Joe McHugh (Donegal North East, Fine Gael) | Oireachtas source

I thank Senator Burke for raising this issue. An overarching principle of our health service is to provide patients with the most appropriate care and service in the most appropriate location provided by the appropriate health care professionals. Patients should not have to attend hospital unnecessarily, with all the added stresses and possible complications that such attendances involve.

It is preferable that patients receive treatment in the community where this has been clinically approved. As part of the phased implementation of the principles outlined in the primary care strategy, a number of national priorities have been set for the development of community-based services. One of these priorities is the development of community intervention teams. The main focus of teams is to reduce hospital attendances and admissions and to facilitate early discharge from hospitals.

A community intervention team is a nurse-led health professional team. The team provides a rapid and integrated response to a patient who becomes acutely ill and needs enhanced services, or acute intervention for a defined short period of time. This may be provided in the community or the home, as deemed appropriate. Community intervention team staff liaise with hospital and community clinicians. They provide services in the person's home and in public and private nursing homes. The community intervention teams provide a safe, cost-effective health service to patients in their homes that would ordinarily require hospital attendance and, in most cases, hospital admission.

In 2014, more than 14,600 patients were treated by community intervention teams. At any one time, to date in 2015, approximately 220 patients are being managed at their place of residence. The service the programme provides to its patients includes but is not restricted to the following: intravenous cannulation and administration of intravenous antibiotics at home; acute anticoagulation care; acute wound care and dressings, including negative pressure dressing; enhanced nurse monitoring following fractures, falls or surgery; care of patients with central venous catheters; urinary-related care; care of patients with a respiratory illness, including nebuliser care, peak flow measurement and intermittent pulse oximetry; bowel care, including ostomy care; short-term older person support and care; and other medication management and administration as part of the patient's acute intervention package.

The community intervention team programme has met with representatives of Nursing Homes Ireland and is working with them in developing direct referral pathways for nursing home residents. There are currently nine teams in operation, in Dublin north, Dublin south, Galway, the mid-west, which includes Limerick, Tipperary and Clare, Carlow and Kilkenny, Cork city, Wicklow, Kildare and Louth. The Wicklow service was established in 2014 and the services in Kildare and Louth both commenced in January 2015. There is clear and strong evidence from various studies and bed utilisation reports demonstrating that a cohort of all hospital admissions can be treated in a non-acute setting, many through services provided by community intervention teams. The strategic priority is to realise national coverage and to make a community intervention team service available to every person in the country if needed.