Health plan to reorganise hospital services for heart and stroke patients

A GOVERNMENT initiative to improve heart health in Ireland will reorganise hospital services dealing with cardiac and stroke patients.

The implementation of the new policy will be financed from within existing budgets and will not close any hospitals, the HSE has said.

Cardiovascular disease is the single largest cause of death in Ireland, accounting for one in five premature deaths in the country.

Though death rates have decreased over the past 30 years, Ireland still ranks below the EU15 average for life expectancy. The reduction in deaths could be reversed by levels of smoking, obesity and physical inactivity.

Changing Cardiovascular Health: National Cardiovascular Health Policy 2010-2019 was published yesterday by Minister for Health Mary Harney.

It was developed by the cardiovascular health policy group set up by the Minister in 2007 and was chaired by Prof Hannah McGee, professor of health psychology the Royal College of Surgeons of Ireland.

The plan has 69 recommendations and is to be implemented over 10 years. Recommendations include improvements in health promotion and prevention of heart disease, changes in primary care services and in acute hospital services. The plan has not yet been costed and Ms Harney has said it will be resourced within the existing HSE budget.

“The new cardiovascular health policy is basically about getting the best care to the patient at the right time in the right place, delivered by the right experts at all stages,” she said.

“It is about implementing a higher level of care on a national, standardised basis, and to make this accessible in each region.”

Hospital services will be reorganised into networks along the lines of the reorganisation of the national cancer service.

Each network will cater for half a million people and will provide specialist cardiovascular services using a combination of local general centres and regional comprehensive centres.

Full 24-hour services will be available only at regional centres. However, Barry White, national director of quality and clinical care with the HSE, said the implementation of the programme will not result in the closure of any hospitals.

The plan will enhance the treatment of cardiac and stroke patients. For example, instead of being treated as a general patient, when the person suffering from stroke presents at AE the triage nurse will immediately summon a stroke team. The patient will be assessed for suitability for clot-busting treatment within a short time of being presented.

According to Dr Peter Kelly, head of stroke services at the Mater hospital in Dublin, for one-in-three patients this treatment can mean a full or substantial recovery from the stroke if administered within first three hours.

The patient will be treated by a multidisciplinary team in a stroke unit, which is associated with significant additional benefits for patients. The programme is in place in the Mater and will be rolled out around the State over the lifetime of the plan.

The prevention element of the plan includes a target to reduce obesity by 5 per cent by 2019, to reduce salt intake to 6g per adult per day and to increase fruit and vegetable intake. It also aims to encourage increased physical exercise and reduce smoking, in particular the initiation of smoking in young people.

The plan recommends media and education campaigns to increase awareness of cardiovascular risk factors which will be reinforced in GPs surgeries.