Heart Failure waiting lists reduced from 6 months to 6 weeks thanks to Galway health services in the community

Patients in Galway are saving themselves hours of travel time, and hundreds of euros in travel expenses now that they can access routine heart check-ups and care closer to home. This new service, funded by Sláintecare, provides heart failure diagnostics and care in the community, meaning patients can avoid a trip to Galway University Hospitals.

Galway University Hospitals is running this community-based service with Primary Care Centres in Tuam, Gort, Claremorris and Galway City, that allows patients to receive care closer to home in a Primary Care Centre. GPs can refer their patients with suspected Heart Failure directly to the service for tests and diagnosis. This makes it easier for patients to access routine care related to their heart condition.

Direct access for GPs to diagnostics allows patients to be treated in a community setting, going to hospital only where necessary, meeting the Sláintecare vision of shifting care appropriately, away from a hospital centric model.

This new model of care is reducing pressure on hospital services such as Outpatient Cardiology (OPD), Emergency Department (ED) and Acute Medical Units (AMU). Recent results from the service show that:

• Over 1,000 patients have received diagnostic tests through the service;
• 88% of patients of the service have come through a GP referral;
• 89% of patients received tests within 6 weeks of referral;
• 55% had appointments in 2 weeks or less.

This is compared to common wait-times of up to 33 weeks for the hospital service.

Patients and GPs are delighted with the service:

• 95% of patients were satisfied or very satisfied with the service;
• 94% of GPs agreed or strongly agreed that the service reduced referral to cardiology outpatients;

Joined up services between the cardiology department in Galway University Hospitals and Primary Care Centres in the community, allows for quick follow-up where a patient requires further care.

This meant that one patient who required further care after a Primary Care Centre test, had an appointment in the Acute Medical Unit the same week, started their medication and care straight away, and is due back for follow-up care, without having to go through OPD or ED.

The service currently operates from five clinics in Tuam, Claremorris, Gort and two in Galway city. These sites are reachable by staff within 45 minutes, thus maximising the number of diagnostic slots available. The service is currently providing direct access for GPs to forty diagnostic slots per week.

The service is provided by the team of Cardiac Physiologists, under the clinical support of the Consultant Cardiologists, from Galway University Hospitals, rotating out to the centres. The Cardiac Physiologists providing the service have internationally recognised accreditation in Echocardiography. This, combined with it being under the clinical governance of the hospital gives associated quality assurance. The clinical support and governance of the Consultant Cardiologists is vital, in terms of their expertise for more difficult cases and continuity of care in referral pathways.

Background

The Sláintecare Report and the intended approach, embodied by the “Right Care, Right Place, Right Time” mantra has seen a focus on shifting more care into the communities, closer to patients’ homes.

Sláintecare Integration Fund

In 2019, Sláintecare invited all healthcare staff and organisations to submit ideas to access some of a €20m fund for projects that would integrate care across the health service. There was a particular emphasis on initiatives that would support the shift to community-based care and help to reduce and prevent hospital visits. The cardiology department in Galway University Hospitals was successful in its application and received Sláintecare support to commence its Community Cardiac Diagnostics Programme, funding a portable echocardiography machine, of an equivalent standard to the hospital based machine and ten heart (R-test) monitors. It also covered the salary of a Senior Cardiac Physiologist, who performs and reports the echocardiograms and an administrative post.