New Care Pathway Provides Vital Supports For Cardiac Patients as HSE marks World Heart Day

• Patient centred care in the community
• Empowering cardiac patients

Significant steps in the care of patients with chronic heart disease closer to their homes are being highlighted as the HSE marks World Heart Day (today, 29th September 2023).

Cardiology care pathways represent a shift towards providing more healthcare service outside of traditional hospital settings, bringing care closer to patients’ homes. They aim to deliver more comprehensive and patient-centred care within the community, with a focus on prevention of chronic disease and its complications, early and specialist intervention and empowering patients to live well with chronic disease in their communities.

The roll out of the pathways for cardiology are four of the 36 Modernised Care Pathways being introduced and are a key component of the newly established Integrated Care Hubs being set up nationwide as part of Enhanced Community Care. Through the work of the Enhanced Community Care (ECC) programme and Modernised Care Pathways, patients are being treated for their chronic heart disease closer to home. This is proving life changing for those now availing of the community based service.

In the west of Ireland, the pathways for Cardiology has been up and running since March 2023 under the joint governance of the Saolta University Health Care Group and Community Healthcare West.  Since then, it has seen 300 patients removed from the Galway University Hospitals’ waiting list through a chest pain initiative and the redirection of GUH hospital heart failure waiting list with appointments been given to the hub instead of hospital.

Dr Sarah M. O’Brien, HSE National Clinical Advisor for Chronic Disease, said:

"On this World Heart Day, we mark the roll out of Modernised Care Pathways for chronic disease, signifying a significant step in improving care for patients with chronic conditions like heart failure. These pathways are designed to offer integrated and patient-centred care, specifically targeting patients with heart failure, atrial fibrillation, and other chronic cardiovascular diseases."

Dr Susan Connolly, Cardiologist with UHG who also leads the cardiology service in the Galway City Integrated Care Hub, said: 

“The ECC programme has been absolutely transformational for the care of patients with chronic cardiovascular disease. We have seen almost 300 new patients in the hub and had 1,300 clinical contacts since we started."

Noel Ridge, a patient at the Galway Integrated Care Hub, where services are provided in an integrated fashion between GPs, practice nurses, community specialist teams and hospital specialist teams, shares how his experience has positively impacted his life:

"I've had three heart attacks and been in the hospital nine times in the last 18 months. But I've come through it.

“The support I receive at the hub provides great comfort because I'm not waiting for hospital appointments that are months or a year apart. If I don't feel well, I can call the hub right away and explain what's happening. Overall, visiting the hub is much more convenient as it is closer to home and appointments are scheduled at specific times, which reduces a lot of stress."

Dr Connolly added: 

“One of the main benefits we hear from patients is that they now feel they have a safety net. With the Chronic Disease Management service we meet these patients in hospital and establish the link with the community service.

“Two in five patients in Ireland present with more than one chronic condition, which traditionally saw each patient attending a wide range of different hospital services. This care is now streamlined in the hub for patients with multiple conditions.

We hold regular multi-disciplinary meetings with colleagues across diabetes and nephrology, [who treat chronic kidney problems]. By all working together we make this journey much more manageable for our patients by ensuring they are only receiving appointments that are necessary.

It’s not just about providing heart failure care, it’s about providing a holistic service that addresses all their needs in terms of being a cardiovascular patient and helping them live with the chronic disease but empowering them so that they can live with that disease,” added Dr Connolly."

Dr John Lally, a GP in Galway City, described the Enhanced Community Care programme as a ‘game-changer’ for care:

“We are now able to send our patients to community based services for both their diagnostics and their clinical opinion.

Each Integrated Care Hub will have a dedicated team of healthcare professionals, including cardiologists, nurses, physiotherapists, physiologists and psychologists, our goal is to provide more flexible and comprehensive care to individuals living with complex chronic disease and multi-morbidity (more than one chronic condition) in the community. This initiative aims to enhance the patient journey, offering specialist and multidisciplinary consultations in community settings and even virtual consultations, ultimately improving specialist cardiac care accessibility."

Watch the video Cardiology Care Services in action at the Galway City Integrated Care Hub