The Irish College of GPs has welcomed the “highly positive” findings of a new report on the GP led chronic disease management (CDM) programme, issued by the HSE.

The report found that the programme was achieving a “high level of impact” on the health of the population and freeing up capacity in the health service – reaching over 400,000 patients, with 91 per cent of these now receiving routine chronic disease care within the community. 

The report stated that participants had 30 per cent fewer emergency department attendances, 26 per cent fewer hospital admissions, and 33 per cent fewer GP out-of-hours visits.

“This GP led programme has been transformative for eligible patients [those with medical cards or doctor visit cards] living with Type 2 Diabetes, COPD, Asthma and cardiovascular illness – and is a very positive step forward for the provision of care outside of hospitals,” said Irish College of GPs’ Medical Director, Dr Diarmuid Quinlan.

“The findings also demonstrate the power of general practice to deliver whole country large population health impacts when appropriately resourced.”

He added that the “success” of the CDM stems from a strong sign up by GPs with 97 per cent providing the service.

The CDM has been in operation for five years and this is the third report the HSE has published on its impact and reach within healthcare system.

The report Structured Chronic Disease Management Treatment Programme in General Practice showed a decrease in unscheduled admissions to hospitals among patients in the programme.

Dr Quinlan also highlighted the impact on prevention and early detection. “Since 2020, 51 per cent of new chronic disease diagnoses have been made through GPs in the programme. This prevents the need for more intensive hospital-based treatments – this is transforming people’s health journeys and promoting sustainable healthcare practices”.

The full report can be accessed here: https://www.hse.ie/eng/services/publications/primary/third-chronic-disease-report.pdf

Minister for Health Stephen Donnelly has announced that over 700,000 directly referred community radiology diagnostic scans have been completed since the launch of the GP access to community diagnostics (GPACD) scheme in 2021. 

Demand for community radiology diagnostics delivered through GPACD has more than doubled since the scheme launched. 

• 138,000 radiology scans were undertaken in 2021 (vs target of 94,000). 
• 250,000 radiology scans were undertaken in 2022 (vs target 195,000). 
• And over 331,000 scans (vs target of 240,000) were conducted in 2023. 

The budget for the GPACD scheme has increased from €25 million in 2021 to €46.8 million in 2023. This “substantial investment” is being maintained in Budget 2024, with a total allocation of €47.9 million secured for continued provision this year, according to the Department of Health. 

The Minister launched the scheme in January 2021 to enable easier GP and patient access to radiology scans. Under the scheme, GPs can refer patients directly for tests including x-ray, dual-energy x-ray absorptiometry, computed tomography, and magnetic resonance imaging (MRI) at no cost to the patient, with access to the scheme available to the total adult population. 

Dr Diarmuid Quinlan, Medical Director of the Irish College of General Practitioners, commented: “The GP access to community diagnostics scheme has had tangible benefits for patients’ diagnoses, shortened waiting times for hospital admissions, and helped reduce hospital admissions. 

“GPs have reported that patients are commonly seen for their scan within a few weeks. The scheme accelerates patient treatment by the GP, avoids some hospital referrals, helps compress our hospital waiting lists, and prioritises patient treatment by hospital doctors – a win-win scenario.” 

GPs are predominantly using the scheme for MRI scans, which account for almost two-thirds of the scans organised. MRIs of the spine, lower limbs, and brain are the three most commonly performed MRI scans. 

Due to timely access to scans through the scheme, the care of many of these patients is remaining with their GP. More than 50 per cent of patients who would have needed an outpatient appointment to organise a scan prior to the initiative did not require an outpatient referral once the scan was possible via this scheme, research has found. 

“Timelier access to diagnostic scans for certain conditions has enormous benefits for patients. While not workload-neutral for general practice, GPs report this scheme improves patient care in more than 90 per cent of cases and thus engagement with the scheme from general practice has been very strong,” according to the Department of Health.

Registration for GP visit cards for children aged six and seven begins today.

From today the under sixes GP visit card scheme has been expanded to become the under eights GP visit card scheme, providing free GP care for all children aged under eight in Ireland.

The move represents the “first stage in the biggest expansion in eligibility for free GP care in the history of the State” according to the Department of Health, and in the end will cover “up to 500,000 people”.

The Minister for Health Stephen Donnelly encouraged families to register for the scheme.

On the role of GPs, Minister Donnelly noted the agreement with the IMO signed last month “which supports GPs to recruit and retain more staff to better meet demand”.

He said that the Government is “investing in a significant increase in GP training places, with a recent announcement outlining how training places would increase by a third by 2024, and have partnered with the Irish College of General Practitioners on its very successful non-EU GP Training Scheme which is delivering immediate increased capacity”.

This expansion of free GP care to children aged six and seven is the first stage of the expansion in eligibility for GP care without charges under the GP Agreement 2023. It will be followed by the expansion of free GP care to people earning up to the median income in September and November this year.

GPs have expressed concerns about the capacity of general practice to meet additional demands associated with expanded eligibility.