Dáil Éireann Debate, Thursday - 9 November 2023
18. Deputy Frankie Feighan asked the Minister for Health to outline the progress made to date in expanding community-based care by increasing opening times for unscheduled care, radiology, and diagnostic services. [48867/23]
Amharc ar fhreagraSince the July 2023 review of HSE Injury Units (July 2023), 12 units under acute governance operate on a 7 day per week basis, including Monaghan Hospital which expanded to a 7-day basis since July 2023. A new injury unit was opened in Mullingar in December 2022 and by this August there were approximately 600 presentations per month. Between January and August this year, over 110,000 patients have attended injury units, 15% above the numbers treated during the same period last year.There has been a doubling in the use of National Ambulance Service alternative pathways, with those pathways now accounting for over 5% of total emergency call compared to approximately 2% in September 2021. GP access to diagnostics has exceeded 285,000 tests by the end of October, 14% more than the number of tests conducted during all of 2022. Over the last ten weeks, 27% or over 14,000 more radiology diagnostic tests have been accessed by GPs compared to the same 10 weeks last year.GPs now have direct access to NTproBNP testing for their patients, which can indicate that the walls of the heart are stretched and that the heart is struggling to meet the body’s demands. From January to September this year, there were approximately 138,000 test reports, nearly 300% more than the same period in 2022.
Enhanced Community Care Programme (ECC)
· In line with Sláintecare, the Enhanced Community Care Programme (ECC) objective is delivering increased levels of health care in general practice, primary care, and community - based services.
· Significant progress is being made with 95 of the 96 Community Healthcare Networks (CHNs), 24 of the 30 Community Specialist Teams (CSTs) for Older People ICPOP and 24 of the 30 CSTs for Chronic Disease are now operational.
· Part of the ECC, a service which allows for direct referral pathways to diagnostic tests for GPs, has proven hugely successful with over 280,000 scans have already been provided this year.
· However, referral of GPs of patients who require immediate access to scans is not provided for through this initiative as it is intended for patients that can wait up to one month for an urgent scan and up to three months for a nonurgent or routine scan.
Supplementary Briefing Material
Enhanced Community Care Programme (ECC)
In line with Sláintecare, the Enhanced Community Care Programme (ECC) objective is delivering increased levels of health care with service delivery reoriented towards general practice, primary care, and community - based services, enabling a “home first” approach to the delivery of healthcare.
The focus is on implementing an end-to-end care pathway for people at home and over time, it is expected that it will prevent referrals and admissions to acute hospitals where it is safe and appropriate to do so and enable a “home first” approach.
Progress to date
Over 2,900 staff have been onboarded or are at an advanced stage of recruitment (78% of full recruitment target achieved).
· 95 of the 96 CHNs are now operational
· Community Specialist Teams (CSTs) for Older Persons – 24 of 30 are now established
· Community Specialist Teams for Chronic Disease Management – 24 of 30 are now established
· Community Intervention Teams –21 are operational, with national coverage secured.
GP Access to Diagnostics
· The nationwide GP Access to Diagnostics programme began accepting referrals in January 2021 and enables GPs to directly access diagnostic tests (X-Ray, CT, MRI, and DEXA scans) enables a greater level of care to be delivered in the community, supporting patient-centred care, early diagnosis, and early intervention. Limited access to diagnostics can result in patients being referred into hospital Emergency and Outpatient Departments for services.
· In the year to date 285,676 scans of various modalities have been completed as follows:
o 180,748 MRI scans (63%), 55,472 X-ray (20%), 22,255 CT scans (8%) and 27,201 DEXA scans (9%)
