Written Answers Nos. 580-593
580. Deputy Fergus O'Dowd asked the Minister for Health the actions being taken by his Department to deliver transgender health services in Ireland; if his Department has considered the 'informed consent' model; and if he will make a statement on the matter. [2466/24]
View answerAs this a service issue I have referred the matter to the HSE for direct reply to the deputy.
581. Deputy Fergus O'Dowd asked the Minister for Health if he will provide an update on the expected timelines on the establishment of a new statutory home support scheme; how he plans to scope and plan for such a scheme; and if he will make a statement on the matter. [2472/24]
View answerThe Programme for Government commits to "Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high quality, regulated home care".
In 2024, the Department of Health is focused on developing the regulatory framework for providers of home support services. It aims to ensure that all service users are provided with regulated care. Work is ongoing within the Department across four broad areas to progress this commitment: (i) Regulation of home support providers; (iii) working with the HSE to develop a reformed model of service delivery for home support; (iv) Implementation of the recommendations of the Strategic Workforce Advisory Group.
(i) Regulation of home-support providers
In 2024, the Department of Health is focused on developing the regulatory framework for providers of home support services. It aims to ensure that all service users are provided with regulated care. It will consist of primary legislation, regulations and HIQA national standards. This work is at an advanced stage, with ongoing engagement with key stakeholders and legal advisors.
The primary legislation provides for the licensing of home support providers. Transitional timelines are being finalised for the registration of home support providers under this framework. Further details will be available following the expected publication of the General Scheme in Q1 2024.
The regulations will set out the minimum requirements that a home support provider must meet to obtain a license. Final revisions are being made to the draft regulations, informed by a public consultation.
Finally, the draft HIQA standards for home support will go out for public consultation in 2024.
(ii) the examination of future funding options for home-support services.
Currently, home support services are fully exchequer funded. How home support will be funded in the future will be an essential factor of the new Statutory Scheme. With this in mind the Department is researching different funding models. The Economic and Social Research Institute (ESRI) also undertook a programme of work on behalf of the Department on the potential demand and cost of home support which culminated in two reports:
www.esri.ie/publications/demand-for-the-statutory-home-care-scheme
www.esri.ie/publications/home-support-services-in-ireland-exchequer-and-distributional-impacts-of-funding
A rapid response from the European Observatory on Health Systems was commissioned and published in March of this year.
eurohealthobservatory.who.int/publications/i/improving-home-care-sustainability-in-ireland-are-user-charges-a-promising-option
This research will form an important part of the evidence base for the development of a sustainable funding model for home care services. No final decision on future funding has been made and further research is currently underway to enhance the evidence base.
(iii) working with the HSE to develop a reformed model of service delivery for home support
In 2022 a Pilot for testing of a reformed model of service for the delivery for homecare became fully operational in 4 Community Healthcare Organisations. Evaluation of the pilot has been completed.
The national rollout of interRAI as the new standard assessment tool for care-needs in the community is underway. The HSE is in the process of establishing of a National Home Support Office. Four WTEs, including the Head of Service of the new National Home support Office, have been appointed.
(iv) Implementation of the recommendations of the Strategic Workforce Advisory Group.
Addressing the shortage of care workers in Ireland is an urgent priority. In March 2022, Minister Butler established the cross-departmental Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. It set out to examine the challenges in front line carer roles in the home support and long-term residential care sectors.
The report was published on 15 October 2022:
www.gov.ie/en/publication/492bc-report-of-the-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-health-care-assistants/I
Implementation of the 16 recommendations is underway by a cross departmental group, chaired by the Department of Health. The group meets quarterly and publishes progress reports thereafter. The next meeting is scheduled for February 1st. The most recent progress report was published in October 2023 which can be viewed below:
www.gov.ie/pdf/?file=https://assets.gov.ie/275876/c0889fbf-3f9c-4235-9e79-e1240790fac7.pdf#page=null
582. Deputy Fergus O'Dowd asked the Minister for Health to provide a progress update on the expansion of community intervention teams to prevent unnecessary hospital admissions and to support the timely discharge of patients to their homes, since the establishment of the Government; and if he will make a statement on the matter. [2473/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
The Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
583. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment on the target of community services assigning a case manager for older people with chronic conditions to assist them with accessing the care they need, since the establishment of the Government; and if he will make a statement on the matter. [2474/24]
View answerIn line with Sláintecare priorities, the Enhanced Community Care Programme (ECC) objective is to deliver increased levels of health care with service delivery reoriented towards general practice, primary care, and community-based services. The focus is on implementing end-to-end care pathways that will care for people at home and over time prevent referrals and admissions to acute hospitals where it is safe and appropriate to do so.
ECC funding will support the ambitious, programmatic, and integrated approach to the development of the primary and community care sector which, amongst other initiatives, includes the development of primary care teams within 96 Community Healthcare Networks across the country, alongside 30 Community Specialist Teams for Older People, 30 Community Specialist Teams for Chronic Disease, and national coverage for community intervention teams.
To date, 96 Community Health Networks have been established, 24 Community Specialist Teams for older people, and 24 Community Specialist Teams for chronic disease.
Further ECC teams will be implemented in early 2024, with the focus for the Programme this year being on consolidating the progress made to date, increasing productivity and outputs to maximise impact from the existing level of resources.
Community Healthcare Networks
Through the implementation of the ECC Programme, 96 Community Healthcare Networks (CHNs) have been established, with each serving a population of on average 50,000. Each CHN is comprised of a multi-disciplinary team and provides the foundation and organisation structure through which integrated care is delivered locally at the appropriate level of complexity. This new approach will improve integrated team working between GPs, Health and Social Care Professionals, and nursing and other staff working in primary care services, moving towards more integrated end-to-end care pathways for individuals, especially older persons and those with complex and chronic conditions. Multidisciplinary Clinical Team Meetings now take place on a scheduled basis to support this approach.
Community Specialist Teams (Hubs)
The work that has been undertaken by the Integrated Care Programme for Older People (ICPOP) and Chronic Disease over recent years has shown that improved outcomes can be achieved particularly for older people who are frail, and those with chronic disease, through a model of care that allows the specialist multidisciplinary team engage and interact with services at CHN level, in their diagnosis and on-going care.
With the support of the Department of Health and Sláintecare, these models are now being implemented at scale by the HSE, with the establishment and full rollout of Community Specialist Teams for Older People and Community Specialist Teams for Chronic Disease to support CHNs and GPs to respond to the specialist needs of these cohorts of the population, bridging and linking the care pathways between acute and community services with a view to improving access to and egress from acute hospital services.
These Community Specialist Teams will service a population on average of 150,000, equating on average to 3 CHNs. Ideally, the teams will be co-located together in ‘hubs’ located in or adjacent to Primary Care Centres, reflecting a shift in focus away from the acute hospital towards general practice, and a primary care and community-based service model.
With regard to case managers for older people with chronic conditions to assist them with accessing the care they need, the HSE recognises the importance of embedding the multi-disciplinary Clinical Team Meetings as previously referenced. To ensure that these meetings are optimised and deliver a coordinated approach to individual clients, the roles of Clinical Coordinator and Key Workers have been created within the CHNs.
The Clinical Coordinator is a member of the multidisciplinary team, at senior therapy or nursing grade, and is central to the organisation and coordination of Clinical Team Meetings. A Key Worker may be identified for service users with complex needs and is also a member of the multidisciplinary team. The role of Key Worker is to assist in coordinating the delivery of services to the individual, while acting as a single point of contact and enhancing the experiences and outcomes for individuals.
The importance of the Clinical Coordinator and Key Worker roles are recognised within the ECC resource allocation, and a total of 3 WTE resources have been allocated to each CHN to allow protected time to carry out these essential functions.
Older adults with complex care needs who require the input of the Community Specialist Teams for Older People also require a proactive care coordination approach for their episodes of specialist care. As well as undertaking comprehensive assessment, MDT members will act as key workers until outcomes are optimised. This includes working collaboratively with other care providers across primary and secondary care to agree on how the older person’s care needs are to be met, in line with their will and preference, and ensuring seamless transitions back to the CHN team at the completion of the episode of specialist input.
584. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment on the development of the role of advanced nurse practitioners in older person services and chronic disease management, since the establishment of the Government; and if he will make a statement on the matter. [2475/24]
View answerI am pleased to provide the Deputy with an update on the Programme for Government commitment to develop the role of advanced nurse practitioners in older person services and chronic disease management. In November 2021, I increased the target of the number of nurses and midwives practicing at an advanced level across the health service from 2% of the total nursing and midwifery workforce to 3%. I am pleased to note that , as of November 2023, the total number of nurses and midwives at advanced practice level was 1,087 WTE, which is just over 2.3% of the nursing and midwifery workforce.
Advanced Nurse / Midwife Practitioners (ANMPs) provide complete episodes of care and timely access to healthcare and earlier interventions. Creating a critical mass of ANMPs will contribute effectively and efficiently to addressing population health needs and has demonstrated improved patient experience, reduced waiting times and reduced admissions to hospitals. ANMPs contribute to service reform by providing the right care, at the right time, and in the right place.
This Government has invested heavily in Advanced Practice for Nurses and Midwives, particularly since the publication of the Policy on the Development of Graduate to Advanced Nursing and Midwifery Practice for Nurses and Midwives (Department of Health, 2019). The role of ANMPs and the allocation of ANMPs across the various service areas is aligned with policy priorities. This includes older persons services and chronic disease management.
In 2020, 52 new ANMP posts were created. Of these, 12 were allocated to older persons services and a further 16 to chronic disease management.
In 2022, I allocated €11m to the HSE to recruit 149 ANMPs, 15 of which were allocated to Integrated Care Programme for Older Persons and 12 were allocated to chronic disease management.
In 2023, I announced the creation of a further 80 ANMP posts. 10 of these posts were allocated to older persons and 27 were allocated to chronic disease management. The table below sets out the total number of new ANP posts allocated to Older Persons Services and Chronic Disease Management since 2020.
New ANP posts since 2020 for Older Persons Services and Chronic Disease Management
|
Older Persons Services |
Chronic Disease Management |
|
|
2020 |
12 |
16 |
|
2022 |
15 + 1 post ED post in CUH Trauma Older Persons |
12 |
|
2023 |
10 |
27 |
|
Total |
38 |
55 |
The HSE have advised that within the older persons service, there are currently 148 ANP posts; and in chronic disease management there are currently 78 ANP posts. These numbers will be added to when the 37 allocated posts for 2023 have all been filled.
585. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment on the development and targeted expansion and availability of step-down facilities across each of the CHO areas, since the establishment of the Government; and if he will make a statement on the matter. [2476/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE
586. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to develop and support eHealth and the increased use of assistive technologies, supporting people to live independently, across each of the CHO areas, since the establishment of the Government; and if he will make a statement on the matter. [2477/24]
View answerThe provision of digital health solutions is a fundamental enabler for the reform of the health service and the implementation of Sláintecare.
Digital health solutions played a key role during the Covid-19 pandemic with solutions developed to facilitate monitoring and managing the spread of infection as well as the administration of vaccines when they became available. Many other digitally enabled services were deployed such as digital COVID certificates, electronic referrals from GPs for those who needed testing and electronic transfer of prescriptions to reduce close contacts and support social distancing.
Government has continued to support eHealth in recent years by increasing both capital and revenue funding provided for ICT and digital health. Investment in Capital funding has increased from €60 million in 2018 to €155 million in 2024. (Capital funding for ICT was just €40m in 2012).
A new digital health strategy for Ireland (Digital Health Strategic Framework (2024-2030) is currently being finalised by the Department of Health. It will set out a shared vision and guide a clear roadmap for investment in digital health, including delivery of digital patient records. The framework will be supported by rolling delivery plans developed by the Health Service Executive to achieve the desired level of accelerated digitalisation of health and social care services in future years.
Through the delivery of the Digital Health & Social Care Strategic Framework, we will continue to invest strategically in our digital health infrastructure, evaluate and invest in emerging technologies, integrate our systems for better security and collaboration and develop new ways of working through innovation.
The Framework will put a greater focus on empowering our patients to take greater control of their own health and wellbeing by providing access to their own digital health record. We will also offer more choice by delivering more services through digital channels, where it is safe to do so.
The framework is being developed in parallel with the Health Information Bill, which will be completed shortly. The Bill aims to deliver patient-centred integrated care, improve performance and innovation in the health service, and support digital and data initiatives in healthcare.
Digital Health Technology has matured over the last number of years and many health care organisations have adopted some aspects of digital health from video and phone consultation to remote health monitoring. In October 2023, the National Telehealth Steering Committee approved the HSE Telehealth Roadmap 2024-2027. The official launch took place at the Better Together for Digital Healthcare Conference on 1 December 2023.
A public procurement process is underway to establish a framework that different parts of the health service can use to select and deploy suitable telehealth platforms. There are 14 proposed telehealth sub-projects focussed on reducing demand for hospital beds through a combination of hospital admission avoidance and reduced length of stay. Initially these projects aim to address the needs of between 10 and 20 patients per month, but this will be scaled up rapidly if the model is successful. The sub-projects target a range of disciplines including Respiratory, Cardiology and Renal initiatives. An example is support for Remote Health Monitoring on the islands, in this case in Achill.
Separately, under the National Dementia Strategy, the Government has funded a national network of 29 Memory Technology Resource Rooms (MTRRs) which provide free occupational therapist assessments and advice on assistive technology, to help people adapt to their condition and maintain a degree of independence for as long as possible, while also providing support to family carers. The MTRRs are an important component of the post-diagnostic support framework set out in the Model of Care for Dementia which was published in May of last year.
587. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to develop and deliver a ‘carers guarantee’ proposal that will provide a core basket of services to carers across the country, regardless of where they live, across each of the CHO areas, since the establishment of the Government; and if he will make a statement on the matter. [2478/24]
View answerThe 2020 Programme for Government commits to delivering a ‘Carers Guarantee’ to provide a core basket of services to carers across the country, regardless of where they live. Annually recurring funding of €2 million was provided in Budget 2021 towards delivering the Carers’ Guarantee, providing a more standard package of supports to family carers in every region, in tandem with the community and voluntary sector. €1.9 million of this funding is being channelled through a Service Level Agreement with Family Carers Ireland (FCI), while the remaining €100,000 is supporting the operation of a professionally moderated online Family Carer Support Group through Care Alliance Ireland.
The €1.9m recurring allocation to FCI aims to improve access to carer supports across the country. The funding has enabled FCI to significantly upscale their support provision using a public health approach of universal, targeted and intensive interventions. Under its service level agreement with the HSE, FCI is providing both community and individual supports, with an allocation of €950,000 for each, across five areas of activity: community carer supports, intensive and emergency supports, education and training, FCI’s freephone careline, and psychosocial support. In 2023, FCI engaged directly with an additional approximately 5,000 family carers and engaged with thousands more through their universal self-directed supports and carer identification campaign.
Care Alliance Ireland receive €100,000 in funding as part of the Carers’ Guarantee funding to provide a professionally moderated online support group for Family Carers. This platform is monitored by staff and volunteers and has increased its numbers from 1,850 Carers in 2021 to over 6,420 carers in September 2023, with a 97% retention rate. The service promotes supports to assist family carers in carrying out their caring roles, thus allowing people in receipt of care to be maintained in their own homes and communities.
588. Deputy Alan Kelly asked the Minister for Health the number of WTE Staff by grade working in the pharmacy department of Nenagh General Hospital as of 12 January 2024; and if he will provide same figures as of 1 January 2023, in tabular form. [2479/24]
View answerAs this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently not in a position to answer PQs due to industrial action. It is hoped that normal services will resume soon. In the meantime, this Department will continue to refer PQs to HSE for their direct reply as soon as possible
589. Deputy Alan Kelly asked the Minister for Health the number of WTE ENT registrars working in Tipperary University Hospital in 2022 and 2023, in tabular form. [2480/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
590. Deputy Cathal Crowe asked the Minister for Health if an implementation budget has been earmarked for the recommendations that will come from the Rare Disease Strategy Steering Group; and if he will make a statement on the matter. [2490/24]
View answerIn December 2023, I announced the establishment of the National Rare Disease Steering Group. Since its establishment the Group has convened twice and has begun the process of developing a new Rare Disease Strategy that sets out the vision for Rare Disease services in Ireland and the actions required to achieve this. An implementation plan is expected to be developed by the Steering Group and will form part of this new Strategy. It is anticipated that the new strategy will be launched in Autumn 2024.
591. Deputy Cathal Crowe asked the Minister for Health for an updated on the implementation of Electronic Health Records in Ireland; and if he will clarify why Ireland is so far behind its European counterparts in this regard. [2491/24]
View answerWhilst it is true to say Ireland is still behind many of its peers in relation to the use of electronic health records (EHRs), actions are now being taken to address this deficit.
In addition to the delivery of EHRs into specific hospitals like St James Hospital in Dublin, three of our largest maternity hospitals, the national rehabilitation and national forensics hospitals, all GP practices now use electronic health records to manage patient data. Furthermore, the evidence we have seen from most other countries that have a national EHR, suggests that these patient records are delivered by collating data from existing, local or regional systems, and combining this data into a singular view that is accessible by healthcare professionals and increasingly, by patients themselves.
The evidence further suggests that clinicians in these countries mostly use local IT systems to manage data about the patients they are treating, and use the national or regional records to understand more about their patient if or when they were treated by clinicians elsewhere.
This is positive for Ireland because it means that we can build on the existing investments we have made in EHR systems (and other clinical systems) to date, and take a stepwise approach to delivering national and regional electronic health records, to overcome the deficit in how we compare to international peer countries to date.
Furthermore, most countries we have engaged with also highlight the opportunities that exist by deploying EHR systems now, rather than when they started their journey, which in some cases was over 10 years ago. These include the opportunity to deploy newer technology, access more mature and better proven solutions than those that were available in the past, and to leverage mobile technology, cloud based solutions and more digitally literate staff and patients. Indeed, during recent engagements with other countries, many of their technical teams commented on the challenges of being tied to older technology and legacy solutions.
To that end, whilst we will continue to invest in major EHR systems deployments across a number of care settings, such as the one at the new National Children’s Hospital - which will be the most extensive and capable EHR in Ireland to date - we will also invest in other capabilities such as the technical platforms and standards that enable us to collate data from existing systems. For instance, the HSE are in currently in the market to procure a technology platform to deliver a National Shared Care Record, which is a form of electronic health record that is similar to what many other European countries have delivered, and importantly allows us to join data from across existing systems to present a single view to clinicians and patients. It is anticipated this procurement will complete in 2024. Design, configuration, build and testing will all take time, but we anticipate initial deployments in 2026/27, delivering a national capability to allow both clinician and patients access medical records and in time more comprehensive health records as we deploy future EHRs.
However, these forms of national electronic health records are only as good as the data that can be derived from the source systems. For this reason, in parallel with the national shared record, we must continue to invest in core clinical systems and accelerate investment in the large enterprise EHR systems, like the one at Childrens Health Ireland.
The decision in 2018 not to proceed with large scale investment in this area and only to proceed with CHI at the time, was based on availability of funding and the capacity of the health system to take on such a large scale and complex programme of work.
Since 2018, the Government has consistently invested in digital health to build the capability and capacity of the ICT team extensively. Combined with the companies that specialise in supporting health services in the deployment and optimisation of enterprise level EHR systems (some of whom already work with CHI and others who work with the health service in Northern Ireland), we believe we can now address the challenge of capability.
As we invest further in digital and commit to electronic health records, we must be mindful of the devastating impact that the criminally motivated cyber-attack had on the Health Service in 2021. It is therefore equally important that we continue to invest in building cyber resilience, to ensure we have secure technology foundations, and the ability to protect data and keep it safe.
It is acknowledged that while there is a need to invest in EHRs with some urgency, there is still the challenge of funding this in order to make the desired progress. We estimate that a strategy based on a regional deployment of EHRs is likely to cost between €200m and €300m for each of the new 6 regional health areas. This will be considered by Government in the context of ongoing deliberations regarding additional funding to be made available in the upcoming review of the National Development Plan.
In the meantime, the HSE are examining ways in which Ireland can meet its EU obligations under the ‘EU Digital Decade’ Policy, whereby all EU citizens should be able to access their own digital health record by 2030. commission.europa.eu/strategy-and-policy/priorities-2019-2024/europe-fit-digital-age/europes-digital-decade-digital-targets-2030_en
We plan to do this by looking at combining data derived from GP systems, the reimbursement service and existing hospital level data where available, and by leveraging the shared care record technology platform to deliver this to citizens through a secure portal and patient app. This is completely aligned with how many other EU member states have delivered this capability.
In summary, a ‘stepwise’ approach to the delivery of electronic health records is typical when compared to many other countries. It also facilitates a good balance between making progress whilst managing risk, for what are quite complex programmes.
It should be noted that those countries that are recognised as leaders in digital health have been working in this area consistently for over 20 years. By way of context, Denmark, often cited as a Digital Health leader, was coding clinical diagnosis and procedures long before EHR systems become available. This coding enabled Denmark to manage the health of their entire population very effectively and made the transition to digital health systems more straightforward. Estonia, another country that is considered a leader in digital health, had already built its national infrastructure before EHR systems were deployed, so the health service there was able to ‘tap into’ that capability when it came time to deliver their national electronic health record system.
Finally, by maintaining a consistent focus and investing strategically in digital health, Ireland will, in the coming years, considerably improve its status when compared to other EU member states.
592. Deputy Cathal Crowe asked the Minister for Health if there will be a rare disease clinic at the new National Children’s Hospital. [2492/24]
View answer594. Deputy Cathal Crowe asked the Minister for Health if he will confirm the locations of the centres of excellence identified in the 2016 Rare Disease Plan; and if he will make a statement on the matter. [2494/24]
View answerI propose to take Questions Nos. 592 and 594 together.
European Reference Networks (ERNs) of Centres of Expertise (CoEs) are virtual networks involving healthcare providers across Europe established in line with Article 12 of EC Directive 2011/24/EU (Cross-Border Care Directive). They aim to facilitate discussion on complex or rare diseases and conditions that require highly specialised treatment, and concentrated knowledge and resources.
In line with the recommendations from the National Rare Disease Plan (2014-2018), Ireland is currently a member of 18 of the 24 ERNs. These ERNs include representation from five academic hospitals (Children's Health Ireland, Beaumont Hospital, St. Vincent's University Hospital, Mater Misericordiae University Hospital, Tallaght University Hospital) and three universities and is coordinated by the National Rare Diseases Office. This represents a significant achievement by the health service, to drive innovation, training, and clinical research for highly specialised care. Through the European Reference Networks, the National Rare Disease Office (NRDO) is leading out on the development of optimal care pathways across a range of rare diseases.
The first ERNs were launched in 2017, involving more than 900 highly specialised healthcare units from over 300 hospitals in 26 EU countries. Following a call of interest in 2016 Ireland joined 3 ERNs as full members in 2017. A second call was opened in 2018 and invitations for Irish Centres of Expertise to join were sent to all HSE Group CEOs and Clinical Leads. A further 15 Irish consortia composed of at least 40 centres of expertise, led from 5 major academic HSE teaching hospitals, received full ERN approval in December 2021.
With ERNs, patients with rare and complex conditions will be able to benefit from the best treatment and advice available in the EU for their specific condition. Their doctors will have access to a highly specialised pool of colleagues from all over Europe. ERN coordinators convene virtual advisory panels of medical specialists across different disciplines, using a dedicated IT platform, Client Patient Management System (CPMS) and telemedicine tools.
Below is a full list of the ERNs that Ireland currently has membership of:
|
ERN BOND |
European Reference Network on bone disorders |
|
ERN CRANIO |
European Reference Network on craniofacial anomalies and ear, nose and throat (ENT) disorders |
|
Endo-ERN |
European Reference Network on endocrine conditions |
|
ERKNet |
European Reference Network on kidney diseases |
|
ERN-RND |
European Reference Network on neurological diseases |
|
ERN LUNG |
European Reference Network on respiratory diseases |
|
ERN Skin |
European Reference Network on skin disorders |
|
ERN EURACAN |
European Reference Network on adult cancers (solid tumours) |
|
ERN EuroBloodNet |
European Reference Network on haematological diseases |
|
ERN EURO-NMD |
European Reference Network on neuromuscular diseases |
|
ERN EYE |
European Reference Network on eye diseases |
|
ERN GUARD-HEART |
European Reference Network on diseases of the heart |
|
ERN ITHACA |
European Reference Network on congenital malformations and rare intellectual disability |
|
MetabERN |
European Reference Network on hereditary metabolic disorders |
|
ERN PaedCan |
European Reference Network on paediatric cancer (haemato-oncology) |
|
ERN RITA |
European Reference Network on immunodeficiency, autoinflammatory and autoimmune diseases |
|
ERN TRANSPLANT-CHILD |
European Reference Network on Transplantation in Children |
|
VASCERN |
European Reference Network on Multisystemic Vascular Diseases |
Children’s Health Ireland is a member of 5 ERNs. It is expected that membership of these ERNs will continue under the National Children’s Hospital.
593. Deputy Cathal Crowe asked the Minister for Health if he will clarify why the Midwest is the only CHO without a Model 3 hospital. [2493/24]
View answerMy Department continues to work closely with the HSE and the University Limerick Hospitals Group (ULHG) in the provision of acute services in the Midwest region. This has included significant and sustained investment in University Hospital Limerick (UHL) and the Model 2 hospitals in this region. There are currently no plans to introduce a Model 3 hospital.
In 2013, the Smaller Hospitals Framework defined the role of smaller hospitals and outlined the need for both smaller and larger hospitals to operate within Hospital Groups. This Framework provided a stronger role for smaller hospitals, like Ennis, Nenagh and St John’s Hospitals, in delivering a higher volume of less complex care in many cases closer to patients’ homes. It also ensures that patients who require true emergency or complex planned care are managed safely in a larger hospital environment.
Within ULHG, there are two Model 2 Hospitals, Ennis and Nenagh Hospitals. St John's Hospital is classified as a Model 2S Hospital, i.e. St. John's can carry out intermediate surgery, which requires in-patient stay and accommodation in addition to day case surgery. These hospitals play a pivotal role in the delivery of high-quality patient care within the region, alongside Croom Orthopaedic Hospital, University Maternity Hospital Limerick and UHL.
There has been significant recent investment into the Model 2 Hospitals in the region to further extend and enhance acute services. This includes investment in the new €2m purpose-built Injury Unit at Ennis Hospital, which opened in 2022. Additional funding of €5.2m was provided in 2023 to extend the Medical Assessment Unit (MAU) opening hours across Nenagh, Ennis and St John's to 12 hours a day, seven days a week.
The Model 2 hospitals accept transfers of appropriate patients from UHL on a daily basis. These patients can either be stepped down from an inpatient ward in UHL or they may, where a clinician has decided it is appropriate, transfer to Ennis, Nenagh or St John's directly from the Emergency Department (ED) in UHL.
In January and February 2023 a 112/999 pathway was introduced for all three MAUs. This allows patients that meet agreed clinical criteria to be transferred by ambulance and treated in a Model 2 hospital. This pathway will result in patients receiving medical treatment in a hospital closer to their home, will reduce patient presentations to EDs, and will release ambulances more quickly to respond to other emergency calls. The MAUs in Ennis and Nenagh Hospitals treat patients referred by GPs, ShannonDoc, and now National Ambulance Service paramedics. 112/999 patients that do not meet these clinical criteria will continue to be transported to EDs for assessment and treatment.
To increase capacity within UHL, there has been significant capital investment, including two separate rapid-build projects, providing 38 additional inpatient beds, in response to the Covid-19 pandemic, and the opening of a new 60-bed modular ward block in 2021. Work commenced on new 96-bed ward block in September 2022. It is anticipated that this much-needed additional bed capacity for the Midwest will become operational in mid-2025. Enabling works have begun on a second 96-bed block.
In addition, planning for a Surgical Hub for Limerick will provide for two new operating theatres and two procedure rooms in a state-of-the-art development on the Scoil Carmel site. This development will improve access and reduce waiting lists within the region.
All of these targeted developments will improve the overall health system in the region.
