New Primary Care Centres “can alleviate trolley crisis”

ALONE/HSE North Dublin project provides template for elderly care

The provision of Community Support services for older people and the soon to be delivered Primary Care Centres in Waterford City, Dungarvan and Carrick-on-Suir can both play practical roles in easing the trolley crisis which continues to bedevil the region’s hospitals.
That’s the view of ALONE, the charity which supports older people throughout the country to maintain independent living and well-being from the comfort of their own homes.
Speaking to The Munster Express, ALONE’s Head of Development, Pat Doherty said the provision of additional community services via the Primary Care Centres, offered a potential means of easing trolley occupancy levels at UHW and South Tipperary General Hospital.

“Community-based healthcare centres, such as the ones you mentioned in Waterford and South Tipperary, if they’re resourced adequately and accessible to older people, then they will help people to access the supports they need outside of their nearest Emergency Department,” he said.
“Community-based medical interventions and providing medical supports at an earlier stage on a local basis as opposed to what might be available when attending an ED, thus avoiding a potential crisis situation, is the way to go as far as ALONE is concerned. This would be of particular significance for those older people who do not have immediate family supports that others have available to them, and it’s worth remembering that we have 170,000 people living alone in this country, a great many of whom are vulnerable to isolation and ill health.”

Pat Doherty, Head of Development with ALONE

Pat Doherty, Head of Development with ALONE

Pat Doherty stated: “We believe that resourcing home care packages and boosting community heath care services would also go a long way to easing the fears of such older people, be they in Waterford or any other part of the country.”
With 20,000 additional people turning 65 in this country annually, the need for a long-term means of providing health services to an ageing population outside of EDs is something the Government and HSE ought to be already planning for.
And given the “staggering” numbers on trolleys as noted by the Irish Nurses and Midwives Organisation (INMO) last week (reaching 677 on Wednesday last), Mr Doherty said that measures must be taken to ease the “huge stresses” on the country’s Emergency Departments.

“We’d like to see more investments in supports in the community which will enable the community voluntary sector, including ALONE, to support the HSE and the hospitals in keeping people at home longer, and receiving services locally, away from Emergency Departments. But that’s going to require investments for additional supports in the community.”
Mr Doherty added: “As we referenced in a statement last week, there are 20,000 more people reaching the age of 65 annually and at any given time, we know that over 70 per cent of people waiting to be discharged from hospital are over the age of 65. So what’s required now is a concerted effort on behalf of the HSE, the local authorities and the community and voluntary sectors to work together to provide supports that will avert people from having to go into hospital. And that will involve having to work with the Primary Care Centres and local GPs, local authorities to ensure that older people have the supports they need within their own community – that they get the flu jab when they need to, that their homes are adequately equipped to deal with their increasing needs as they age – and if we can work together on these issues, then we can reduce the incidences of older people having to resort to go into hospital, and by stepping in earlier and alleviating some of the matters which lead to older people having to attend Emergency Departments can only be to everyone’s benefit.”

A drawing of the Primary Care Centre which is being built on the grounds of St Otteran's Hospital.

A drawing of the Primary Care Centre which is being built on the grounds of St Otteran's Hospital.

Minister of State John Halligan (The Munster Express, June 7th 2016) said that the new Primary Care Centres “will allow local people to access, in their local community, a wide range of services including GP, community nursing, dental, occupational therapy, physiotherapy, social work, speech and language therapy, mental health, counselling, home help and nutrition. The Centres will be open at least five days a week, with extra hours at weekends and evenings for some services”.
Resourcing these new centres while implementing the ‘Innovative Support Co-ordination for Older Persons’ model which ALONE and the HSE has successfully run in North Dublin (city and county) on a nationwide basis, could greatly improve community health provision for the elderly. Pat Doherty agreed.
“That project has proven very successful in terms of addressing some of the key health needs of older people in their own community when it comes to providing the relevant supports that they require,” he added.

“And if this model was put in place (nationwide) on the basis of what we’ve seen in North Dublin to date, we would start to see more older people in our communities not having to resort to going into hospital. Of course we also know that going into hospital can be a frightening experience for a lot of older people so what we’ve been doing in North Dublin has been based on visiting people in their homes, to work with them and try and assess what their needs are to ensure that, through our support co-ordination and befriending services, that we get older persons to get the flu jab – and when’s the best time to get it – to make sure that their homes are suitable in terms of age-proofing and that they have the relevant technology and facilities in their own house that will support them best and independently. And this type of support just means that the complex (health) system which exists for older people in this country is more easily navigated with the support of a professional worker and also a visiting ‘befriender’ who visits the older person. We can then start to work with the older person to identify the additional supports they may need and encourage them or maybe go with them to visit their GP where they can talk about (the) potential health issues they may have.”

And given that the North Dublin project was recently presented with the overall HSE Excellence Award, this model would appear ready made and ideally suited for a national roll-out.
“ALONE hopes that we can use this pilot project on a nationwide basis eventually,” said Pat Doherty.
“We are looking to see how we can resource this going forward so that this valuable support is available in different parts of the country. We’re working with the HSE and other bodies to see how this could be replicated at a local level, no matter where you are in the country.”

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