I propose to take Questions Nos. 212 to 214, inclusive, together.
Many EU countries are moving towards a system where chronic diseases are managed within a primary care setting and are at different stages of development. Scandinavian countries, Germany and the UK Health Systems, in particular, have led the way in terms of chronic diseases being delivered in primary care settings. Here in Ireland, the HSE is developing chronic disease programmes to improve patient access and to manage patient care in an integrated manner across service settings. The programmes will be multidisciplinary in nature and will involve GPs, nursing staff, allied health professionals and other members of the primary care team, who will deliver appropriate care in the primary care setting. The programmes aim to deliver better health outcomes, enhanced clinical decision making and more effective use of resources.
Work is ongoing on the development of the following programmes which are particularly relevant to primary care: Diabetes; Stroke; Heart Failure; Asthma; and COPD. The Diabetes programme is due to commence in Quarter 4 of 2012. The model of care for the Integrated Care Diabetes Package prescribes that:
1. Uncomplicated Type 2 Diabetes patients will be managed in Primary Care only.
2. Patients with complicated Type 2 Diabetes, as defined by the National Model of Diabetes Care, will be managed by both primary and secondary care.
3. All patients with Type 1 Diabetes, genetic causes of Diabetes (MODY Diabetes), secondary causes of Diabetes, post-transplant Diabetes and pregnancy and Diabetes, will be managed in secondary care only.
The integrated model of care for diabetes is to be rolled out on a phased basis as resources permit. Work is also continuing on progressing initiatives introduced in 2011, including the national multidisciplinary foot care programme and the national retinopathy screening programme.
A National Steering Committee has been set up to oversee implementation of the Diabetes programme and the key work streams are:
Alignment of 10 pilot diabetes initiatives with nationally agreed model of care;
Selection of Phase 1 sites;
Recruitment of Integrated Care Diabetes Nurse Specialists;
Progression of ICT Development;
Discussions with Irish Medical Organisation (IMO) and other relevant parties;
Identification of Drug Savings.
The roll-out of the national Diabetes programme is to be phased over 4 years (2012-2015) as follows—
In 2012, it is aimed to cover up to 1 million of the population;
2013 targeted to cover additional population of 1.7 million;
2014 targeted to cover further additional population of 1.7 million;
2015 targeted to cover final population of 0.45 million.
€2 million is required for the Diabetes programme in 2012 and this has been identified from within existing HSE resources. Funding for implementation in 2013 to 2015 is dependent on the identification of savings within the health system which will be re-invested in diabetes care.