Waiting lists have long been a challenge for the Irish healthcare system, impacting on patient experience and patient outcomes. It is recognised that, to improve this situation, progress must include the multi-annual reform of scheduled care services to allow patients to access high-quality care closer to home – the right care in the right place at the right time.
As part of the HSE’s commitment to improve access to scheduled care services and reduce waiting times, new Modernised Care Pathways have been developed by the National Clinical Programmes and are now being implemented across the country by the Strategic Programmes Office (SPO), Office of the Chief Clinical Officer.
Modernised Care Pathways are a key deliverable of the Waiting List Action Plan 2023, a frontrunner of integrated care delivery, and a building block for the new HSE health regions (formerly Regional Health Areas) organised under Sláintecare. In 2023, the Government has allocated funding of €43 million on a recurrent basis for the HSE to implement the first 36 new pathways.
About the Modernised Care Pathways
The implementation of Modernised Care Pathways is a multi-annual change initiative that includes 72 pathways which have been designed to broaden the points of access to healthcare for specific conditions and ensure that patients are seen faster and progress through a simplified journey towards definitive treatment, often without having to visit hospital.
Thirty-six of the 72 pathways have been approved for funding and implementation in 2023, with a priority focus on making seven pathways that are among the most feasible and have significant waiting lists fully operational within the year.
Goals and Impact
By centring services primarily in the Community, embracing advances in e-health technologies, and entrusting care to multidisciplinary teams of highly trained nurses and allied health professionals, the new Modernised Care Pathways will ultimately reduce scheduled care waiting lists and alleviate pressures on the Acute system.
With these new pathways, service users will not have to wait as long for routine healthcare services and will in many cases be able to receive that care without having to go to hospital. Additionally, a large variety of healthcare professionals working in Acute and Community settings – including advanced nurse practitioners, physiotherapists, optometrists, dieticians, and many others – will have increased career opportunities and be empowered to provide advanced specialised clinical care as a result of the new pathways.
The Modernised Care Pathways will have a number of beneficial impacts, including:
- Patients able to access routine care services locally via their GP and Community multidisciplinary team;
- Patients seen in a more timely manner in line with best practice;
- Improved patient experience, with easier access to appointments and a reduction in the number of appointments which the patient needs to attend;
- Telehealth options and digital innovations made more available for use when appropriate;
- Healthcare professionals empowered to work to the tops of their licenses to deliver advanced care most appropriate to their role;
- Scheduled care demands on consultants reduced, thus increasing capacity for more serious cases and expediting specialist and surgical interventions for those on waiting lists;
Implementation
The implementation of Modernised Care Pathways will take place over a number of years in a phased approach. The 36 Modernised Care Pathways (MCPs) that have been approved for roll-out in 2023 lie within 15 specialties with some of the highest outpatient demand and the longest waiting lists as per the National Treatment Purchase Fund (NTPF).
Of those 36, there is a priority focus on seven pathways within the Ophthalmology, Orthopaedics and Urology specialties that will establish localised integrated eye care teams, virtual fracture clinics, and community-based multidisciplinary urology teams within CHOs and Hospital Groups nationwide.
Those seven pathways are:
- Ophthalmology: Cataract, Medical Retina and Paediatric Eye Care
- Orthopaedics: Virtual Assessment Fracture Clinics
- Urology: Continence, Haematuria, Lower Urinary Tract Symptoms (Males)
Implementation is being led and coordinated nationally by the SPO, with critical advisory, monitoring and reporting support provided by the National Clinical Programmes. The pathways are being delivered on the ground by healthcare professionals and operational implementation partners in Hospital Groups, Community Health Organisations, and funded hospital and primary care services sites.
Stakeholder Engagement
The Modernised Care Pathways programme of work is complex in nature and will affect HSE staff and a large variety of healthcare professionals across the country. As such, the SPO is engaging regularly and meaningfully with stakeholders via informational webinars, meetings and memoranda, query responses, site visits, and special events.
Read about the "Future of Integrated Care in Ireland: Modernised Care Pathways Implementation Workshop" held in the Royal College of Surgeons in Ireland on May 23rd, 2023.
Questions?
If you have any questions about the development of the strategy, please email StrategicProgrammes.CCO@hse.ie
For press queries, please contact the HSE National Press Office by email at press@hse.ie or by phone at 01 9213912
About the Strategic Programmes Office
The Strategic Programmes Office (SPO) works to improve the delivery of healthcare for people in Ireland in alignment with the priorities of the Office of Chief Clinical Officer and through the development and implementation of innovative new programmes that drive clinical transformation throughout the HSE.
Ongoing programmes in 2023 include Modernised Clinical Pathways, the National Perioperative Patient Pathway Enhancement Programme (in collaboration with the RCSI and other partners), and the implementation of the National Strategy for Genetics and Genomics .Previously, the SPO was responsible for developing and implementing plans for the operational roll-out and use of novel COVID-19 therapeutics (programme now administered by the HSE Medicines Management Programme), the implementation of Public Health Reform in alignment with Sláintecare priorities, and the development of the National Strategy for Genetics and Genomics.
The Chief Clinical Officer (CCO) is responsible for ensuring clinical leadership, encompassing medical, nursing, midwifery and health and social care professions, at the most senior level of the organisation and works closely with National Directors, other Clinical Leads and with senior leaders within Community Healthcare Organisations and Hospital Groups to secure sustainable improvements in patient and service user outcomes, safety and experience.
