Mr. Robert Morton:

We are working on about five different initiatives. In total, the number of patients who have, thankfully, benefited from all of these schemes is approximately 10,000 to date this year. What this basically means is that the majority of those patients are captured at what we are calling the clinical hub. Effectively, it is where we review and triage a call and determine that there may be a better alternative for that patient. They will speak to a nurse or doctor. As a result, we have nurses and doctors working in our national emergency operations centre. What they are able to do is either discuss the patient's care, come up with alternative solutions or make an alternative referral. That is working very well. We have other initiatives, one of which is the community paramedicine project, which, again, is proving to be very effective. In the region of 50% of the patients that are being seen are staying at home or being referred to their GP. Those community paramedics have specialist training and undertake a master's degree programme. It is a joint programme. I might ask Dr. O'Donnell to touch on it because he was one of the leaders in putting the programme together. This model is operating in Donegal, Cavan, Monaghan, Tallaght in Dublin, Limerick and Cork. To put that model into every community health network in the country as it rolls out is part of the enhanced community care programme.

We also have the Pathfinder model, which is in operation in north county Dublin. As part of the HSE's winter preparedness plan, we are in dialogue about the funding to roll that out to nine further centres - six model 4 sites and three model 3 sites - in Kilkenny, Letterkeny and Tralee. Overall, we are going in the right direction. The main thing has been to prove the models worthy and safe. Now that we are satisfied that the evidence is there, we are moving an issue of scaleability. I might ask Dr. O'Donnell to touch on the clinical aspect.