Review of acute hospital services in the Mid - Health Service Executive

Review of acute hospital services in HSE Mid-West
An action plan for acute and community services
- ‘Hospital at Home’ 84 85 service to safely avoid admission to acute care or allow earlier
discharge from acute care.
Planned care
• Out-patient clinics, with all major specialties providing an outreach service from the
regional hospital 86 ;
• Physiotherapy, occupational therapy and podiatry services;
• Admissions avoidance services for chronic disease and long term conditions including
mental health liaison and outreach;
• Minor surgery under local anaesthetic. GP trained surgeons may undertake this range of
procedures;
• Day surgery/23 hour surgery led by visiting consultants from the regional hospital, for
conditions suitable for local or regional anaesthesia 87 . Provision of a day surgery theatre
needs to ensure that it can generate sufficient workload for appropriate and effective use.
In rural localities serving larger populations, there is potential to develop General
Practitioners with a specialist interest, particularly, for specialties such as ENT,
ophthalmology, dermatology and musculoskeletal medicine, who can accept referrals and
provide advice and support. The roles of nurses and allied health professionals can also
be extended to provide and support rural service provision 88 ; and
• Ambulatory services for a range of conditions, for example, chemotherapy and blood
transfusion.
Local non-acute bed base
• A local bed base, providing short term care for:
83
The Future Hospital, The Progressive Case for Change, Joe Farrington-Douglas and Richard Brooks, Institute of Public Policy
Research, January 2007.
84
Montalto M et al. Acceptability of early discharge, hospital at home schemes. Treatments that can be safely managed at home
need to be defined. BMJ 1998:317:111652.
85
Richards SH et al. Randomised controlled trial comparing effectiveness and acceptability of an early discharge hospital at
home scheme with acute hospital care. BMJ 1998:316:1796-1801.
86
The Future Hospital, The Progressive Case for Change, Joe Farrington-Douglas and Richard Brooks, Institute of Public Policy
Research, January 2007.
87 Suitable procedures include superficial hernia, selected laparoscopic cholecystectomy, cataracts, and simple foot operations.
88 The National Framework for Service Change in NHS Scotland, Rural Access Action Team, Final Report, 2005.
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