HSE Enhanced Community Care - Improving health outcomes for patients across Ireland

The HSE is making significant progress in improving healthcare for older adults and people with chronic diseases through the Enhanced Community Care (ECC) Programme, a key pillar of Sláintecare. The programme is bringing services closer to home, reducing hospital admissions and enhancing patient care.

ECC impact in 2024

• 133,000 patient contacts by Community Specialist Teams (CSTs) for Older People - 31.5% increase.
• 81% of patients discharged home after community-based interventions. Only 5% of older people required long-term care, with another 5% needing acute care services.
• Over 7,000 frail adults supported by CSTs for older people avoided unnecessary hospital admissions.
• 15% reduction in hospital admissions for chronic disease patients (2019-2023).
• Over 645,000 GP-led patient reviews under the Chronic Disease Management (CDM) Programme.
• 900+ virtual clinics held, with 85% reduction in hospital visits for Heart Virtual Clinic patients.

Minister for Health, Jennifer Carroll MacNeill TD, said, “I really want people to have access to as much care as possible in their home and in their community. The Enhanced Community Care Programme, a cornerstone of Sláintecare, is transforming patient care by expanding local healthcare services, reducing hospital dependency, and enhancing patient outcomes. This programme shows our commitment to delivering high-quality, patient-centred care that meets the evolving needs of our communities, in our communities."

Bernard Gloster, HSE CEO, said, “I am delighted by the progress we have made for our patients through Enhanced Community Care. By strengthening community teams, reducing reliance on hospitals, and leveraging digital solutions, we are improving patient outcomes and quality of life. Thank you to our dedicated teams driving this transformation. The new specialist teams are improving chronic disease management for heart failure, COPD, asthma, and diabetes. Over 90% of patients attending their GP for structured chronic disease management are now managed solely by their GP, reducing hospital pressures.”

Expanding hospital avoidance initiatives

The Mobile X-ray service is benefiting over 600 nursing homes, reducing the need for hospital visits:

● Over 7,000 patients were x-rayed in 2024 using mobile X-ray services.

● 95% were treated at home, avoiding hospital transfers.

Enhancing chronic disease management and reducing hospital dependency

● 15% reduction in hospital admissions for those with Chronic Disease across 2019-2023, this is in comparison to a 1.3% reduction in all medical admissions.

● Over 645,000 patient reviews completed by General Practitioners (GPs) as part of the Chronic Disease Management (CDM) Treatment Programme in General Practice.

The ECC Programme is improving chronic disease care through specialist consultant support

● 59 new Integrated Care (IC) Consultants and their acute based teams completed over 117,000 patient contacts in 2024.

● Over 13,000 new patients received care through direct GP referrals and OPD waiting lists.

● 59% (almost 8,000) were seen from OPD waiting lists, with 11% seen within two weeks.

Community and voluntary supports

• Over 42,000 people were supported by Alone, a voluntary partner, in facilitating co-ordinated support, visitation support, befriending, age friendly housing technology and community supports.

Strengthening community diagnostics and therapy services

Expanding Access to Diagnostics

● Over 280,000 radiology tests completed

● Almost 218,000 NT-proBNP tests completed to detect new-onset heart failure.

Improving multidisciplinary care through Community Healthcare Networks (CHNs) - increasing access to therapy services

● Almost 1.2 million patient contacts were completed across the five therapy services, including physiotherapy, occupational therapy, dietetics, speech & language therapy, and podiatry.

● Over 305,000 patients seen for first-time assessments with increases in physiotherapy and dietetics.

Digital for Care - Advancing integrated healthcare and digital transformation

The Community Healthcare Networks (CHNs) support team-based care:

● The HSE Area Finder tool helps GPs refer patients to CHN teams via HealthLink.

● 188,000+ e-referrals were made through HealthLink in 2024, improving patient coordination.

New ways of working for integrated care consultants

● Over 900 virtual clinics were held, 86% focused on heart conditions.

● 85% reduction in hospital attendance for patients using Heart Virtual Clinics (HVCs), with GP-led care supplemented by specialist input.

Mobilising remote care solutions

● The national rollout of video consultations via Attend Anywhere is advancing the digitisation of community care services.