Dáil Éireann Debate, Monday - 11 September 2023
1540. Deputy Jackie Cahill asked the Minister for Health what action is being taken to improve and expand community support services for heart failure patients to address physical and mental health, social and financial challenges that may arise for patients following diagnosis; and if he will make a statement on the matter. [37353/23]
View answerHeart Failure is an important public health issue that affects approximately 90,000 of population, it is a complex condition with increasing numbers. Across Europe, and in Ireland heart failure remains a significant demand on health services and in particular hospital-based care. While not all hospital admissions can be avoided there is growing evidence of how to improve hospital avoidance.
There has been progress across Ireland in heart failure care and the detection and prevention of this syndrome is a priority. The National Clinical Programme for heart failure is developed to improve quality of life for people living with the syndrome.
Ireland’s wider community of clinical practice in heart failure has provided leading research and innovation that continues to inform this care around the world. The STOP-HF project for example is a dedicated heart failure prevention strategy. This first-of-type concept has been proven to be successful and has resulted in changes in international guidelines. Ireland is among the world leaders in developing strategies to prevent heart failure.
Ireland is promoting pioneering innovations like the HeartCare at Home, a primary care project, which is open to all people with heart failure in Ireland. To get heart failure specialist care to a wider cohort of patients ‘Virtual Consultation’ allows on-line, real-time discussion of heart failure case questions with a family doctor. This consultation results in very effective remote management, avoiding unnecessary referrals and travel for the patient and facilitates the sharing of specialist expertise.
There has been significant investment in Integrated Care Programmes for Chronic Disease which includes heart failure. This investment has enabled the development of structures of care which will significantly improve all aspects of heart failure care including speed of diagnosis, access to cardiac diagnostics and therapies.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. To ensure the medical card system is responsive and sensitive to people's needs, the Department of Health keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.
There are clear, evidence-based guidelines and excellent exemplars of effective heart failure models of care however, recognising the importance of preventing unnecessary hospitalisations and deaths and maximising people’s quality of life is the priority. Progress has been made and to inform the next steps for this important work and to understand the challenges more, a National Review of our adult Specialist Cardiac Services which includes heart failure was commissioned. The Report is now finalised and is being prepared currently for my consideration. The Reviews recommendations will inform the future provision of cardiac services nationally.
