I propose to take Questions Nos. 909 and 910 together.
The HSE is developing integrated chronic disease management programmes to improve patient access and to manage patient care in an integrated manner across service settings, resulting in best health outcomes, enhanced clinical decision making and the most effective use of resources. Guidelines are being developed for the following priority programmes relevant to primary care: Stroke; Heart Failure; Asthma; Diabetes; and COPD.
The National Integrated Care Diabetes Programme is being rolled out on a phased basis including:
- National Retinopathy Screening;
- A foot care screening and treatment service to prevent diabetic foot ulceration and lower limb amputation;
- An Integrated Care Programme for all patients with diabetes;
- A National Diabetes Register; and
- The introduction of a National Model of Care for children and young adults with Type 1 diabetes and the implementation of continuous subcutaneous insulin infusion therapy for children under 5 years with type 1 diabetes.
It is expected to take approximately three years to fully roll out the National Integrated Care Diabetes Programme.
The Government has approved funding for the appointment of 17 Integrated Care Diabetes Nurse Specialists (one per HSE Integrated Service Area) to support the phased roll out of the programme. These Diabetes Nurse Specialists will work 1 day per week in a hospital setting and 4 days per week in primary care. They will play a key role in the development of clinically sound collaborative links between primary care and secondary care providers and will also be an essential resource in empowering patients to achieve optimum diabetes control. It is anticipated that all 17 positions will be filled soon.
Funding has also been secured to appoint 16 podiatrists and a number of these posts have been filled. Recruitment for the remaining posts is underway and the aim is to have them filled as soon as possible in 2013.
The Programme for Government provides for the introduction of a new General Medical Services (GMS) General Practitioner (GP) contract with an increased emphasis on the management of chronic conditions, such as diabetes and cardiovascular conditions. It is envisaged that the new contract, when finalised, will focus on prevention and will include a requirement for GPs to provide care as part of integrated multidisciplinary Primary Care Teams.
Officials in my Department are in consultation with the HSE with a view to drawing up a new contract. The appropriate arrangements in relation to the management of chronic conditions, including diabetes, will be considered as part of the new GMS contract.
