Dr. Duncan Rogers:

I was the first consultant medical ophthalmologist appointed in Ireland. Integration was built into my role. I am based split-site between the community and hospitals. That is my background. One could look at me as an example of what we are trying to achieve more broadly. There was an upfront staffing cost in employing me. I was put into a situation where one of my primary tasks was to remove a consistent waiting list of about 3,000 patients in the children's health community service. I achieved that within six weeks of being in post. To this day - two years later - we still do not have a waiting list. That allowed us space to rejig our capacity in such a way that we now take patients and decompress Temple Street. We saw approximately 600 patients from Temple Street in the past six months. That was done using our existing facilities and staff, and changing how much they could do on their own and working more collaboratively with Temple Street. There was an initial upfront cost but costs are no longer increasing. We are still seeing appropriate capacity while decompressing a system. That has been done by using lean methodology and working in collaborative ways, not just with Temple Street but with the broader community. I hope to see that mirrored in the north-east region project.