 2 of the process was that payment was again warranted with a comment in relation to partnership within the organisation. The decision in relation to phase 3 was payment was warranted.

The HSE South Western Area have not provided a summary overview document as requested.

Improved Customer Service The report cites many examples under this heading where progress is being achieved and also a large number of examples of new initiatives in this area.

There are many excellent examples of initiatives taken to enhance the client experience in all areas including a number of examples which display excellent skill mix initiatives and flexible working arrangements.

Industrial Relations

There has been no strike action in this area. However, two instances have been mentioned where staff worked under protest, both issues have now been resolved.

There is evidence in the report that partnership is now being actively encouraged.

Performance Management The report cites good progress in the performance management pilot sites and the intention to expand the number of sites.

Customer Service standards applied are those recommended by the National Performance Indicators Group.

Modernisation/Equality

The report contains a range of good examples from areas of the board on reform processes and equality diversity strategies in operation.

The HSE SWA employs in excess of 3% of staff who could be categorised as people with disabilities.

Value for Money

A good range of VFM examples are reported, including revised tendering arrangements, and use of train-the-trainers as an alternative to external consultants. However, the report would benefit from more financial information on VFM projects. There are also good examples given in relation to redeployment of staff to meet work demands.

Staff Training & Development

Training has been given in all categories required and figures provided for each category. The budget for Staff Training and Development is 1.75% of payroll

Summary

This report is strong in all areas. Actual savings should be included under the Value for Money Heading in the next phase of the process.

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Health Service Executive South Eastern Area

General

The report has a comprehensive executive summary which point to development under all the main headings to be considered by the PVG. The report provides comprehensive update on all initiatives together with details of further developments under all headings. In Phase 3, the PVG unanimously decided that payment was warranted for the South East.

Improved Customer Service

A number of initiatives which are detailed in the report are being undertaken to improve customer focus through programmes agreed at partnership groups with staff. There is a continued emphasis on increasing opening hours in clinics and services. Skill mix initiatives and multidisciplinary team working are being developed.

Initiatives are being undertaken to improve access for the public to services and to enable customers to appeal decisions or have their complaints dealt with in a prompt objective manner. The report gives updates of the initiatives which have already impacted on customer service and provides details of new initiatives being undertaken.

The HSE South Eastern Area is committed to change and staff have co-operated with changing rosters, work practices and systems in order to provide a better service for the customer. A number of services have received Accreditation and standards continue to be improved.

Satisfactory progress is reported on Phase 3 projects.

Industrial Relations

There has been no strike action undertaken or threatened. Management, staff and unions have worked hard to maintain industrial stability through the agreed channels and remain committed to resolving any such difficulties. A training programme is in place on People Management policies which has assisted in reducing queries and resolving issues at local level.

A Future Search Conference was held recently in conjunction with Partnership. Progress is now being made on developing an Internal Communications Strategy, through partnership.

Performance Management

The report details the progress made in the pilot site for the national system, which is planned to be extended to 40 further sites in the South Eastern Area during 2005.

Customer Service standards are constantly being reviewed and improved. This area has been successful in receiving Accreditation awards which illustrates the high standards maintained in services.

Modernisation/Equality

A number of areas have been identified which require reform, and the HSE South Eastern Area is committed to the ongoing training and development of staff. Staff whose work practices are being modernised and reformed is acknowledged and supported. The board is well above the national 3% target for the employment of persons with a disability.

Value for Money

The report is again strong on VFM with initiatives cited through many service areas. Continued progress is cited in this area with implementation of many initiatives well underway, including a Business and Efficiency Unit which was established in August 2004. The report also details instances where re-deployments and staff flexibility were required to meet service demands.

Staff Training & Development

The report details many training activities showing the number of staff trained and the costs involved under each of the required headings. The T&D expenditure was 1.12% of payroll costs, however a Clinical/non-clinical breakdown has not been provided as requested.

Summary

The HSE South Eastern Area’s report is strong and well focused with good examples of initiatives in multiple areas.

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Health Service Executive - Northern Area

General

The unanimous decision of the PVG for the then Northern Area Health Board in Phase 3 of the process was that payment was warranted.

The phase 4 report now under consideration comes with the required corporate summary which is positive And stresses the spirit of participation and commitment to the change agenda in the organisation. The overview highlights the significant projects of the commissioning of the new Connolly Hospital and the ongoing de-institutionalisation of St Ita’s.

Improved Customer Service

The report cites good progress on a range of examples under this heading. The establishment of out of hours childcare service is just one of a number of good examples of progress in previously reported examples. There are also reports of many new initiatives which is indicative of continuing good work in this area.

The report includes a number of examples of initiatives taken to improve the client experience and good progress is reported in work with the NTPF. The report does not contain any examples of initiatives in the various headings of examples which may not have succeeded, despite being invited to do so in the reporting template and there is a lock of detail in certain areas e.g. waiting lists.

Industrial Relations

There has been no strike action or threatened strike action.

The report is strong on the area of partnership with 11 committees in place within the region. The report contains good evidence of training to support partnership in the organisation and the utilisation of these structures to progress issues.

Performance Management

There is one national pilot in the Northern Area with a further 12 sites identified across the region for the expansion of the model. Preparatory work has begun in this regard. There is also evidence reported of similar initiatives in the region taking place outside the national framework.

Customer Service and organisation performance standards are well reported over several service areas/locations.

Modernisation / Equality Again there is good evidence presented of both ongoing and new initiatives in the area of modernisation. Of particular note is the progress in establishing a GP Out of Hours service in North Dublin.

Value for Money

Further progress is reported in relation to the previously reported Rapid Access Clinic. Significant new examples, such as the introduction of a courier service for diagnostic specimens are also worthy of note. The report outlines the measures in place to manage the employment ceiling for the region and notes a number of staff re-deployments.

Staff Training & Development

The report details training activities showing the number of staff trained and the costs involved

Summary

The HSE Northern Area have again produced a report that is strong is all areas and conforms very well to the required format.

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Health Service Executive North Western Area

General

The report has a comprehensive executive summary which point to development under all the main headings to be considered by the PVG. The report provides comprehensive update on all initiatives together with details of further developments under all headings. In Phase 3 (as for Phases 1 & 2), the PVG unanimously decided that payment was warranted for the NWHB.

Enhanced Customer Service

Once again this is a strong area of the report with many initiatives cited, however due to the lack of date specificity it is not entirely clear how much progress has been made in the current period. Extended hours have bedded-in and improved services are evidenced in primary / community care services. Developments have also occurred in the acute sector under extended hours. Good examples are also given of new initiatives since the last report including the extending of hours that theatre is in use in Letterkenny General Hospital.

Improved I.T. links have resulted in more timely patient care including for example better communications between services and GPs have resulted in easier patient access and reduced waiting times for appointments and results. A number of good skill mix projects have been introduced which have led to more focused patient care, however, as cited in previous reports, the introduction of Senior Dental Nurses has been hampered by IR issues in another HSE area.

Satisfactory progress is reported on Phase 3 projects.

Industrial Relations

There has been no strike action undertaken or threatened. A minor issue regarding a transfer of Nurse Tutors has arisen which was referred to the LRC. The recommendation of the Labour Court is currently awaited. Some progress is evidenced in relation to outstanding issues from previous phases.

There is a strong partnership group operating within the board with many positive outcomes.

Performance Management

There are two national pilots in the HSE North Western Area and the report details the staff numbers involved and outlines the progress to date. Further initiatives are also detailed in the report, which includes the development of a draft local Public Health Emergency Plan.

A strong set of Customer Service and organisation performance standards are well reported over a large number of service areas/locations. Strong partnership is evident, with the Partnership Forum continuing to meet on a regular basis, and three sub-groups continue to function.

Modernisation/Equality

There are a number of new examples of processes in support of reform process with further advances in areas already reported on in previous phases. Strong detail is also given in relation to equality / diversity agenda. The Disability Service actively promoted employment opportunities to people with a disability and the 3% target has been reached.

Value for Money

The report is again strong on VFM with initiatives cited through many service areas. Continued progress is cited in this area with implementation of many initiatives well underway. The report also details several instances where re-deployments and staff flexibility were required to meet service demands.

Staff Training & Development

The report details many training activities showing the number of staff trained and the costs involved. The T&D expenditure was 2.99% of payroll costs.

Summary

The HSE North Western Area report is strong and well focused with good examples of initiatives in multiple areas.

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Health Service Executive North Eastern Area

General

The report has a comprehensive executive summary which point to developments under all the main headings to be considered by the PVG. The summary provides comprehensive update on all initiatives together with details of further developments under all headings. In Phase 3, the PVG unanimously decided that payment was warranted for the North East.

Enhanced Customer Service

A number of initiatives which are detailed in the report are being undertaken to improve customer focus through programmes agreed at partnership groups with staff. There is a continued emphasis on increasing opening hours in clinics and services.

Initiatives being undertaken have complaints and appeals dealt with in a prompt objective manner. The report gives updates of the initiatives which have already enhanced customer service and provides details of several new initiatives being rolled out.

Previously reported skill mix initiatives are progressing well and new initiatives outlined include GPs being provided with automated defibrillators (AEDs) to better equip them to manage cardiovascular emergencies in the primary care setting. Multidisciplinary team working is also evident in the report.

Satisfactory progress is reported on Phase 3 projects.

Industrial Relations

There has been no strike action undertaken or threatened. A working group was established, facilitated by the Regional Partnership Facilitator to improve communication and consultation and involve key stakeholders in the process of developing a joint surgical department between Our Lady of Lourdes and Louth County Hospitals.

There is continued delivery of ‘Joint Problem Solving’ training.

Performance Management

Two team based performance management pilot sites operated during 2004 and staff continue to engage with the system. It is planned to expand the TBPM on a phased basis to twenty sites during 2005.

Customer Service standards are detailed in the report and are constantly being reviewed and improved.

Modernisation/Equality

An update was provided in the report on the Health Inequality Fund initiative which has been reviewed and improvements have been identified for any similar exercises arising in the area of health inequalities.

Serveral initiatives with regard to Cultural Diversity have been reported, including the translation of information booklets for multicultural attendances in various departments. A Dignity at Work policy is also being implemented.

The HSE North Eastern Area at 2%, falls below the national target the employment of persons with a disability.

Value for Money

The report is again strong on VFM with initiatives cited through many service areas. Continued progress is cited in this area with implementation of many initiatives well underway, including improved management, financial and information systems.

Staff continue to be redeployed to meet service demands.

Staff Training & Development

The report provides details of numerous training activities under multiple headings. The T&D expenditure was 2.5% of payroll costs.

Summary

The HSE North Eastern Area’s report is strong and well focused with good examples of initiatives in multiple areas.

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Health Service Executive Midwestern Area

General

The report has a comprehensive executive summary which points to development under all the main headings to be considered by the PVG. The report states that the Health Service Executive Midwest continues to build on initiative introduced in previous phases under all six categories.

Improved Customer Service Once again this is a strong area of the report with new initiatives being introduced to complement the initiatives already in place. These include extended hours, building & service transfers, complaints procedures and the utilisation of the NTPF.

Industrial Relations There has been no strike action; however, the IR climate shows some signs of weakness with several instances of “work to rule” and non-cooperation in certain initiatives including partnership by certain grades. Nonetheless, improvements are being made on communications and problem solving by both management and unions.

Performance Management

One pilot site is in existence (previously reported). Good progress is also being made on organisation performance management/ monitoring.

Modernisation/Equality

There are a number of new examples of processes in support of reform process with further advances in areas already reported on in previous phases.

The reported figure of 1% is well under the national 3% target for the employment of persons with a disability; however it should be emphasised that this is the disclosed level.

Value for Money

The VFM section details the roll-out of a VFM reporting framework, PPARS etc. Impressive savings are detailed in relation to the purchasing of aids and appliances, however, no other figures are included on cost efficiencies. The MW is one of the few Health Service Executive areas in compliance with their employment ceiling.

Staff Training & Development

2.36% of payroll for 2004 was spent on Training and Development. The report is very strong in this area with good detail.

Summary

The MW report is strong and well detailed.

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Health Service Executive Midland Area

General

The report has an executive summary which points to development under all the main headings to be considered by the PVG. The report states that the Health Service Executive Midland continues to build on initiative introduced in Phases 1-3.

Improved Customer Service Once again this is a strong area of the report with new initiatives being introduced to complement the initiatives already in place. All initiatives from previous phases are continuing

Industrial Relations There have been no IR difficulties. The partnership process is well refined and mainstreamed in the Health Service Executive Midland Area.

Performance Management

One pilot site is in existence (previously reported) and 18 further sites have been identified and await rollout as part of the national programme. Strong customer services standards have been put in place to monitor organisational performance.

Modernisation/Equality

There are a number of new examples of processes in support of reform process with further advances in areas already reported on in previous phases. Strong detail is also given in relation to equality / diversity agenda.

The reported figure of 2.2% is under the national 3% target for the employment of persons with a disability, however it remain a good performance.

Value for Money

The VFM section is short with no great detail given and only a small number of examples. The Midland expects full compliance with employment ceilings by year-end.

Staff Training & Development

1.84% of payroll budget for 2005 is devoted to Training and Development. There is an obvious understanding shown in the report for the importance of Training and Development however no breakdown is given and between clinical and non-clinical as requested

Summary

The Midland report is good in most areas but lacks detail in respect of the final two sections (VFM and Training).

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HSE Eastern Area

General

This report covers the 19 large non-HSE, non-DATH voluntary agencies in the eastern area together with the HSE Eastern Corporate (formerly ERHA corporate). The report is, necessarily, extremely long running to just over 100 pages including the summary. Because of the large and diverse number of agencies it is easy of uncover examples under each heading. However, it is cumbersome and the reporting structure, as specified, is somewhat unsuitable for a diverse grouping such as this. As the report is composite (cut & paste) of 19 reports the structure as requested is not adhered to and by-and–large each agency is covered under each individual query (even where limited numbers of examples are requested).

Improved Customer Service
The report identifies multiple areas where extended hours, increased activity, reduced waiting lists, improved communications, patient advocacy are adding to improved customer services. Progress appears good with improvement reported in all areas including further engagement with the NTPF.

Industrial Relations

No IR action taken by any staff save the non-involvement of IHCA members in committees etc as part of their national actions and a number of very minor incidents of non-cooperation involving small numbers.

Performance Management

Commitment to PM is strong with the report with rollout evident in many areas, however given the great number of areas covered it is difficult to gage if there are obstacles elsewhere going unreported.

Modernisation /Equality Steady progress is evidenced under this heading with good communications on change also shown in many areas.

Value for Money

The report is very detailed on VFM with the employment ceiling cited in several cases as a strong inhibitor in several cases. Good staff flexibility is exhibited across all agencies

Staff Training & Development

Some agencies (particularly those with high numbers of non-professional /non-medical staff) report a very poor performance in this area with T&D at only 0.5% of payroll.

Summary

This report is strong in most areas and improved since the phase 3 submission. Good progress is being made with the resources available in most areas in most agencies.

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HSE - East Coast Area

General

The unanimous decision in relation to the first phase in respect of the then East Coats Area Health Board was that payment was warranted, with comment. The comment in this instance related to the format of the Phase 3 report not conforming to the required format.

In phase 4, the HSE - East Coast Area have provided a very good summary overview document setting out the main points contained in the report and highlighting the major points under each of the required headings.

Improved Customer Service The report cites good examples under this heading where progress is being achieved and also a number of examples of new initiatives in this area. The speech and language school based pilot is a particularly example of improved customer service. I note that the concerns expressed by the PVG in the previous round of the process have been addressed in this report, which adheres to the required format.

The report also places improved customer service in the context of issues relating to the employment ceiling.

Industrial Relations

There are no reported IR difficulties in the report, with any ongoing issues in process. The report also contains reference to the appointment of an Employee Relations Manager in 2004, which has strengthened the ability to progress issues in a timely fashion

Partnership structures are now being mainstreamed and local partnership committees are being established. This is an encouraging aspect of the report, especially in light of previous concerns regarding the pace of partnership development in this area.

Performance Management

The report cites continued good progress in the four performance management pilot sites in the EHSS. A planned major expansion of performance management in 2005 is also reported. Customer service standards continue to be a particularly strong part of the report.

Reform The report contains a range of good examples from areas of the board on reform processes and equality diversity strategies in operation.

Value for Money

The report highlights the VFM aspects inherent in continuing to provide services at existing levels, with limited new developments, within budget. The resultant savings programme focussed on non-patient/client areas.

Staff Training & Development

The required information of Training and Development is mostly reported although the breakdown of expenditure between clinical and non-clinical is not provided.

Summary

The HSE East Coast Area has provided a strong report, addressing the points raised previously by the PVG. There is a strong corporate overview provided in the high level summary document included with the report. The report is particularly strong in the areas of initiatives to improve the client experience and customer service standards.

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Beaumont Hospital, Dublin

General

Beaumont Hospital is an independent Dublin Area Teaching Hospital. The summary overview submitted with the report is both comprehensive and highlights key successes under all headings.

Improved Customer Service The report identifies several areas where extended hours, increased activity, reduced waiting lists, improved communications, patient advocacy are adding to improved customer services. The utilisation of St. Joseph’s Hospital Raheny for day cases and as a feeder, so as best utilisation of the main hospitals facility is impressive and imaginative. The hospital is strong on advocacy with the patient representative service operational 7/7. Bed management is impassive and enhanced communications with patients awaiting admission is good. NTPF utilisation is good and waiting times show considerable improvement. The report also contains good progress in the areas of staff flexibility with cooperation on improvements in many areas.

Industrial Relations

A very positive IR climate exists and there has been no IR action taken by any staff. The hospital has provided new staff/union facilities and communications are good. One small blot appears to be the absence of agreement on the appointment of an IR Officer – the matter has been referred back to the Partnership Steering Committee.

Performance Management

The Hospital is a national pilot site. PDP has been complete in Patient Services with rollout continuing in 2005 to Clinical Services (3 departments) and HR. A booklet on absenteeism has also been produced. Partnership based initiatives are also evidenced under this heading.

Modernisation /Equality Strong commitment and flexibility is evidenced in several areas under this heading. The smooth integration of St. Joseph’s and the staff’s willingness to change is also good evidence for the modernisation agenda. Goof flexibility is also evidenced elsewhere and management/staff communications appear strong on this and other matters.

Value for Money

The report is detailed and good initiatives are evidenced with some patient number and financial improvements cited. Progress on previously reported items continues. The hospital operates within its employment ceiling despite the pressures it is under.

Staff Training & Development

The report is very impressive and detailed in this area. T&D stands at 1.1% of payroll.

Summary

This report is much improved since the phase 3 submission and good progress continues to be made in all areas. A good emphasis on Customer Care is evident.

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Adelaide & Meath Hospital, Dublin

General

The A&M Hospital is an independent Dublin Area Teaching Hospital. The summary overview submitted with the report provides a brief overview of the context for the report and, crucially, highlights the increased activity levels, substantial pressures due to the A&E crisis and enhanced productivity with additional throughput provided on similar staffing levels.

Improved Customer Service The report identifies several areas where extended hours, increased activity, reduced waiting lists, improved communications, patient advocacy are adding to improved customer services. Progress appears good with activity levels up year 2000 figures in all areas, however in such areas as theatre the increase on 2000 is marginal – falling from the very high levels set in 2002-3.

The report is good in the areas of initiatives taken to enhance the client experience. Good co-operation with NTPF is also reported. The report contains good progress in the areas of staff flexibility.

Industrial Relations

There has been no IR action taken by any staff save the non-involvement of IHCA members in committees etc as part of their national actions. Improved Management/Staff/Union communications are reported.

Performance Management

The A&M Hospital is not a national pilot site. Commitment to PM is not strong with the report stating that the hospital may pursue one of the schemes emerging from the pilot sites.

Modernisation /Equality Some slow but steady progress is evidenced under this heading with good communications on change also shown.

Value for Money

The body of the report has little detail on VFM with the employment ceiling cited as a strong inhibitor. However, very strong evidence of increased productivity and throughput is cited in the introduction and the figures are impressive. As stated earlier theatre activity is only marginally up on 2000 levels, although it is noteworthy that day procedures are up 15% on the same period and A&E admission are also applying substantial pressure (+34%). This section would benefit from greater detail around timescales and saving achieved or expected.

Staff Training & Development

Some progress since the last report but the hospital is still seeking funding to expand training which stands at 1.7% of payroll.

Summary

This report is much improved since the phase 3 submission. Good progress is being made with the resources available in all categories. Strong performance under most headings with Customer Care shining through since productivity levels are improving within existing resources.