Written Answers Nos. 1103-1144
1114. Deputy Ken O'Flynn asked the Minister for Health whether any cross-regional comparative analysis or reconciliation is conducted to ensure consistency in how counselling activity data is recorded and reported across Health Regions. [29926/26]
View answerAs part of HSE Mental Health Services, the National Counselling Service provides free counselling therapy to adults who experienced childhood abuse or neglect, or are former residents of a mother and baby home. They also provide counselling to those with medical cards, through the Counselling in Primary Care service (CiPC). Outside of this, the HSE also funds many community partners to provide counselling and related services on its behalf. This is an area I have prioritised in recent Budgets, including €1m in Budget 2026 for a new talking therapies fund for providing Community Therapy Services.
There is a strong evidence base for the clinical effectiveness of CiPC, as demonstrated by Changing Lives for the Better: A National Evaluation of the Counselling in Primary Care (CIPC) Service (2022). This was the first national evaluation of the service and analysed data collected across all HSE Community Healthcare Organisations between 2015 and 2020, using routinely collected clinical outcome measures, follow-up data at 6 and 12 months, and feedback from clients and GPs. The evaluation found that 72% of clients improved or recovered following counselling, with large effect sizes, and that the proportion of clients assessed as being at risk reduced from 26.7% before counselling to 8.5% afterwards. Improvements in psychological distress, functioning and quality of life were largely maintained up to one year after counselling ended, and both clients and GPs reported high levels of satisfaction with the service, describing it as effective and beneficial.
Counselling data
The HSE collects a wide range of data on service provision across HSE Mental Health Services. These key performance indicators (KPIs) are used by both the Department of Health and the HSE to monitor service performance against agreed targets and to support service planning and policy implementation. The data underpin Departmental performance engagement processes with the HSE, providing information to inform structured discussions on delivery, pressures and priorities. These KPIs are kept under ongoing review by the Department of Health and the HSE to ensure they continue to accurately reflect service provision and effectively support future service planning and development.
This includes a range of data on Counselling in Primary Care (CiPC) activity, including number of clients referred each month, number of re-referrals, waiting times for initial assessment and ongoing counselling, and the number of appointments offered. Re-referral data is captured through the service’s information management system by identifying subsequent referral events for the same service user after case closure, using unique client identifiers to link new episodes of care to prior service contacts.
The National Business Information Unit (NBIU), operating within HSE Community Health Care, is responsible for collating and analysing national performance and activity data across primary and community services. It is the unit that produces HSE Performance Reports, supports monitoring against the National Service Plan, and provides data for oversight by the National Planning Oversight Group and the Department of Health.
As outlined above, the HSE performance reports are essential to the performance monitoring work of the Department of Health and play a key role in service planning.
There is a pathway for Community Services Monthly Data and at various stages along this pathway data is quality checked and agreed, data is collated and reported, and queries are raised and explored. This is an iterative process and there may be various stages of checking and agreement before data is finally agreed by the NPOG at the end of the month and included in performance reports.
Activity data is submitted by CiPC to the NBIU in a standardised format using the approved Corporate Information Facility (CIF) template. Definitions for all data collected are set out in the HSE Mental Health Services Key Performance Indicator Metadata document.
Data validation begins at source. The National Counselling Service uses an electronic client management system that generates a standard report from which monthly activity data is compiled. Each Health Region then validates the submitted data for accuracy, completeness, and month-on-month consistency before forwarding it to the NBIU.
Digital for Care and Community Connect rollout
Community-based health and social care services have historically relied on a mix of paper records and local IT systems, which limited the availability of timely, consistent and reliable data at service, regional and national level.
To address these challenges, improvements in community data are being progressed as part of the HSE’s Digital for Care programme, which sets the national framework for digital health transformation. A key element of this work is Community Connect, the national programme delivering a single integrated digital solution for community services.
Community Connect is standardising how information on referrals, access, appointments, caseloads and activity is recorded across community settings. By shifting paper-based processes to a digital platform, the programme is improving the quality, availability and comparability of community data.
These changes will result in more accurate and timely information on service demand, activity and capacity, improved national and regional reporting and oversight, reduced duplication and administrative burden for staff, and better support for service planning, performance monitoring and policy development.
Community Connect also establishes national data standards across community services. This work aligns with the Digital for Care roadmap and represents a step towards the National Electronic Health Record (NEHR), ensuring that community data can be integrated with wider health service information over time. When fully rolled out, this work will benefit all community services, including counselling supports.
1123. Deputy Ken O'Flynn asked the Minister for Health whether counselling activity data is used to inform budget allocations or resource decisions; and if so, whether the absence of patient-level reporting has been assessed as a limitation. [29936/26]
View answerThe annual budget allocation for the Department of Health is arrived as follows:
The Department forecasts future annual expenditure by care group such as acute hospital care, mental health, primary care etc. The forecast for each particular care group is broken down into 3 distinct categories namely
- Pay Expenditure
- Non pay expenditure
- Income
Pay expenditure forecasts are based on known pay agreements, expected staffing headcount increases and other known costs pressures less any targeted pay savings
Non pay expenditure forecasts are based on projecting forward existing expenditure adjusting for expected inflation, demographic changes and non-pay savings. Different growth assumptions are made for individual care groups.
Income forecasts are made by extrapolating forward existing income by care group in line with projected non-pay growth with adjustments made for expected changes such as projected income losses due to the implementation of the Public Only Consultant Contract.
The Department of Health's budget bid is then subject to negotiation with the Department of Public Expenditure Infrastructure Public Service Reform and Digitalisation where assumptions are examined and challenged. Following these negotiations a final budget allocation is made to the Department of Health.
Once the budget is allocated it is issued to the HSE and the other health agencies. It is at this level that the HSE make operational decisions to prioritise and allocate at a lower level. They may consider multiple factors including counselling activity to inform their budget allocations or resource decisions.
