Patients at risk of feeling brunt of cash-strapped HSE as it slashes use of agency staff by one third

Patients are at risk of feeling the impact of the HSE’s spending cuts which include €275m in pay savings, leaving fewer staff delivering care to a higher number of people.

The HSE’s service plan for 2024, which sets out how it will spend its €23.5bn budget, says the Government funding falls short of what it will need to run existing services and it will need another top-up later this year.

In a bid to rein in spending, it is cutting €275m through pay savings over ten months mostly in the use of agency workers, including for overtime, some of which will be converted to directly employed HSE staff – subject to approval.

Agency staff are a vital safety valve for several services, including hospitals, and plug gaps due to a lack of full time workers and absenteeism.

It will mean reducing the hours of agency staff used by around one third.

The plan said the reduction in agency staff hours means that “we will need to increase productivity and safely see, assess, treat and care for more people with the same or less staff, without reducing service quality or overburdening our staff”.

It will cut €10m from the drugs and medicine spend – using cheaper versions such as biosimilars.

A further €50m will be shaved from Covid-19 costs and a further €34m in hiring outside consultancy services.

The HSE warned: “This level of reduction in agency staffing hours is the equivalent of 3,000-4,000 full time staff and will be a challenge for services.”

It will require managers to carry out risk assessments to measure the potential impact on patient safety.

The plan said the scale back “needs, however, to be looked at in the context of the over 24,000 more directly employed staff that are working in our health services today, compared to the start of 2020”.

The HSE is undergoing another reorganisation with the establishment of six regional authorities, covering hospitals and community services, with each responsible for a number of counties.

Although the health funding for 2024 is a rise of 4.6pc on last year with €2.8m going to Roderic O’Gorman’s department , HSE chief executive Bernard Gloster has made it clear it is inadequate and a supplementary will be needed later this year.

Writing in the service plan, he said 2024 would be a year of “smaller growth and better control”.

The HSE said its focus for 2024 is to improve access to urgent and emergency care; prioritise waiting lists; continue to enhance mental health and disability services, and build on existing partnerships to develop and improve services.

It involves modest targets in reducing the numbers of patients on hospital waiting lists.

It will increase activity targets in the areas of inpatient, day case, outpatient and gastrointestinal scopes by 5pc above the 2023 outturn.

It said targets for mental health services are to treat 25pc more children and adolescents this year.

In the area of disability, it said an extensive and ambitious programme of work is ongoing to improve timely access to services, including in the areas of day, respite, multidisciplinary, residential, home support, neurorehabilitation and personal assistance services.

Get ahead of the day with the morning headlines at 7.30am and Fionnán Sheahan’s exclusive take on the day’s news every afternoon, with our free daily newsletter.