Regional ‘variation’ in ECC programme roll-out raised by DPER

Regional “variation” in the implementation of the HSE’s enhanced community care (ECC) programme has been raised by the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation (DPER).

DPER officials questioned the drivers of this regional variation during a special meeting of the health budget oversight group that focused on primary care services. The meeting took place in April.

In response to DPER’s queries, HSE officials told the meeting that the integrated care programme for older persons and the community healthcare networks were “not fully rolled out” in all six regions. Where rolled out, “they are not always implemented in the same way,” the HSE added.

“Clinical leadership and clinical buy-in is necessary in each area,” stated the minutes.

“The HSE suggested that positive experiences in one region could be used to encourage another region to implement the changes. The HSE is working with REOs [regional executive officers] and their teams on this.”

The HSE has previously said it is making “significant progress” in improving healthcare for older adults and people with chronic diseases through the ECC programme, which it regards as “a key pillar” of Sláintecare.

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In 2024, over 7,000 adults with frailty were supported by community specialist teams for older people and avoided unnecessary hospital admissions, according to HSE data. There was also a 15 per cent reduction in hospital admissions for patients with chronic diseases between 2019 and 2023.

This year, the ECC programme moved “beyond establishment and mobilisation into a more mature phase of measurable impact, system learning, and regional delivery”, a HSE spokesperson told the Medical Independent.

The spokesperson said that the ECC programme is demonstrating how integrated, community-based care can improve access, support earlier intervention, reduce reliance on acute services, and strengthen the delivery of care closer to home.

They added that ECC teams are operational nationwide and the programme is delivering HSE National Service Plan 2026 commitments to increase access to primary and community services.

According to the HSE website, “the programme is bringing services closer to home, reducing hospital admissions, and enhancing patient care.”

“This is further supported by digital and innovative initiatives, including telehealth, and the virtual care in the community initiative.”