Cork's northside leading the way on shift from hospital to community care

Mari O'Donovan (left), Community Healthcare Network Manager and John Sheehan GP Lead. “People can go to St Mary’s for chronic disease and care for older adults." Photo: Sasko Lazarov / Photocall Ireland

People in the north of Cork city have been among the first to benefit from a shift away from hospitals to community care with one GP saying treatment has completely changed.

It has been estimated nationally the number of over-75s attending hospital emergency departments could be reduced by 20% through better community care. It is hoped to reduce emergency admissions related to chronic illness by 20%.

Health minister Stephen Donnelly described the ongoing switch as “the biggest expansion of primary care in the last 20 years". 

In Cork, a community healthcare network has been linked to St Mary’s Health Campus, Gurranabraher. GPs can refer patients to teams there instead of multiple appointments across the city.

Dr John Sheehan, lead GP with the network, covering Mayfield, Montenotte, The Glen and Blackpool, said: “It really is a big shift. 

“I’m in practice in Blackpool for 20 years and when I started I couldn’t refer people to physio, OT, dietician, counselling; all of that came through hospitals.

“Now we have referrals to that, and now this is the next step where people are working in teams.” 

He said elderly patients in particular appreciate the ease of having one centre. “I can refer people now to the geriatric service,” he said. “They get a very comprehensive assessment there, it’s a fast-track. The feedback has been very very positive for that.” 

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Network manager Mari O’ Donovan said later this month they will meet with voluntary groups to explain the changes. She said people feel they need the Emergency Department for every condition when that is no longer the case.

“People can go to St Mary’s for chronic disease and care for older adults, that’s been phenomenal,” she said. “We’re not fully there, we need to communicate better with the public, and with our own services, the acute services. We need to integrate this care.” 

A key aim is better access to carers in the home. “They are the cornerstone to keeping people at home. There are waiting lists, absolutely there are. It is hard to recruit but it runs very effectively,” she said.

GPs are informed about ‘social prescribing’ including links to Men’s Sheds and flower arranging groups in an expansion of older services.

“Prevention is a huge component of our work,” she said. “We work with Cork City Council, Cork Sports Partnership. It’s about keeping people well and healthy and giving them a choice.” 

Mari O'Donovan: “Prevention is a huge component of our work.” Photo: Sasko Lazarov / Photocall Ireland

They addressed a conference on Enhanced Community Care programmes, part of Sláintecare reforms, in Dublin on Thursday. 

At the same conference, Mr Donnelly said 3,500 staff will be hired to join 2,200 already recruited. The programme has €195 million in funding for this year which he said is an unprecedented investment in primary care. 

“This is about bringing care into the home,” he said. “Our hospitals should be reserved for emergencies, for scheduled medical care, for people with serious conditions. Really these teams have shown just how radical the improvements can be for patients in terms of rehab, and keeping people out of hospital.” 

So far 87 of 96 community healthcare networks are running, 21 of 30 integrated care programme older persons (ICPOP) teams, and 14 of 30 chronic disease teams.