Billy Kelleher (Cork North Central, Fianna Fail)
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152. To ask the Minister for Health the consideration being given to the expansion of thrombectomy in the national service plan; the actions being taken to advance the recommendations of the HIQA health technology assessment of mechanical thrombectomy; and if he will make a statement on the matter. [51273/17]

Billy Kelleher (Cork North Central, Fianna Fail)
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154. To ask the Minister for Health the level of additional clinical staffing that is required to sustain the increasing level of service provided by the thrombectomy service annually; if this is being provided for in the HSE national services plan; and if he will make a statement on the matter. [51275/17]

Simon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 152 and 154 together.

The majority of strokes are caused when blood clots travel to a blood vessel in the brain and block the flow of blood to that area. Clot-dissolving treatment (thrombolysis) can contribute to improved outcomes for treated patients, with one-third experiencing important improvements in their ability to walk or self-care and other possible disabling conditions caused by the stroke with sometimes complete reversal of the effects of the stroke. More recently a new therapy, Thrombectomy, has been developed where people with the most severe strokes can have their strokes treated by skilled interventional neuroradiologists who remove the obstructing clots via their blood vessels. This has been shown to halve the mortality and disability from such strokes in some patients.

HIQA who completed a Health Technology Assessment (HTA) found that this intervention is value for money. Full report of the HIQA HTA can be found at: .

Provision of emergency endovascular thrombectomy remains highly specialised in Beaumont Hospital and Cork University Hospital and this model has been endorsed by the HSE, Acute Hospital Division with a view to a third centre when numbers increase as expected.

To date, the number of patients undergoing this procedure has risen annually, on average almost 50% increase each year: 2015 - 122 cases; 2016 -172 cases; 2017 (end of August) 154 cases. These patients have been referred from 20 different hospitals around the country.

Emergency thrombolysis is provided to patients in all parts of the country, via improved hospital and ambulance protocols, health professional training and the appointment of new stroke physicians. The national stroke thrombolysis rate has increased from 1% in 2006 to 12% in 2016.

The National Clinical Programme for Stroke (NCPS) has developed a number of initiatives including a telemedicine programme to allow delivery of expert thrombolysis therapy in smaller level three hospitals. It has been involved in the training of over 250 doctors nationally to deliver thrombolysis therapy and has participated in a training programme for Stroke in the Royal College of Physicians of Ireland.

The HSE is currently in the process of preparing its 2018 National Service Plan and discussions are continuing with my Department. The timeframes for submission of the HSE Service Plan for approval are set down in legislation and on receipt of the letter of determination, the HSE has 21 days to prepare and submit its Service Plan for 2018 for my approval. Following this, the National Service Plan will be laid before the Houses of the Oireachtas and then published at the earliest possible time.