Dr. Diarmuid O'Shea:

This is the value of clear leadership and clear models of care from the clinical programmes. We are saying there should be local governance groups in place that are cross-community and hospital and that they can influence and drive change and they should comprise health care professionals, patient representatives and primary care. The answer to the Chairman's question is that is the value of evolving integrated care sites and frailty education programme sites because they have governance groups that are mandated in the programme. When we went to some of the hospitals and community health care organisations about these programmes, they already had version of those groups in place. Where they are not in place, they effectively should be making themselves integration-ready by having these governance groups in place. I would go back to something a Senator of yore said, when Senator William Butler Yeats wrote in a poem:

We thread the needles' eyes, and all we do. All must together do.

If we are not all on the same page clinically, it serves the purpose to have us fighting internally, if we break down these silos. I am a firm believer that education is a real tool to break down barriers and it is important to have that in place.

We see that continually in the context of the growing number of integrated care sites and frailty education programme sites. In this way, we harness the enthusiasm of the health care professionals who are working there.