Strengthen HSE national disability function

The national disability function within the HSE must be strengthened and given a central directional role in funding, shaping and driving the Disabilities Service Programme, Mr. Brian O’Donnell, Chief Executive of the National Federation of Voluntary Bodies told the HMI West Regional Meeting in Galway.  Maureen Browne report.

The national disability function within the HSE must be strengthened and given a central directional role in funding, shaping and driving the Disabilities Service Programme, Mr. Brian O’Donnell, Chief Executive of the National Federation of Voluntary Bodies told the HMI West Regional Meeting in Galway.

Brian O'Donnell
Brian O'Donnell

He said this had been one of the five main recommendations of the Value for Money & Policy Review of the Disability Services, which, under the chairmanship of Mr. Laurence Crowley, had evaluated the efficiency and effectiveness of the disability services in Ireland.  Its primary purpose was to assess how well current services for people with disabilities met their objectives and supported the future planning and development of services and to make recommendations to ensure that the very substantial funding provided to the sector was used to maximum benefit for persons with disability, having regard to overall resource constraints.

The over-riding focus of the recommendations of the Value for Money & Policy Review were on a programme of governance, delivery model change and a detailed upgrading of information in respect of precision, scope and format.

The HSE should drive migration towards a person-centred model of services and supports through the Service Level Agreement process.

It recommended that the HSE should drive migration towards a person-centred model of services and supports through the Service Level Agreement process. Work was already being done in this regard in the Genio Projects and Next Steps Project.

Mr. O’Donnell said that on commissioning and procurement, the review had recommended the reshaping of certain services and models.

It recommended the development of a national resource allocation model as well as an information infrastructure which would cover strategic information requirements such as national disability databases and service level agreements.

It urged six immediate actions:

  1. The Service Level Agreement process should provide improvements to information gathering and performance monitoring.
  2. Standardised Financial Reporting, which would provide for the development of a common coding system to enable expenditure to be tracked, analysed, and compared at national regional and local levels.
  3. A unique identifier to facilitate individual needs assessment, person-centred planning and individualised budgeting.
  4. An examination of Value for Money Findings should which would cover:
    • An audit of rosters to rationalise staff deployment across service units in accordance with client need and cost effectiveness.
    • Skill mix, where national guidelines would be developed to advise on the appropriate mix of professional and non-professional staff.
    • Unit cost, where the HSE would work jointly with service providers to critically examine existing cost bases in the light of the findings and recommendations contained in Chapter 5 of the Value for Money Review.
    • Average Costs – pending the development of resource allocation model, the Service Level Agreement process should be used to reduce current direct pay cost
  5. A Policy appraisal
  6. An Implementation Plan, where a robust implementation framework should be developed which takes account of the policy appraisal.

Mr. O’Donnell said the Implementation Plan should facilitate more choice and more control, facilitate a framework to assess need, identify outputs and outcomes and plan and monitor resource usage, develop national indications to objective measure the effectiveness of the Disability Services Programme, provide for SLAs agreed with the HSE Regional Directors of Operations and the Integrated Service Area Managers and a new funding framework ,as block grant funding was no longer sufficient to address degrees of accountability and transparency required.

“Existing services should be re-configured, new resource allocation models developed and there should be a transition from the traditional programme type to more individual costing approaches.”

Dealing with future policy direction, he said current objectives were still valid, but the policy approach used to deliver these objectives had not been effective and the continued sustainability of the current policy approach was questioned.

He urged “Existing services should be re-configured, new resource allocation models developed, there should be a transition from the traditional programme type to more individual costing approaches and all future developments will be delivered in line with the new vision.”

The National Federation of Voluntary Bodies has 61 member organisations who account for in excess of 85 per cent of this country’s direct service provision to people with an intellectual disability.