Reactive health services ‘not fit-for-purpose’

The 75th Irish Cardiac Society Annual Scientific Meeting heard a presentation from Prof Ken McDonald titled: ‘The initial experience with the HSE Integrated Care Programme for CV Disease’.

“We have talked about borders, but there is another border between primary and secondary care,” noted Prof McDonald.

He presented figures from The Irish Longitudinal Study on Ageing on the challenges posed by chronic disease. In Ireland and internationally, many health systems were not fit-for-purpose as they were “predominantly reactive, sickness-managing, acute-based hospital [systems]”.

He said health services had to be rebalanced to place more focus on chronic illness, while still ensuring development of acute services.

Prof McDonald added: “The HSE is often the butt of criticism but it’s important to note that the HSE is taking an international lead in this and has received an award from the UN for evolving structures for the care of patients with chronic disease.

“There are two particular aspects they are going to focus on over the next short while. One of these is the specific GP-led chronic disease prevention and management programme, and the second is the integrated system between the cardiology specialists services… and our GP colleagues.”

Data presented by Prof McDonald showed 95 per cent of GPs were involved in the General Practice Chronic Disease Management Programme. To date the programme had access to 80 per cent of eligible patients and almost 90 per cent of eligible patients aged over 65. Almost 500,000 people were enrolled in the treatment programme, and more than 200,000 people had been seen in these protected GP slots.

In terms of cardiovascular risk, over a period of three visits, 45 per cent fewer of these patients had hypertension; 45 per cent fewer patients had uncontrolled diabetes; and there was a one-third reduction in people remaining outside of the recommended low-density lipoprotein range.

“This represents hard work by our GP colleagues,” stated Prof McDonald.