Dáil Éireann Debate, Thursday - 30 November 2017
143. Deputy Billy Kelleher asked the Minister for Health the details of the working group set up by the national stroke programme to develop guidelines on the affect a stroke has on a person's mood; the timeframe for the completion of the guidelines; and if he will make a statement on the matter. [51264/17]
Amharc ar fhreagra144. Deputy Billy Kelleher asked the Minister for Health the support that will be put in place to ensure that the availability of counselling and psychology services to support the consequences of stroke are enhanced in locations once guidelines are developed and published; if this will be provided for in the HSE's service plan; and if he will make a statement on the matter. [51265/17]
Amharc ar fhreagra148. Deputy Billy Kelleher asked the Minister for Health his plans to increase the number of stroke units; if so, the number and locations; if funding is being made available in the HSE's service plan for same; and if he will make a statement on the matter. [51269/17]
Amharc ar fhreagra149. Deputy Billy Kelleher asked the Minister for Health his plans to increase the number of stroke beds; the number and location; if funding is being made available in the HSE's service plan for same; and if he will make a statement on the matter. [51270/17]
Amharc ar fhreagra151. Deputy Billy Kelleher asked the Minister for Health if the recommendation by the national stroke programme, as part of the phased introduction of early supported discharge for a further nine teams to be established over a three-year period, will be part of the 2018 national service plan; and if he will make a statement on the matter. [51272/17]
Amharc ar fhreagraI propose to take Questions Nos. 143, 144, 148, 149 and 151 together.
In 2016 the National Stroke Programme published an Irish Heart Foundation/HSE National Stroke Audit of Stroke Rehabilitation Units, available at
http://www.hse.ie/eng/services/publications/Clinical-Strategy-and-Programmes/National-Stroke-Audit-Rehabilitation-Units-2016.pdf.
It found that standardised assessment of patients for cognitive difficulties is performed on all patients in 89% (23/26) of sites, with mood being assessed using a standardised tool in 27% (7/26) of services, counselling services are also accessible in 27% of sites and psychology services were available in 31% of sites.
In recognition of the requirement to enhance the availability of counselling services to support the consequences of stroke (e. g. depression, anxiety), this has led The National Stroke Programme to establish a working group to develop guidelines in relation to mood in stroke. This group includes representation from acute, rehabilitation and community services .
The first national stroke care audit report in 2006 reported one stroke unit in the country. In 2016, 65.6% of Stroke patients were admitted to a Stroke Unit. Access to stroke unit care has been shown to improve stroke patient outcomes through reduced mortality rates, reduced dependency and shorter lengths of stay in hospital by patients. Since the commencement of the National Clinical Programme for Stroke (NCPS), nine new stroke units have been opened, bringing the total number of stroke units in acute hospitals to twenty-two. Two further stroke units are currently in development with a third at planning stages. It was recommended in the National Stroke Programme Model of Care 2012 that all hospitals admitting stroke patients should have a Stroke Unit large enough to accommodate all stroke patients.
In relation to early supported discharge it has been recognised internationally that Early Supported Discharge of stroke patients from hospital, improves outcomes, reduces need for long term care and increases acute hospital capacity by freeing up beds. It is estimated that 10-25% of patients could benefit from an ESD service.
The NCPS has helped to establish 3 small but effective ESD teams in Dublin and Galway. In 2016, 137 patients were discharged to ESD services representing 15.6% of total stroke discharges. It is estimated that there was an average reduction in length of stay of 10.4 days per ESD patient.
Funding for increasing capacity in the three operational sites was secured for 2017 with further funding secured to support the establishment of two further teams in University Hospital Limerick and Cork University Hospital. Recruitment of these ESD staff is on-going.
The HSE is currently in the process of preparing its 2018 National Service Plan and discussions are continuing with my Department. The timeframes for submission of the HSE Service Plan for approval are set down in legislation and on receipt of the letter of determination, the HSE has 21 days to prepare and submit its Service Plan for 2018 for my approval. Following this, the National Service Plan will be laid before the Houses of the Oireachtas and then published at the earliest possible time.
