Colm Burke (Fine Gael)
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I welcome the Minister of State, Deputy Joe McHugh. The matter before the House this morning relates to the need for community intervention teams in each area. The reason I raise the issue on the Commencement debate is the need for the health service to reduce the number of people admitted to hospital, particularly from nursing homes. I understand Nursing Homes Ireland has had detailed discussions with the HSE on this matter. I also understand there has been a slowdown in the process of introducing community intervention teams. The idea is that more services would be delivered within nursing homes or to people living in their own homes rather than in hospitals.

A simple example of where we are falling down relates to the provision of dietitians. If someone in a nursing home needs to see a dietitian, he or she has to go into hospital, as HSE dietitians are not available to go to nursing homes. More intervention at local community level would mean that fewer people would have to go into hospital or attend outpatient clinics. That approach is especially important in cases in which a number of people are gathered, as in nursing homes, and that is the context in which I raise this matter.

Joe McHugh (Donegal North East, Fine Gael)
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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.

Denis O'Donovan (Fianna Fail)
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An bhfuil an Seanadóir sásta leis an bhfreagra sin?

Colm Burke (Fine Gael)
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I thank the Minister of State for his detailed reply, which I welcome. Approximately 14,000 patients were treated by community intervention teams in 2014. That is a very small number in comparison to the number that could be treated. I know the area does not come within the responsibility of the Minister of State, but could he convey to the relevant Minister the need to expedite the implementation of the process? Given that attendance in accident and emergency departments in hospitals every year is more than 1.1 million, which is approximately 22,000 per week, and a high percentage of those who attend are elderly people who are referred from their own homes or from nursing homes, community intervention teams are essential.

Denis O'Donovan (Fianna Fail)
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I am sure the Minister of State, Deputy McHugh, will convey the message to the Minister for Health, Deputy Varadkar.