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District hospitals could significantly reduce delayed discharges and provide more convenient, local care for elderly and disabled patients, he said.
Dr Swanwick highlighted the “twin benefit” in fully utilising the services of a district hospital to prevent admission to, and facilitate timely discharge from an acute hospital.
“Early admission to a district hospital can really help relatively minor medical situations from escalating into something more serious. For example – provide a medication review; or treatment of a chest infection, a chest x-ray or to allow patients access to other health professionals like chiropody/ physiotherapy – this type of early intervention and treatment can greatly assist in offsetting later admission into an acute hospital where the patient’s condition is invariably more serious,” Dr Swanwick said.
The NAGP believes that this proposal is in line with the HSE’s vision of providing care at the lowest level of complexity and in a setting as convenient as possible to the patient.
“The country’s district hospital network is an example of a resource that is still very much in existence, which has an important role to play but which is seriously underutilised. There is one in almost every county – there are four in Mayo – so it is a nationwide resource, still functioning, albeit at varying levels. Because the network is there already – we are not proposing a new layer of bureaucracy. We simply need to make better use of the existing facilities.
“Add some modest investment into updating the facilities and you create an altogether new dynamic at a district hospital level around the country, that can allow this network assume new relevance in keeping the pressure off acute hospitals,” Dr Swanwick said.
Dr Swanwick outlined his proposal on revamping the country’s district hospitals during his presentation today at the 6th Annual Seminar of the Irish Association of Former Parliamentarians, in Leinster House. The theme of the Seminar was “Ageing Well – Ageing Positively” and Dr Swanwick highlighted the essential role of primary care in managing chronic diseases.
During his presentation Dr Swanwick stressed that the problems in secondary care will never be rectified until primary care, specifically general practice, is adequately resourced.
The NAGP has previously highlighted international evidence that the main reason for attending EDs is to access services that are not available through primary care. Only half of all ED attendees require specialist consultation. Resourcing general practice to provide such services would have a substantial effect on continuing ED overcrowding.
Dr Swanwick said he is available to discuss his proposals with the HSE, Department of Health and the Emergency Department Taskforce.
The services a district hospital can provide include:
1. Step down from secondary care, for example: post-operative recovery and rehabilitation;
2. An interface with the Fair Deal system to alleviate the 16 week delays currently being experienced
3. As an intermediate care setting to facilitate older people prior to integrating back into own their homes.
4. Early intervention to prevent the health issues of vulnerable patients deteriorating and leading to avoidable trips to the ED.