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

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Review of acute hospital services in HSE Mid-West An action plan for acute and community services Key role of primary, community and social care in delivering care at or close to home The development of primary and community teams need to deliver a range of services to support admissions avoidance and early supported discharge including assessment and rehabilitation. Discharge criteria for community services need to be robust to ensure that patients length of stay is dependent on interventional need All users of and referrers to community services should be signposted to the most appropriate service via one access point to maximise use of all services There is recognition of the need to develop fully integrated multi-professional teams to deliver care closer to home Teams should be supported with an appropriate infrastructure to support them in the delivery of care pathways closer to home including referral rights, access to diagnostics including radiology and pathology with timely turnaround of results, access to in-reach assessment facilities including OT and physiotherapy gyms in community settings as well as access to appropriate specialist opinion Community services are increasingly developed as nurse and therapy led models with access to medical opinion or review when necessary. It is essential that as care is delivered closer to home, the skills and competencies of community staff reflect the changing acuity and profile of patients. Community services should have an in-reach component to their structure, with communication and information sharing capability with acute hospitals to ensure patients can be transferred to an appropriate community setting as early as possible. 115
Centralising specialist acute services The patient at the new regional ‘centre of excellence’ Review of acute hospital services in HSE Mid-West An action plan for acute and community services There is a clear international trend towards the centralisation of specialist acute services to ensure there is a sufficient concentration of a ‘critical mass’ of patient volumes to optimise the provision of safe, effective and high quality services through a well resourced and highly trained workforce 92 . Typically, acute regional ‘centres of excellence’ will provide co-located 24/7 services for: • Major accidents and emergency; • Trauma; • Emergency medicine, including cardiology, gastroenterology, respiratory medicine, endocrinology, rheumatology; • Emergency surgery, including general, trauma, urological, vascular, ENT and ophthalmology; • Complex planned surgery, applicable to all acute surgical specialties; • Critical care; • Cancer services; • Obstetrics; • Acute psychiatry; • Paediatrics; and • Neonatology. These acute services will have a full range of 24/7 clinical support services, in particular, ‘high tech’ diagnostics and pathology services. 92 The Future Hospital, The Progressive Case for Change, Joe Farrington-Douglas and Richard Brooks, Institute of Public Policy Research, January 2007. 116
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Key messages Review of acute hospit
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educe the length of stay in hospita
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What is ‘International Best Pract
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Integrating PCCC services with the
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Key findings from the analysis are:
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Resource type Proportion Patients A
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The Mid-West needs 3 local ‘centr
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The regional elements of the networ
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Page 75 and 76: Developing the implementation plan
Page 81 and 82: Within three years Review of acute
Page 97 and 98: Appendix 3 - Documents provided Rev
Page 103 and 104: Current service delivery Regional s
Page 105 and 106: Consultant Medical Workforce Review
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