Dáil Éireann Debate, Thursday - 14 February 2013
354. Deputy Caoimhghín Ó Caoláin asked the Minister for Health when the first phase of the national asthma programme will be implemented; the initial actions that will be taken in order to implement the programme; the deadlines for these actions; and if he will make a statement on the matter. [8003/13]
View answer355. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the reason implementation of the national asthma programme was not prioritised in the 2013 Health Service Executive service plan in view of the fact that there are 470,000 persons in Ireland with asthma, that more than one person per week dies from asthma and in view of the fact that it is a chronic respiratory disease that is particularly prevalent in children, with one in five children here suffering from the disease; and if he will make a statement on the matter. [8004/13]
View answerI propose to take Questions Nos. 354 and 355 together.
The HSE is developing programmes to manage patients with chronic diseases in an integrated manner across service settings, resulting in best health outcomes, enhanced clinical decision making and the most effective use of resources. The following priority programmes are particularly relevant to primary care: Stroke; Heart Failure; Asthma; Diabetes; and COPD. The Diabetes programme is the most advanced. The delivery of the National Asthma Programme (NAP) is a priority for progression in primary care settings in 2013. 85% of asthma is managed in primary care, which is in line with the Government's policy of providing care as close as possible to the patient's home. The overarching aim of the NAP is to reduce the morbidity and mortality associated with asthma in Ireland and to improve clinical outcomes and the quality of life of all patients with asthma. A key component is improved management of people with asthma in primary care and thereby, avoiding emergency attendance at General Practitioner (GP) out-of-hours services, hospital emergency departments and in-patient admission services. The target is to reduce bed days by 10% per year over three years through implementing the programme’s asthma guidelines and national model of care, which is in development. The model of care document will be available by the end of Quarter 1, 2013. In 2011, the first year of programme implementation, there was an 8% reduction in acute hospital bed days for acute asthma.
The initial focus of the work of the NAP has been on the development and implementation of national asthma guidelines based on international best practice, both for acute care and ongoing asthma management. The National Model of Care for Asthma will detail how physicians, nurses, and other health care professionals will work with engaged patients to make the clinical decisions most appropriate to their circumstances and to collaborate with specialist colleagues in providing a safe, seamless experience through their journey within the health system in Ireland. This includes a model for the management of asthma in primary care and the necessary links with secondary specialist services.
It is reported that one person dies from asthma each week, however, the most recent year of validated data is 2009. Studies on asthma deaths internationally, such as Confidential Enquiries in the UK, have shown that up to 90% of asthma deaths have preventable factors. The NAP is developing a proposal to undertake a similar study. Adult Emergency Asthma Guidelines were published in November 2011 and are available on www.hse.ie. These guidelines are being revised at present and will be submitted to the National Clinical Effectiveness Committee (NCEC). Paediatric Emergency Asthma Guidelines have also been developed and will be available for circulation by the end of Q1, 2013. Asthma Control in General Practice (guidelines for managing a patient with asthma in primary care) have been developed and recently approved by the Irish College of General Practitioners (ICGP). These are currently being circulated.
A self-learning asthma e-learning 6 modular theoretical programme, based on the national evidenced based guidelines and developed by NAP in conjunction with the Asthma Society of Ireland (ASI), is available on http://www.hseland.ie and www.asthmasociety.ie for any health care professional who wishes to update their knowledge. This will enable healthcare professionals to underpin their skill sets with theory. There is also a similar programme available for GPs on the ICGP website.
