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New modernised care pathways a ‘significant step’ for cardiology care

By Denise Doherty - 01st Mar 2024


Reference: March 2024 | Issue 3 | Vol 10 | Page 38


Cardiology care pathways represent a shift towards providing more healthcare services outside of traditional hospital settings and closer to patients’ homes, and are being rolled out across the country. They aim to deliver more comprehensive and patient-centred care within the community, with a focus on prevention of chronic disease and its complications, early and specialist intervention, and empowering patients to live well with chronic disease in their communities.

Dr Sarah M O’Brien, HSE National Clinical Advisor for Chronic Disease, said the roll-out of these modernised care pathways (MCPs) signifies “a significant step in improving care for patients with chronic conditions like heart failure”.

The roll-out of the pathways for cardiology are four of the 36 MCPs being introduced and are a key component of the newly established integrated care hubs being set up nationwide as part of the Enhanced Community Care (ECC) programme.

In the west of Ireland, the pathways for cardiology have been up and running since March 2023 under the joint governance of the Saolta University Health Care Group and Community Healthcare West. By September 2023, the pathway saw more than 300 patients removed from the Galway University Hospital (GUH) waiting list through a chest pain initiative and the redirection of GUH heart failure waiting list with appointments given for the hub instead of hospital.

Dr Susan Connolly, Cardiologist with GUH who also leads the cardiology service in the Galway City Integrated Care Hub, said: “The ECC programme has been absolutely transformational for the care of patients with chronic cardiovascular disease. We have seen almost 300 new patients in the hub and had 1,300 clinical contacts since we started.”

The implementation of MCPs is a multi-annual change initiative that seeks to reduce waiting lists, as well as enhance patient care by the transitioning of a number of scheduled-care services from hospitals to community settings.

These new care pathways will achieve this by embracing advances in e-health technologies and empowering multidisciplinary teams of consultants, GPs, nurses, and health and social care professionals to work at the highest level of their respective training in delivering advanced clinical care.

Dr Connolly added: “One of the main benefits we hear from patients is that they now feel they have a safety net. With the Chronic Disease Management service, we meet these patients in hospital and establish the link with the community service.

“Two-in-five patients in Ireland present with more than one chronic condition, which traditionally saw each patient attending a wide range of different hospital services. This care is now streamlined in the hub for patients with multiple conditions. We hold regular multidisciplinary meetings with colleagues across diabetes and nephrology. By all working together we make this journey much more manageable for our patients by ensuring they are only receiving appointments that are necessary.

“It’s not just about providing heart failure care; it’s about providing a holistic service that addresses all their needs in terms of being a cardiovascular patient… but empowering them so that they can live with that disease.”

Dr John Lally, a GP in Galway city, described the ECC programme as a ‘game-changer’ for care, as GPs “are now able to send our patients to community-based services for both their diagnostics and their clinical opinion”.

“Each integrated care hub will have a dedicated team of healthcare professionals, including cardiologists, nurses, physiotherapists, physiologists, and psychologists. Our goal is to provide more flexible and comprehensive care to individuals living with complex chronic disease and multi-morbidity in the community.

“This initiative aims to enhance the patient journey, offering specialist and multidisciplinary consultations in community settings and even virtual consultations, ultimately improving specialist cardiac care accessibility.”

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