Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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247. To ask the Minister for Health the comprehensive review that took place that led to the decision to cease provision of primary percutaneous coronary intervention in St. Vincent's University Hospital; the evidence upon which this decision and the placement of intervention centres was based; his plans for changes to intervention centres; and if he will make a statement on the matter. [16328/15]

Leo Varadkar (Dublin West, Fine Gael)
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As of 17 April 2015, there are two 24/7 primary percutaneous intervention (PPCI) centres for Dublin, located in the Mater and St James’s Hospitals. These centres accept all ambulance transfers of patients with ST Elevation Myocardial Infarction (STEMI). The provision of PPCI from three 24/7 centres in Dublin had proved unsustainable and the decision to consolidate the service into two centres was made following a comprehensive review and reflects the international trend towards the consolidation of such specialised services on smaller number of sites, to allow for the concentration of volume and expertise.

In November 2014, the Acute Hospitals Division of the HSE requested the National Clinical Programme for Acute Coronary Syndrome (ACS Programme) to review the current configuration of PPCI services in Dublin, having regard to the requirement to deliver safe, sustainable services on the designated sites. The model of care produced by the ACS Programme was informed by advice from the principals involved in centres in the UK and other European countries. The Programme was also informed by models of care from the US and Australia. Experience at national and international level highlights the importance of having sustainable rotas of clinical staff to support the 24/7 requirements of this service.

The review looked at the number of centres that should be delivering PPCI in Dublin, where these centres should be located and the feasibility of maintaining 9 to 5 PPCI services on any cardiology intervention site. Following consultation with the National Ambulance Service and with all relevant hospitals, the ACS Programme recommended that there should be two 24/7 PPCI centres for Dublin, located in the Mater and St. James’s Hospitals, which would accept all ambulance transfers of patients with STEMI.

The ACS Programme also recommended that there should be a clear definition of the role of the three other cardiology intervention centres in Dublin (Beaumont Hospital, Tallaght Hospital and St Vincent’s University Hospital) in the management of Non ST Elevation Myocardial Infarction (NSTEMI). NSTEMI forms an increasing proportion of interventional work which will continue and develop in those cardiology intervention centres which will not be designated 24/7 PPCI centres, including St Vincent’s Hospital.

The designation of PPCI centres outside Dublin is based on the recommendations of the ACS Programme report of 2012 as follows - Cork University hospital (24/7), University Hospital Waterford (9-5) and Galway University hospital (24/7).