Dáil Éireann Debate, Tuesday - 31 May 2022
714. Deputy Matt Shanahan asked the Minister for Health further to Parliamentary Questions Nos. 1849 to 1851, inclusive, of 26 April 2022, if his Department requested the HSE to comment on the way that these transfers (details supplied) align with clinical treatment protocols; and if he will make a statement on the matter. [27750/22]
View answer715. Deputy Matt Shanahan asked the Minister for Health further to Parliamentary Questions Nos. 1849 to 1851, inclusive, of 26 April 2022, if his Department made contact with the clinical leadership in the acute coronary syndrome programme to examine the proportion of cardiac STEMI transfers and the possible implications to health outcomes given these delays (details supplied); and if he will make a statement on the matter. [27751/22]
View answer716. Deputy Matt Shanahan asked the Minister for Health further to Parliamentary Questions Nos. 1849 to 1851, inclusive, of 26 April 2022, if his Department made contact with the clinical leadership in the acute coronary syndrome programme to examine the proportion of cardiac STEMI transfers and the possible implications to health outcomes given these delays (details supplied); if his Department considered the potential of State risk to medical injury claims through the courts as a result of not providing full-time service access at University Hospital Waterford which could significantly reduce the transfer times and by extension reduce the times to receipt of optimal PCI treatment; and if he will make a statement on the matter. [27752/22]
View answer718. Deputy Matt Shanahan asked the Minister for Health further to Parliamentary Questions Nos. 1849 to 1851, inclusive, of 26 April 2022, the present status of the Herity report that was compiled in 2016 advising that a transfer window of 90 minutes was possible between hospitals in Cork and Waterford given the transfer time referred to in the response; if this standard has been dispensed with as having relevance to the treatment of STEMI heart attack for patients in the south-east when the Waterford Cath laboratory suite is closed given the new evidence; and if he will make a statement on the matter. [27754/22]
View answer721. Deputy Matt Shanahan asked the Minister for Health further to Parliamentary Questions Nos. 1849 to 1851, inclusive, of 26 April 2022, if he will publish the communications between his Department and the clinical leads in the acute coronary syndrome programme that make reference to the elongated transfer times being experienced by University Hospital Waterford for STEMI heart attack patient transfers; if the preferred latest transfer protocol timelines of an organisation (details supplied) will be published with reference to European and United States transfer standards also; and if he will make a statement on the matter. [27757/22]
View answerI propose to take Questions Nos. 714 to 716, inclusive, 718 and 721 together.
In line with its performance oversight role my Department meets with Health Service Executive (HSE) colleagues regularly on issues across the entire range and volume of public health services and their associated targets as set out in the HSE's National Service Plan.
In regard to the details enclosed with the Deputy's questions, the HSE's response to him of 5 May 2022 concerns the National Ambulance Service's (NAS) operation of Protocol 37 hospital to hospital patient transfers. The Protocol 37 Standard was introduced by the Pre Hospital Emergency Care Council (PHECC) and is intended to ensure that requests from hospitals for emergency inter-hospital transfers are clinically prioritised in the same way as 999 emergency calls. Protocol 37 calls are clinically categorised as Bravo (serious not life threatening – urgent), Charlie (serious not life threatening – immediate) or Delta (life threatening other than cardiac or respiratory arrest) depending on the patient’s condition and need for transfer to another facility. Protocol 37 Transfers are allocated the nearest appropriate resource, and subject to P37 category, may respond on blue lights and sirens to the referring hospital. All Protocol 37 requests are made by a registrar, consultant or clinical nurse manager, and all Protocol 37 requests must come through the 112/999 system. The timeframe within which the emergency ambulance or intermediate care vehicle is needed is provided by the hospital at the time of booking. The ability to achieve the desired timeframe is dependent on the availability of resources at the time of the request. I have been informed by the HSE that the majority of the information provided by the HSE in its reply of 5 May to the Deputy relates to non-cardiac-related cases.
Since early summer 2021 and into 2022, the NAS has experienced a growing demand for its services when set against available capacity. Last year the NAS dealt with a record 366,438 emergency calls and the latest data to the end of March indicates that current demand is already around 12% higher than at the same period last year. Patient transfer delays at highly pressured hospital Emergency Departments and the continuing requirement for ambulance crews to carry out necessary Covid 19-related infection prevention and control measures also continue to present significant challenges for the NAS and mean that its performance in servicing all requests is very much dependent on resource availability.
The Government remains committed to increasing capacity in the NAS. The operating budget for NAS in 2022 has reached €200.7m, up from €187.5m in 2021, which at the time was also a record allocation and overall it represents an increase of approximately €30 million since 2019. This year's investment includes a total of €8.23m in funding for new service developments and involves the recruitment of an additional 128 staff, which will help build further front-line capacity in the service, strengthen governance arrangements and improve access to alternative care pathways for patients.
Regarding contact with the clinical leadership in the acute coronary syndrome programme, as Minister for Health, I am awaiting the final report of the National Review of Specialist Cardiac Services, which was established in late 2017 under the independent chairmanship of Professor Philip Nolan. The National Review of Specialist Cardiac Services is examining the delivery of cardiac services nationally with the aim of ensuring that as many patients as possible have access, on a 24/7 basis to safe, quality assured and sustainable emergency interventions following an acute myocardial infarction. The Review seeks to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality, and sustainability of the services that patients receive by establishing an optimal configuration of a national adult cardiac service. The review is underpinned by a rigorous systematic evidence review, data analysis of existing service provision, and examination of relevant international good practice.
In regard to the further points raised by the Deputy in his questions I have asked the HSE to respond directly to him in the matter, as soon as possible, with any further pertinent details it may have.
