Dáil Éireann Debate, Thursday - 2 May 2024
310. Deputy Bernard J. Durkan asked the Minister for Health if he is satisfied that the health services can be co-ordinated in such a way as to ensure a modern response to patients' needs in all areas throughout the country; and if he will make a statement on the matter. [20145/24]
View answerI can assure the Deputy that considerable progress is being made in the ongoing effort to integrate our health and social care services, and to ensure that patients have access to safe, timely, affordable care that is coordinated in an integrated manner.
On 4th March, the HSE was reorganised into six operational Health Regions. This represents one of the most significant reforms to our health and social care service in recent years. The HSE Health Regions, each led by a Region Executive Officer (REO), will have responsibility for the planning and coordinated delivery of the vast majority of health and social care services to their respective populations. The six REOs have commenced in their post earlier this year and are now driving the regional implementation of this reform. As part of the transition, the HSE is actively developing an Integrated Service Delivery model focused on the provision of multidisciplinary, community-based care. Integrated Healthcare Areas (IHAs) will be the core units of integrated care delivery within the Regions and will comprise both acute and community services.
The Health Regions will also take a population-based approach to how it plans, funds and delivers care – this is an approach that was championed by the Sláintecare Report. This means we will be delivering services which are informed by the health needs of the population. In March, the Department established a PBRA Expert Group to develop a Population-Based Resourcing Approach, the goal of which is to ensure that each region is provided with a fair and equitable share of the existing healthcare resources which is informed by population health need.
Alongside the Health Regions reform, other important developments have continued to progress, for example, the continued implementation of the Enhanced Community Care (ECC) Programme, with annual funding of €195 million. To date:
• All 96 of the planned 96 Community Healthcare Networks (CHNs) are now operational.
• 27 of 30 Community Specialist Teams (CSTs) for Older Persons are now established.
• 26 of 30 Community Specialist Teams for Chronic Disease Management are now established.
• 23 Community Intervention Teams (CITs) are operational with national coverage secured.
• 80% of the Programme's recruitment target has been achieved, with 2,766 WTEs onboarded and a further 41 WTEs at an advanced stage of recruitment.
The Community Healthcare Networks (CHNs) - for the first time in Ireland - provide for the integration of General Practice (GP) with wider community services. They act as the foundational structures of community-based care within the new Integrated Healthcare Areas (IHAs). Alongside these, the Community Specialist Teams (CSTs) provide consultant-led multi-disciplinary care to older persons, and those with chronic disease, in the community. The Community Intervention Teams (CITs) seek to prevent unnecessary hospital admission or attendance, and to facilitate early discharge of patients appropriate for CIT care. Through its fast-tracked provision of services, the CIT provides access to nursing and home care support seven days per week. The CITs provide a range of services including the administration of home IV antibiotics, acute anticoagulation care, acute wound care and dressings, enhanced nurse monitoring following fractures, falls or surgery, care of a patient with a central venous catheter and urinary related care, among others. Combined, these represent a re-orienting of care provision towards primary and community care setting, enabling quicker access to care and more local decision-making.
The continued delivery of the GP Access to Community Diagnostics (GPACD) initiative ensures that GPs can access this specific suite of diagnostic tests quickly for their patients, without the patient requiring referral to a consultant, and without having to attend hospital. GPACD enables a greater level of care to be delivered in general practice, located in the community, supporting patient-centred care, early diagnosis, and early intervention. In 2023 the GPACD scheme provided a total of 339,984 community diagnostic radiology scans including X-rays, CT scans, MRI scans and DEXA to patients referred directly by their GPs to contracted private providers, located in convenient settings within the community and closer to home, with a further 92,000 community radiology scans, alongside CDM diagnostics such as the 35,643 NT-proBNP blood tests, provided to end of March 2024.
While none of these initiatives alone are a panacea for all the challenges our system experiences, each are a necessary step towards providing rapid access to better, high-quality care for patients. When combined, these important programmes complement each other and serve to enable the integrated coordination of our acute, community and primary care in a way that is modern, equitable, and responsive to the health needs of the people of the country.
