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«RVEEH2013 Page 1 Royal Victoria Eye and Ear Hospital – Annual Report 2013 Mission Statement In partnership with the Department of Health and ...»

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Royal Victoria Eye and Ear Hospital – Annual Report 2013

RVEEH2013 Page 1

Royal Victoria Eye and Ear Hospital – Annual Report 2013

Mission Statement

In partnership with the Department of Health and Children, the Health

Service Executive and in co-operation with other statutory and non-

statutory bodies our mission is to maintain the Hospital as a national

centre of excellence for the treatment of patients with ophthalmic or

otolaryngeal diseases, through providing a first class, caring, efficient and cost effective service, while fostering and recognising the contribution of staff and developing and promoting the Hospital's reputation in Research and as a teaching Hospital.

RVEEH2013 Page 2 Royal Victoria Eye and Ear Hospital – Annual Report 2013 Main Committees Council Members Dr. J. Ruane – President of Council.

Lord Mayor of Dublin: Councillor Naoise ÓMuirí 01/01/13 - 30/06/13 Councillor Oisin Quinn 01/07/13 - 31/12/13 Mr. H. J. Byrne Mr. J.P. Donnelly Ms. M. Durcan Councillor G. Ashe Mr. P. Brazel Mr. W. O’Reilly Mr. J. Casey Prof. A. Curran Ms. D.Delahunty Mr. D. Dunne Ms. E. Hanley Dr. D. Kelly Mr. H. Kelly Mr. W. Power Hospital Management Group Mr. D. Dunne - Chief Executive Ms. A. Doyle. - Medical Director Prof. C. Murphy – Medical Director Ms. S. Buckley - Director of Operations and Human Resources Mr. P. O’Connor - Director of Finance and Organisation Services Ms. M. Tighe - Director of Nursing (until June 30th 2013) Ms. E.Finlay – Acting Director of Nursing (From July 1st 2013) RVEEH2013 Page 3 Royal Victoria Eye and Ear Hospital – Annual Report 2013 Medical Board Professor A. Curran - Chairman Dr. D. Kelly Mr. D. Brosnahan Mr. M. Cahill Professor L. Cassidy Dr. A. Doyle Mr. S. Hone Dr. S. Kennedy Mr. D. Kilmartin Dr. S. Knowles Dr. D. McAuliffe-Curtin Dr. D. McCoy Dr. D. Malone Mr. P. Moriarty Mr. M. O’Connor Dr. B. O’Hare Mr. W. Power Professor C. Timon Dr. Ronan Killeen Dr. M. Mukhtar Dr. M. Halligan Mr. M. Rafferty Ms. T. Mackle Dr. R. Rohan Mr. P.O’Brien Mr. N.Horgan Mr. J.P. O’Neill Mr. J. Doris RVEEH2013 Page 4 Royal Victoria Eye and Ear Hospital – Annual Report 2013 Report of the President of Council Introduction.

In the past year 12,059 patients were admitted to the Hospital for surgical procedures, an increase of 1,205 or nearly 11% on 2012. This is also an increase of approximately 7% on the target of 11,280 set by the HSE.

Attendances at the Out-Patient Department totaled 51,163, up 6.8% on the previous year and Accident and Emergency attendances were 35,722, a marginal increase on 2012.

In 2013 the Hospital exceeded its obligations underthe terms of the Service Level Agreement with the HSE.

The Hospital also achieved the 8 month maximum waiting time target for inpatient & daycase treatment set by the Special Delivery Unit.

This was all achieved against a background of reduced financial allocation and staffing reductions and is a tribute to the continued commitment and dedication of all staff in the RVEEH.

In addition to our service level obligations the Hospital also engaged in two important

initiatives during 2013:

 RVEEH began participating in the National Diabetic Retinopathy screening programme funded by the National Cancer Screening Service. This is now an ongoing programme and it is a is a strategically important initiative to be involved in one for us to be involved in; and  In the last quarter of 2013, RVEEH undertook additional cataract work from Waterford Regional Hospital – this was funded by the SDU as part of a waiting list initiative. This work took place on Saturdays and Sundays.

Outlook for 2014.

The Hospital again faces significant challenges in the year ahead. The Hospital’s Revenue allocation for 2014 has been set at €19.9 million compared with a final allocation of €20.3 million for 2013 – that is a 2% decrease.

–  –  –

To put the situation into a longer term perspective --- in the 6 year period since 2008, our allocation from the HSE has been cut by €5.3 million or 20% --- from €25million to €19.9million.

In addition, in 2014 there are two significant financial issues not reflected in the HSE


1. The HSE allocation excludes the impact of the decision by the Department of Health to reduce the private day case rate to €407 from €753 (46% reduction) – this will result in an estimated reduction of €920k in our private income for 2014.

2. The on-going burden of underfunded superannuation costs will be exacerbated in 2014 by the cash impact of major retirement lump sums.

These two issues contribute substantially to our forecast deficit of €2.6 million 2014. The Hospital has communicated these concerns to the HSE and will continue to engage with them to secure funding.

The HSE are promoting an Incentivised Career Break Scheme and a Voluntary Redundancy Scheme as means of reducing costs. The schemes come with the proviso that service quality or patient safety cannot be impacted by their use. However as the Hospital is already operating with minimum staffing levels any further reduction risks reducing our ability to deliver services.

Patient Safety/Quality HIQA Visits 2013.

In August 2013 HIQA made an unannounced monitoring visit to the RVEEH.

There were two main points raised in the HIQA report:

 Lack of compliance with hand hygiene standards;

 Manual Cleaning of fiberscopes.

An action plan was put in place to deal with the matter and both Council and HiQA are satisfied that all areas of concern have been addressed.

On-going Quality programme.

–  –  –

Survey took place on February 10th, 11th and 12th 2014 and resulted in partial compliance. A focused revisit is due in May and we are working very hard on this.

The reason for seeking accreditation is to prepare the Hospital for the implementation of the National Standards for Safer Better Healthcare and HIQA Licensing of Hospitals.

I would like to acknowledge all staff for their continued commitment to improving service quality and patient safety.

Internal Governance Risk Management.

Our Integrated Risk Quality and Safety (IRQS) Committee chaired by the Hospital’s Medical Director Dr. Aoife Doyle, continued to keep Council updated on the risk, quality and safety issues arising in the Hospital. Dr. Doyle makes a formal presentation to Council on a quarterly basis.

Audit and Risk Committee.

Our Audit and Risk Committee, under the capable guidance and direction of Patrick Dowling continued to provide professional oversight to our corporate governance during the year. I would like to take this opportunity to thank Patrick and the Committee for their good work and on-going commitment.

Ethics & Medical Research Committee.

This committee, under the guidance of Maresa Durcan continued to provide a first class service to the Hospital. We are indeed fortunate that Maresa continues to chair the committee which governs this very important aspect of our hospital’s work.

Finance Committee.

This committee, which I chair, meets before every regular Council meeting at least, and addresses such matters as financial performance, capital expenditure, cash flow and banking information as well as other relevant issues, with the purpose of ensuring good financial governance in the hospital.

–  –  –

Hospital Management Group The Hospital Management Group (HMG) is the senior management group within the hospital.

This team led by Danny Dunne our Chief Executive for the past few years, continues to provide strong executive management for the Hospital. Under Danny’s active, dedicated and competent leadership, progress continues to be made in a number of key areas and we look forward to a continuance of this progress in the year ahead.

The greatest challenge facing the Hospital in 2013 was the maintenance of service levels in the face of continuing cuts in staffing numbers and reduced HSE funding. Whilst service levels were exceeded the full year financial deficit was €495k.

As for 2014 and beyond, Council and I continue to be confident that our very committed and supportive colleagues at the hospital will, as they have always done, rise to the difficult challenges ahead.

Medical Board.

Aoife Doyle stepped down as Medical Director in Dec 2013. Aoife continued to drive the quality agenda process towards the JCI survey in February. I would like to express the thanks of Council and HMG to Aoife for her invaluable contribution. I am delighted to announce that Prof. Conor Murphy was appointed as Medical Director in January 2014.

Having served on the HMG until September 2013 as Director of Education and Research, Conor is well placed to provide vital continuity in the clinicians input to HMG.

Governance Best Practice.

In accordance with best practice Council carried out a self-assessment of its effectiveness during the year. This will become an annual exercise.

A CEO evaluation was also carried out in 2013 and this will continue yearly in the future.

Council reviewed important Governance documentation during 2013 – this included a Code of Governance for Council Members and Staff and Disclosure of Members Interest.

The Terms of Reference of key committees (Council,HMG, Nominations, Finance, and Audit) were also reviewed during the period.

–  –  –

External Governance.

Annual Compliance Statement.

The HSE introduced an Annual Compliance Statement requirement for all HSE funded Voluntary agencies, commencing for 2013. This statement requires Council sign-off on a wide range of compliance issues by May 31st 2014.

The Hospital is currently carrying out a review of the various areas covered by the compliance statement.

Payment of Allowances to Senior Managers and Public Sector Pay Compliance.

As with all the voluntary hospitals, there was on-going communication between the Hospital and the HSE during 2013 on the matter of allowances paid to senior staff. The RVEEH made full disclosure to the HSE in relation to these.

At a meeting in early January 2014 the HSE agreed that the RVEEH was now deemed compliant in relation to payment of allowances to senior managers and in recognition of our needs, we were requested to submit two business cases in 2014 in relation to appropriate allowances for clinician’s involvement in management duties.

The current and previous Chief Executives are paid on an approved salary scale and there have been no additional payments to any the chief executives or employees from any other sources.

Hospital Groups.

The new Hospital Group structures began to take shape in 2013. RVEEH was confirmed as a member of the Ireland East Hospital Group. Mr. Tom Lynch was appointed Chairperson of the Ireland East Group in 2013. It had been anticipated that the Group Management Team roles would be filled during the year but no appointments had been made by year end.

Despite the absence of a Group Executive, a number of Group meetings were held between July and December - the President of Council, the CE, the Medical Director and the Director of Nursing represented the RVEEH at a number of these meetings.

–  –  –

Retirements Mr. Peter Barry officially retired in December 2013 following a year as President of the ESCRS European Society of Cataract and Refractive Surgeons.

Mr. Barry has given long and distinguished service to the Hospital and excellent care to his patients and I wish him every health and happiness in his new life.

During 2013 there were several retirements in the Nursing Department notably Annette Morgan and Cora Loftus Flynn.

Other retirements were Betty Dodd from Household and Willie Coleman from Portering.

We wish each and every one of them a long, happy and healthy retirement.

New Appointments I would like to welcome Mr. Philip O’Connor who commenced as Locum Director of Finance and Organisation Services in November 2013.

Ms. Elspeth Finlay took on the role of Director of Nursing following Ms. Marie Tighe’s secondment to the HSE.

Mr. John Doris was appointed locum Consultant Surgeon to replace Mr. Peter Barry. Mr.

Patrick Talty was appointed to the permanent role and will take up the post in May 2014.

I would like to thank Mr. Doris for his contribution to the hospital during his time here.

Change in Audit Partner I would also like to acknowledge John Dunne, our new Audit partner from PWC. John, who has taken over the role from Teresa Harrington, is a very experienced auditor and we look forward to working with him in the years ahead.

In Memoriam 2013 It is with regret that I note the following deaths from amongst our retired staff. Ruth Curtin, Healthcare worker – retired from the RVEEH in 2010 and passed away in August

2013. Ruth is a sister of Dr. Denise Curtin, Consultant Ophthalmologist at our hospital.

–  –  –

Frank McAuley retired Consultant Ophthalmologist passed away in Jan 2013.

May they Rest in Peace.

Thanks and Appreciation I would like to express my sincere thanks to all my colleagues on Council and in the Hospital for their continued support and assistance in the past year. In particular I thank our Chief Executive, Mr. Danny Dunne, who is a good colleague and a pleasure to work with.

I also wish to thank the Hospital Management Group for their great work in 2013 in very difficult financial circumstances.

I thank the outgoing Chairman of the Medical Board, Professor Aongus Curran and his colleagues for their support in 2013. I welcome the new Medical Board Chairman, Dr.

Deirdre McCoy who by virtue of holding that position also joins us on Council. I wish her every success in her new role.

To the Medical, Nursing, Administrative and Support Personnel, I say thank you for providing an excellent service to our patients through 2013 and we look forward to your continuing the good work in 2014 and beyond.

Dr. James Ruane, President of Council.

–  –  –

Report of the Chief Executive.


Total income for 2012 was €26.6 million (€27.4 million). This was comprised of:

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