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St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Leading Change
Cathal MageeChief Executive Officer
Health Service Executive
St Luke’s Symposium Novmber 2010 St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Leading Change • where are we?
• where are we going?
• how do we get there?
• plans/projects/resources/implementation
St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Context: Economic • health is 27% of State spending • borrowing €5bn/€6bn p.a. to fund healthcare• our annual budget deficit is €19bn • annual borrowing is 12% of GDP - capital markets and EU require 3% by 2014 • funding outlook is very challenging • opportunity to build sustainability
St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Context: Healthcare Trends
• rapidly ageing population • adults with chronic conditions up 40% by 2020 • number of cancer cases to increase (CAGR +3%) • incumbent models of care struggling to keep up • time for change
St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Context: Public Perception • public are losing confidence and patience
• ‘Irish citizens are divided in their perceptions of the quality of healthcare, 33% rate the quality as ‘fairly good’, 5% rate the quality as ‘very good’ while 40% rate the quality as ‘poor’ ’
Key findings from Accenture Institute for Health and Public Service Value Study 2010
St Luke’s Symposium November 2010 St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
HSE Healthcare Vision
• Is consistent with international trends– integration of primary and secondary care– centres with scale & specialisation – quality & safety with transparency in outcomes – care pathways and standards (clinical programmes) – clinical engagement & leadership
St Luke’s Symposium November 2010 St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
How do we get there?• clear rationale for change • widely shared with key stakeholders • educate the public and the patient • investment required to build and develop
- leadership & governance - information technology - organisation
that can deliver safe, quality healthcare
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Challenges • legacy structures • culture and behaviours • resistance to change • operating model too centralised • management bandwidth & accountability
• governance and management process
St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
People
• commitment of people in the health service• must value people’s work & contribution • protect relationships we have built • change without trust ‘almost impossible’• focus on patient care • aware morale is a problem
• nchd shortage indicates issues need to be addressed
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Unlocking High Performance in Healthcare
‘ the leadership needed to transform the performance of hospitals and health systems must come principally from doctors and other clinicians whether or not they play formal management roles’
- McKinsey
St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Clinical Directors • need strong & effective clinical leaders • critical part of leadership of health service • role needs to be supported and developed • support clinicians in their responsibility to lead change • critical role in resource allocation & decisions• setting this as a high priority
St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Clinical Programmes • innovative and forward looking initiative • provides framework and a blueprint • addresses quality, access and cost • college’s role is critical – joint programmes • national strategy/local ownership • engaging clinicians at large in driving change • challenge is implementation
St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Specialist Training • our ability to provide high quality service inextricably linked
to quality of training • we must work together to attract, develop and retain the
highest quality nchds • strategic importance to colleges and to nchds• HSE committed to facilitating and supporting
St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
Role of Colleges and Forum • collaborative approach with postgraduate colleges • provides for a professional voice – standards
• provides leadership to profession • means by which HSE can engage with clinicians on a
professional, collective basis
• recognise significant progress to date
St Luke’s Symposium November 2010
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
• have to be honest and realistic • economic climate• challenging political and public environment• regulatory environment – more demanding • no quick fix • motivation has to be about patient care
Realistic Expectations
St Luke’s Symposium November 2010St Luke’s Symposium November 2010
• continue to work with the forum & college – clinical directors – national clinical programme– specialist training
• leverage the networks and leadership • clinical programme implementation
– prioritisation,– planning – execution
• change is possible
Looking to Future
