Jackie Cahill (Tipperary, Fianna Fail)
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1538. To ask the Minister for Health to improve and extend cardiac psychological services across the country, given the very limited services currently available to heart failure patients following diagnosis; and if he will make a statement on the matter. [37351/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Changing Cardiovascular Health 2010 -2019 highlighted the importance of cardiac rehabilitation which includes a psychological component. There are at least 35 centres providing cardiac rehabilitation services nationally. Cardiac rehabilitation is an internationally recognised standard of care for patients recovering from a cardiac event and is proven an essential component of secondary prevention for patients with cardiovascular disease. Cardiac psychological services are an important element of multifaceted cardiac rehabilitation programmes. Recent Irish Heart Attack Audit data suggest that 71% of those who suffered a cardiac event are referred to cardiac rehabilitation programmes.

Given that there are clear, evidence-based guidelines in cardiac rehabilitation and the benefits of psychological intervention, it is recognised that this is an important component to maximise people’s quality of life in living with heart failure.

To understand the challenges, requirements and generate an evidence base for next steps in cardiac care, a National Review of our adult Specialist Cardiac Services which includes cardiac rehabilitation and heart failure was commissioned. The Reviews recommendations will inform the future provision of cardiac services nationally. The Report is now finalised and is being prepared currently for my consideration.

Jackie Cahill (Tipperary, Fianna Fail)
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1539. To ask the Minister for Health to expand the cardiac referral service to ensure all heart failure patients are referred for rehab following diagnosis; and if he will make a statement on the matter. [37352/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Changing Cardiovascular Health 2010 -2019 highlighted the importance of Cardiac rehabilitation. Cardiac rehabilitation is an internationally recognised standard of care for cardiac patients and is considered an essential component of secondary prevention for patients with cardiovascular disease.

Cardiac rehabilitation is specifically developed for patients with established cardiovascular disease and positive outcomes for patients are linked to high-quality cardiac rehabilitation. Cardiac rehabilitation is delivered through four phases, from the initial cardiac event in a hospital to phase four in the community. The number of patients (5,063) accessing the service in 2019 increased by 25% from 2010. There are also increasing referrals of more complex, older and frail patients with multiple comorbidities to cardiac rehabilitation programmes.

Recent Irish Heart Attack Audit data suggest a 71% referral rate to cardiac rehabilitation programmes. There are at least 35 centres providing cardiac rehabilitation services nationally.

The National Review of Specialist Cardiac Services commenced in January 2018 with the aim to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of services. This review will also recommend the optimal configuration of a national adult cardiac service in the context of the Sláintecare reform programme. In terms of scope, the National Review covers scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults which includes cardiac rehabilitation and heart failure services.

The Report is now finalised and is being prepared currently for my consideration. The Reviews recommendations will inform the future provision of cardiac services nationally.

Jackie Cahill (Tipperary, Fianna Fail)
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1540. To ask the Minister for Health what action is being taken to improve and expand community support services for heart failure patients to address physical and mental health, social and financial challenges that may arise for patients following diagnosis; and if he will make a statement on the matter. [37353/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Heart Failure is an important public health issue that affects approximately 90,000 of population, it is a complex condition with increasing numbers. Across Europe, and in Ireland heart failure remains a significant demand on health services and in particular hospital-based care. While not all hospital admissions can be avoided there is growing evidence of how to improve hospital avoidance.

There has been progress across Ireland in heart failure care and the detection and prevention of this syndrome is a priority. The National Clinical Programme for heart failure is developed to improve quality of life for people living with the syndrome.

Ireland’s wider community of clinical practice in heart failure has provided leading research and innovation that continues to inform this care around the world. The STOP-HF project for example is a dedicated heart failure prevention strategy. This first-of-type concept has been proven to be successful and has resulted in changes in international guidelines. Ireland is among the world leaders in developing strategies to prevent heart failure.

Ireland is promoting pioneering innovations like the HeartCare at Home, a primary care project, which is open to all people with heart failure in Ireland. To get heart failure specialist care to a wider cohort of patients ‘Virtual Consultation’ allows on-line, real-time discussion of heart failure case questions with a family doctor. This consultation results in very effective remote management, avoiding unnecessary referrals and travel for the patient and facilitates the sharing of specialist expertise.

There has been significant investment in Integrated Care Programmes for Chronic Disease which includes heart failure. This investment has enabled the development of structures of care which will significantly improve all aspects of heart failure care including speed of diagnosis, access to cardiac diagnostics and therapies.

Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. To ensure the medical card system is responsive and sensitive to people's needs, the Department of Health keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.

There are clear, evidence-based guidelines and excellent exemplars of effective heart failure models of care however, recognising the importance of preventing unnecessary hospitalisations and deaths and maximising people’s quality of life is the priority. Progress has been made and to inform the next steps for this important work and to understand the challenges more, a National Review of our adult Specialist Cardiac Services which includes heart failure was commissioned. The Report is now finalised and is being prepared currently for my consideration. The Reviews recommendations will inform the future provision of cardiac services nationally.