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Stephen Donnelly: ‘Under the old way, Rita faced months of outpatient appointments’

A new community care programme officially opened in Bray in May. Here Health Minister Stephen Donnelly tells how it’s already making a difference to Rita Condren

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Minister Stephen Donnelly with Rita Condren.

Minister Stephen Donnelly with Rita Condren.

Stephen Donnelly, Minister for Health.

Stephen Donnelly, Minister for Health.

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Minister Stephen Donnelly with Rita Condren.

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Very few people I meet, even those who have deep political differences with me, fail to acknowledge that being Minister for Health is a difficult job. Famously Health is the portfolio nobody wants, once described as a veritable Angola with landmines threatening every footstep, while reform is slow and tortuous. I am often asked what I was thinking in taking it on.

People like Rita Condren are why I wanted the job and, despite all its frustrations, why I love doing it.

Rita is in her 80s, she lives in Bray in my own constituency and, as sometimes happens people of her age, she recently had a fall at home and broke her hip. She was treated in St Vincent’s Hospital but was faced with reduced mobility because of her fall and the subsequent surgery.

Under the old way of doing things Rita would have faced months of outpatient hospital appointments, having to make the journey in from Bray multiple times for physiotherapy and other supports at a time when her mobility was severely challenged.

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Because of our new Enhanced Community Care programme Rita didn’t have to make those journeys. St Vincent’s referred her to the local Integrated Care Programme for Older People (ICPOP), based in Bray, where she got intensive physiotherapy and occupational therapy over an eight-week period.

This improved her mobility and then she was provided with a Home Exercise Programme, falls prevention advice, a home environmental assessment and home adaptation advice.

Rita is progressing well and achieving her goals of improved mobility and balance, as well as reduced falls risk and fear of falling - reducing the likelihood of Rita needing hospital readmission.

I met Rita in Bray recently and she told me of the essential difference that this programme had made to her, and she and her daughter said how kind and consistent the team members were in the attention they gave to Rita, and how this went a huge way towards helping her regain her physical strength and her confidence.

ICPOP is just one part of the Enhanced Community Care programme.

The programme aims to fundamentally change the way we deliver healthcare - delivering more services close to where people live, particularly older people and those with chronic disease. While we want the programme to ease pressure on hospitals, and it is doing that, it also delivers better care for people like Rita.

Ministers are often accused of announcing far more than they deliver, and it is in the nature of reform that it is much easier to design a programme than deliver it. The most rewarding aspect of the ECC programme for me has been the fact that I have seen it in operation all over the country over the last six months.

The programme is designed around 96 Community Health Networks, each of which deliver health services to approximately 50,000 people. 81 of these networks are now up and running, as are 21 of the 30 specialist teams for older people and 11 of 30 specialist teams for chronic disease. As a result, people like Rita Condren are already receiving the benefit of what these services can deliver.

Also under ECC we have seen a huge expansion in the delivery of diagnostics in the community, with 138,000 scans completed in 2021.

This continues to accelerate, by the end of May over 94,000 had already been delivered this year. We have also now stood up all 21 Community Intervention Teams, providing national coverage for this service for the first time.

These teams provide acute services in the community through referrals by GPs, hospitals, and other community services.

Patients who need IV antibiotics, catheters, acute wound care, Ostomy care and a range of other acute services can now receive them in their own homes and uncomfortable and unnecessary hospital visits are avoided. While that benefits those patients by delivering services in their own homes, it also frees up hospital space for those who need to go there.

Despite all of the challenges faced by the health service in recruiting staff we now have 1,600 of a planned 3,500 ECC staff working in the service, with a further 540 at an advanced stage of recruitment. Traveling around the country I have seen the enormous commitment of the staff providing those services to the public.

They are truly changing people’s lives for the better.

The provision of these services close to people’s homes, allowing for the delivery of care truly integrated between the hospital system and the community was a fundamental part of the vision set out in the Slaintecare all party report in 2017.

From my perspective the ability to turn that vision in to a reality, to make reform actually happen and to deliver real benefits in the lives of people like Rita Condren is what continues to motivate me.


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