Ms Colette Cowan:

It is working very well and is of extreme importance. We have one CHO, as the Chairman noted, which is run by Bernard Gloster, the chief officer in the region. We have an identical footprint and work together day in and day out on patient flow in the region. Anything we develop in UL Hospitals Group is in collaboration with the CHO. We have teams of people from the CHO working on the campus of University Hospital Limerick to assist us and families with discharges. That is an example of how it works. In our view, a lot of funding comes in for transitional care and home care packages to help patients come out of hospital but we do not have delayed discharges in the UL Hospitals Group. The numbers are quite small.

I would like to see funding put into the CHO to develop services for hospital in the home and preventative medicine to keep patients out of hospital because we seem to be the first port of call when we should be the last through the emergency department. There are opportunities there for nursing, including advanced nurse practitioners, in the development of that role in the community. The only way to do that is to co-appoint. Nurses are mainly interested in working in hospitals when they come out of college. If there was creative contract with them so they could work or be required to work in the community on a sessional basis, there would probably be more nurses applying for those jobs. There are real opportunities there which we can stream and work towards. In my view, it works well to have one chief officer to talk to every day rather than several. While several different people will all be very expert in their area, having to deal with them takes a lot of time out of a CEO's day just to keep the show on the road. It is a model people could look at and develop further. It is key to the change for the next ten years.