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
• Acute care is delivered in a single, regional ‘centre of excellence’, responsible for
managing the more complex conditions, the ones that need particular clinical expertise,
continuous medical supervision and the support of critical care, so that patients have the
best clinical outcomes from having access to safe, high quality 24/7 acute care.
The patient at home
The vast majority of patients will be managed away from the traditional acute hospital setting,
that is:
• The patient is at the centre of the model, with services being focused on helping patients
to ‘self care’ and on delivering much more management ‘at home or as close to home as
possible’; and
• The patient is supported by an integrated pre-hospital primary and community service
(Primary Care Teams, general practice, ambulance service, etc) operating a
comprehensive family of programmes for emergency response / care, admissions
avoidance, chronic disease management, health promotion, elderly care, mental health,
rehabilitation, etc.
The new emergency capabilities of the ambulance service
From the patient’s point of view, the ambulance strategy is focused on ensuring that anyone
presenting as a critical emergency has prompt ‘life saving’ treatment, delivered by an
Advanced Paramedic (AP), a new member of the front-line workforce in the ambulance
service. The patient benefits from the AP:
• Being specifically trained to carry out urgent clinical assessment and start emergency
resuscitation in the patient’s home, or at the roadside;
• Having direct tele-medical links with the appropriate specialty duty team at the regional
‘centre of excellence’, to get expert advice and to alert the service to receive the patient;
and
• Having direct access to an air ambulance transfer to the regional ‘centre of excellence’, if
the emergency occurs in a more remote or rural setting, or the patient is in a critical
condition.
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