HSE publishes National Service Plan

The HSE has published the 2023 National Service Plan following approval by the Minister for Health Mr Stephen Donnelly, TD.

Shingles and Risk of MI

we will also continue to support Sláintecare reform and finalise design and commencement of initial implementation of the six Regional Health Areas (RHAs) in 2024.

The National Service Plan (NSP2023) outlines the health and social care services to be provided to the people of Ireland this year. The Government has allocated a budget of ¤21.124bn for this purpose, which is 5.7% above last year’s starting budget.

It includes an additional

• ¤240.2m investment in new service developments

• ¤564.5m once off funding for Covid-19 costs

• ¤899.2m to fund increased costs of providing the existing level of service to cover non pay inflation and national pay awards.

The aims of the NSP2023 are to build further on hospital and community services capacity, improve access to services, including women’s healthcare and mental health services, enhance prevention and early intervention work, take forward the work of the Waiting List Task Force, and implement improvements in the security and resilience of critical national infrastructure.

As we work to build back service capacity affected by Covid-19,

Speaking about the HSE’s priorities for 2023, Mr Ciarán Devane, HSE Chairman said, “Supporting the delivery of universal healthcare and delivering the reforms outlined in Sláintecare remain the priorities for the HSE. Waiting lists for scheduled care in hospitals and long waits in emergency departments, particularly for older people and those who have more complex needs, remain a concern and a priority for the organisation. Our reform programme continues to seek to address this, as well as addressing waiting times for mental health and communitybased services, with the ultimate aim of improving the patient / service user experience through innovative initiatives including the ongoing digitisation of our health service.”

Key Priorities for 2023

Hospitals: Additional general acute beds will come on stream in 2023, bringing the total increase since 2020 to 1,179 by end 2023 along with additional critical care beds, bringing the total to 352 by the end of this year.

Community: The Enhanced Community Care Programme (ECC) will continue to roll out nationally to ensure more people can access healthcare in their local community rather than within the acute hospital setting. These measures include the continued development of 96 Community Healthcare Networks, each

World Immunization Week 2023

servicing a population of c.50,000, 30 community specialist teams for older persons and 30 community specialist teams for people living with chronic disease as well as increased access to community diagnostics (up to 240,000 community radiology tests and 266,500 tests across areas such as echocardiography, spirometry and natriuretic peptide blood tests). 23.9million home support hours will be delivered to 55,910 older persons in 2023.

Mental Health: With an additional budget of ¤14.0m in 2023, we will see an increased number of 12,635 CAMHS referrals, a 17% target increase since 2019.

Disability: We will spend an additional ¤25.0m on disability services including over 70,000 additional hours of personal assistant support to people with disabilities and 1,250 new day services placements for school leavers and graduates of rehabilitative training in line with New Directions policy. We will improve the delivery of a range of specialist communitybased disability services and increase service capacity in the areas of day, respite, multidisciplinary, residential and personal assistant services as well as progressing the delivery of the Assessment of Need process in line with legislative obligations. Recruitment: Regarding staffing, the HSE will expand the workforce by +6,000 WTEs in 2023 whilst also ensuring we have recruited approximately 10,500 staff to replace those that will retire or leave during the year. The HSE is addressing complex challenges in workforce planning and recruitment while maintaining focus on strengthening the retention of the existing workforce.

World Immunization Week, celebrated in the last week of April, aims to highlight the collective action needed to protect people from vaccine-preventable diseases.

Under the theme of ‘The Big Catch-Up’, WHO is working with partners to accelerate rapid progress in countries to get back on track to ensure more people, particularly children, are protected from preventable diseases.

2023 is our global opportunity to catch-up on lost progress in essential immunization. We need to reach the millions of children who missed out on vaccines, restore essential immunization coverage to at least 2019 levels, strengthen primary health care to deliver immunization and build lasting protection in communities and countries.

The goal of World Immunization Week is for more children, adults – and their communities – to be protected from vaccine-preventable diseases, allowing them to live happier, healthier lives.

In a recent study published in Open Forum Infectious Diseases, researchers assessed myocardial infarction (MI) risk after zoster infection.

In the present study, researchers examined the association(s) between herpes zoster and the risk of developing MI after infection. They retrieved data from the US Department of Veteran Affairs (VA) corporate data warehouse (CDW). Patients aged 18 or older with a diagnostic history of herpes zoster who received care at the VA from January 2015 to January 2020 were included as cases.

Overall, the study included 2.15 million patients, with 71,912 cases and 2.09 million controls. MI occurred within 30 days in 244 (0.44%) cases and 5,782 (0.28%) controls. The mean age of zoster cases was 71.3, while controls were, on average, aged 69. Most subjects (> 91%) in either cohort were males.

Patients with a herpes zoster history were 1.35 times more likely than controls to develop MI within 30 days post-infection. Those vaccinated with at least one Shingrix vaccine dose were 18% less likely to develop MI post-index date than nonvaccinated cases. No significant differences were observed in MI rates for individuals vaccinated with Zostavax.

A previous history of MI was a significant risk factor for developing MI after the index date. Likewise, a prior congestive heart failure increased the odds of MI by 29%, while vascular disease history was associated with 14% higher odds of MI. Immunosuppressive conditions increased the odds of developing a MI by 63%.

Further, the male gender was associated with 40% higher odds of MI. Taken together, the findings suggested that herpes zoster infection was associated with a greater risk of developing MI within 30 days of disease. Males, comorbid patients, and older individuals were at a higher risk of MI.