Community care programme leading to ‘very significant’ improvements in waiting lists

HSE sees 16% reduction in hospital admissions for those with chronic diseases in the five years to 2023

The HSE’s Enhanced Community Care Programme has resulted in “very significant” improvements in waiting lists, with a 16 per cent reduction in hospital admissions for those with chronic diseases in the five years to 2023, and 39,772 hospital bed days avoided last year.

Dr Orlaith O’Reilly, clinical lead for the HSE’s Chronic Disease Management Programme, told RTÉ radio’s Morning Ireland that the system was designed to provide care closer to home, to avoid hospital admissions and to support early discharge as well as address waiting lists.

Under the new programme, integrated care consultants, who split their working hours between the community and in hospitals, have been treating patients with chronic conditions such as heart failure, COPD, high blood pressure and diabetes “closer to home”, she said.

“The programme is designed ... to avoid hospital admissions and to support early discharge, as well as address waiting lists. So it’s comprised of a number of elements, both strengthening community networks, providing older people community teams and also providing these care hubs for people with chronic disease, which have specialist teams like specialist nurses, specialist physios in them and these new integrated care consultants,” Dr O’Reilly said.

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New figures published on Tuesday about the programme show significant progress for patients, particularly older people and those living with chronic disease. Improvements, achieved through delivering care closer to the home, include a 65 per cent reduction in the number of people waiting more than 12 months for care.

Community specialist teams have contributed to a reduction by 16 per cent in chronic disease hospital admissions between 2019-2023, compared to a 3.5 per cent decline in overall medical admissions during the same period.

Readmission rates decreased by more than 23 per cent for people with chronic disease, compared with the 5 per cent reduction for all medical patients between 2019-2023.

There were nearly 100,000 patient contacts by the community specialist teams for older people. Of the patients seen, 74 per cent were discharged home with community-based interventions, avoiding acute hospital admissions. As few as 3 per cent of patients were admitted to long-term care, with 6 per cent requiring acute care.

There were 95,962 referrals to community intervention teams, resulting in 39,772 bed days saved through timely interventions and treatments administered at home in 2023.

Under the new programme, there was a record number of radiology scans, with 335,000 carried out in 2023, up more than 85,000 on 2022, through the GP Access to Community Diagnostics scheme, reducing referrals to emergency departments, Acute Medical Units and outpatient departments.

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