The roll-out of home oxygen tanks and physiotherapy to Chronic Obstructive Pulmonary Disease (COPD) sufferers in the Western Trust has been hailed as a major money-saver that epitomises the health service’s policy of treating more people in the community.
Mr. Kieran Donnelly, the Comptroller and Auditor General, cited a recent sea-change in the Trust’s respiratory care service as a model that could be replicated across the North in his audit of the Department of Health’s Transforming Your Care programme, which was launched in 2011.
The department’s road map for the reform of the health service, which was produced with the input of five independent panel members, including Professor Deirdre Heenan, argued that the home should be the ‘hub’ of service provision.
It suggested £83million in resources could be reallocated from the hospital sector to primary and community care.
In his audit, published on Tuesday, Mr. Donnelly said the impact of Transforming Your Care, has been more than limited and that the “hoped-for shift from hospitals into people’s own homes has not happened as rapidly as had been intended”.
However, the audit report hailed the Western Trust for its efforts to roll-out a more home-focused respiratory service, which it said was something that could be implemented across services and across trust areas.
Mr. Donnelly’s report noted that the “service was changed to encourage a consultant-led focus on the community” and that this involved the “introduction of outreach clinics; the use of phone or virtual clinics; phone and email consultations; home oxygen assessment; drugs reviews; and physiotherapy being available at home”.
“The outcome in one year has been a 38 per cent reduction in the length of stay in the South West Acute Hospital for respiratory inpatients; there were 152 new referrals contacted, and 48 of those patients were discharged; using phone and email consultations, 33 admissions and 89 review clinic appointments were averted; the waiting time for oxygen assessment reduced by 10 months,” it stated.
“Five of the top six drugs prescribed in the Western Trust are respiratory drugs. In four months, there was a saving of approximately £70,000, and almost 100 admissions were prevented through physiotherapy interventions. Patients have reduced side effects from drugs, have interventions to
avoid admission, are supported in a more timely fashion and, if admitted, have shorter hospital stays.
“The Haematology Service in the Western Trust has also transformed outpatient services using similar approaches.
“The transformation in services achieved in respiratory care can be replicated in other service areas: work is underway in diabetes, cardiology, ENT and renal services.”