Dáil Éireann Debate, Wednesday - 22 November 2023
221. Deputy Colm Burke asked the Minister for Health to give due consideration to conducting cardiovascular disease screening and management within the pharmacy setting; and if he will make a statement on the matter. [51494/23]
View answerI recognise the significant role community pharmacists play in the delivery of patient care and acknowledge the potential for this role to be developed further in the context of healthcare service reform.
In that regard, various approaches to extending the scope of practice of community pharmacists are being progressed by my department. The implementation of these necessitates engagement with a range of stakeholders and full consideration of all the relevant legislative and operational issues involved. The establishment in July 2023 of the Expert Taskforce to support the expansion of the role of pharmacists in Ireland is evidence of my commitment to that aim. I have accepted the first recommendation of the Taskforce and work to implement that recommendation has commenced with the relevant stakeholders.
There has been constructive engagement between Department officials and the Irish Pharmacy Union especially in recent months to advance consideration of the range of initiatives to support an enhanced role of pharmacy. As the Taskforce progresses its work this close engagement needs to continue with my Department and the HSE, with a view to identifying the key enablers to support realisation of the objectives of an expanded scope of pharmacy practice.
The General Practitioner (GP) Chronic Disease Management (CDM) Programme commenced in 2020 and has been rolled out on a phased basis to adult GMS (Medical Card and GP Visit Card) patients over a 4-year period as planned. The specified chronic conditions included in the Programme are Type 2 Diabetes; Asthma; Chronic Obstructive Pulmonary Disease (COPD) and cardiovascular disease (including Heart Failure, Ischaemic Heart Disease, Cerebrovascular Disease (Stroke/Transient Ischemic Attack (TIA), Atrial Fibrillation).
The CDM programme is an entirely new healthcare service in Ireland that has brought the care for chronic disease further into the community and it aims to reduce hospital attendance by patients with one or more of these specified conditions.
To support patients in managing their chronic condition(s), under the CDM Treatment Programme each patient receives two scheduled reviews with the GP in a 12-month period, each preceded by a practice nurse visit. These reviews include patient education, preventative care, medication review, physical examinations, scheduled investigations and individual care planning.
The Opportunistic Case Finding Programme identifies those at high risk of cardiovascular disease or diabetes for entry to the Preventive Programme. Under the Preventive Programme, patients identified at high risk of cardiovascular disease agree a self-management plan with their GP/practice nurse, setting goals for improvement. Referrals to support services for smoking cessation, harmful alcohol treatment and weight management are made as appropriate.
I am fully committed to supporting our population screening programmes which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population.
Any decisions about further changes or expansion of cancer screening, including the introduction of cardiovascular disease (CVD) screening programme, will be made on the advice of the National Screening Advisory Committee (NSAC). This independent expert group considers and assesses evidence in a robust and transparent manner, and against internationally accepted criteria. It is important we have rigorous processes in place to ensure our screening programmes are effective, quality assured and operating to safe standards, and that the benefits of screening outweigh the harms.
Furthermore, the National Review of Specialist Cardiac Services commenced in January 2018 under the Chairmanship of Professor Phillip Nolan and a Steering Group formed from nominations of interested stakeholders representing medical, professional/technical staff, nursing, and patient representatives.
The aim of the Cardiac Services Review is to recommend configuration for a national adult cardiac service to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive. This aligns with the Sláintecare reform programme. In terms of scope, the National Review covers scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults, which includes screening.
The Review is finalised and has been presented to my office, where it is under my consideration. The recommendations of the review will inform the future provision of cardiac services nationally.
