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National Asthma Programme

Dáil Éireann Debate, Tuesday - 14 May 2013

Tuesday, 14 May 2013

Questions (634, 635, 636, 641, 642)

Róisín Shortall

Question:

634. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 354 of 14 February 2013, if the model of care document for the national asthma programme was completed by the end of March as indicated in that reply; if not, the reason for same; and if he will set a specific date for the completion of this key document. [22463/13]

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Róisín Shortall

Question:

635. Deputy Róisín Shortall asked the Minister for Health the person within his Department or within the Health Service Executive with operational responsibility for the completion of the model of care document for the national asthma programme; and the person who has overall operational responsibility to implement the national asthma programme. [22464/13]

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Róisín Shortall

Question:

636. Deputy Róisín Shortall asked the Minister for Health the economic modelling, if any, that has been undertaken by his Department or the Health Service Executive to identify the savings that would accrue at hospital level were the primary care element of the national asthma programme to be implemented in full; and if any such economic assessment has identified the overall seed capital required to fund the programme at primary care level. [22465/13]

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Mattie McGrath

Question:

641. Deputy Mattie McGrath asked the Minister for Health when the first phase of the national asthma programme will be implemented; and the initial actions that will be taken in order to implement the programme and the deadlines for these actions. [22518/13]

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Mattie McGrath

Question:

642. Deputy Mattie McGrath asked the Minister for Health the reason implementation of the national asthma programme was not prioritised in the 2013 Health Service Executive Services Plan with more than one person a week dying from asthma and 470,000 people here living with this respiratory disease that is particularly prevalent in children, with one in five Irish children suffering from the disease; and if he will make a statement on the matter. [22519/13]

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Written answers

I propose to take Questions Nos. 634 to 636, inclusive, 641 and 642 together.

The National Asthma Programme, which commenced in 2011, is one of a number of chronic disease programmes established in the HSE’s Clinical Care Directorate aimed at bringing a systematic approach to changes in how services for patients are delivered. The overarching aim of the Programme 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 the improved management of people with asthma in primary care, thereby, avoiding emergency attendance at General Practitioner (GP) out-of-hours services, at hospital emergency departments and in-patient admission services.

The initial focus of the work of the Programme has been primarily on:

- The development and implementation of national asthma guidelines based on international best practice for acute and ongoing asthma management and national asthma education initiatives for patients and health care professionals; and

- The organisation and better integration of national asthma services at primary and secondary care levels through the development of a national model of care.

The acute adult and Paediatric asthma guidelines and associated care pathways, treatment protocols and care bundles have now been developed for use in primary and secondary care settings. The acute adult asthma guidelines, which are available online at www.hse.ie , are currently being revised.

The National Asthma Programme is currently working on developing a National Model of Care for Asthma. The National Clinic Lead for Asthma, supported by the programme's GP Lead, have responsibility in the HSE for the development of the model of care for asthma. The Integrated Services Directorate has operational responsibility for implementation of the programme, supported by the Clinical Strategy & Programmes Directorate. The proposed implementation plan will detail how physicians, nurses, and other health care professionals will work with engaged patients to make the clinical decisions most appropriate to the patient’s circumstances; while collaborating with specialist colleagues in providing a safe, seamless patient experience within the health system in Ireland. This is a key deliverable of the National Asthma Programme for 2013. The National Asthma Programme had to prioritise the submission of the Adult Asthma Emergency Guidelines to the National Clinical Effectiveness Committee which had a deadline of March 2013. The Model of Care for Asthma will be ready for stakeholder consultation by the end of quarter 2. It is anticipated that it will be completed by the end of quarter 3 this year.

As 85% of asthma is managed in primary care without the requirement for hospital specialist services, the National Asthma Programme is currently undertaking work to look at providing a yearly programme of assessment for asthma in primary care called Chronic Disease Watch – Asthma (also referred to as Asthma Check). The development of Asthma Check is being done in conjunction with the Irish College of General Practitioners (ICGP). Asthma Check outlines the step-by-step process for implementation of guideline based asthma management in primary care to deliver optimal outcomes for patients. The aim being to facilitate the implementation of best practice asthma guidelines in primary care in order to improve asthma control. This will reduce acute exacerbations and thus their associated overall costs with fewer hospital bed days and less time off school / work. It will also ensure that patients with asthma maximize their quality of life.

The National Asthma Programme expects that savings would be made in, GP out-of-hours visits, Emergency Department attendances and bed days used by implementing the programme. In addition, a 10% reduction in asthma deaths each year is targeted by the programme. Consideration is being given to carrying out an economic analysis of the implementation of the acute asthma guidelines with the support of HIQA. I am satisfied that good progress can be made in the ongoing development of the National Asthma Programme in 2013.

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