We have heard a lot about Sláintecare, but few people know exactly what the reform programme will mean for people who need our health service.
At its heart, the programme is a move away from hospitals and private insurance to local care based on how sick people are — a radical move that could mean being treated at home by staff living in the locality.
It is hoped the reforms will cut waiting times to weeks or months rather than years.
Many local projects are already funded through Sláintecare, and they are a tantalising glimpse of a new world for patients.
In Waterford, a fast-track knee pathway has slashed some waiting lists for people with arthritis or other problems from up to four years to nine months. Dr May Cleary, HSE lead orthopaedic clinician for the South/SouthWest Hospital group, told a webinar recently that around 6,500 new orthopaedic patients are referred to University Hospital Waterford annually, but they can only treat about 3,500.
The new programme means patients see a physiotherapist quickly, they are either treated in the clinic or sent to the hospital with a direct referral, no waiting.
A project run by Cork Sports Partnership and HSE Cork/Kerry community healthcare is targeting injury prevention, taking referrals from GPs and other healthcare workers.
The Well Communities Connect (WellComm) project includes a weight-loss programme, fitness for older people, and a nutrition programme.
Project lead Eoin Kaar said their research shows all participants found their quality of life improved.
A project in the North West is tackling heart failure, one of the most common reasons for over-70s to be hospitalised.
The Donegal Integrated Service for Heart Failure has cut waiting lists for treatment like echocardiograms from years to less than one month. Clinical nurse specialist Karen McCafferty said new clinics in remote areas made it easier for people to come for help and were welcomed by local GPs.
In north Dublin, older people who phone 999 can get treated at home through a partnership between the national ambulance service and Beaumont Hospital. A report on this Pathfinder care pathway for the International Federation for Emergency Medicine found a startling 69% of callers were suitable for home treatment during the pandemic.
These pilot projects are potentially life-changing; a progress report this month shows 38 are being mainstreamed by the HSE.
However, the resignations of senior Sláintecare staff earlier this month in frustration at lack of support for the overall reforms are a worrying sign as exciting health pilots have been known to stutter to a halt.
A tweet sent last month by a Cork healthcare worker to the Sláintecare account perhaps sums up the uncertainty and lack of knowledge that exists about the programme. The health worker wrote: “We have an idea for improving patient care. How do you apply for Sláintecare funding? Thanks.”
We are coming out of the biggest challenge the health service has ever faced in fighting Covid-19. Somehow in that terrifying time, individual staff found a way to run local Sláintecare projects and show us it can be done.
The resignations were an alarm bell for the health of our services, we should all be asking who is listening.