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Alternative to Hospital

June 2008

Press Page

An alternative to hospital

[Posted: Wed 18/06/2008 by Deborah Condon]

Thousands of people in Ireland are living with chronic and critical diseases, such as rheumatoid arthritis, Crohn’s disease and multiple sclerosis. For them, trips to the hospital can be common – some may have to attend as often as every month as part of their treatment.

However such trips can be hard on a patient. It is no secret that acute public hospitals are incredibly busy places. While a patient may have an appointment for 9am, 10 other patients may be given the same appointment, leading to long waiting times. And this is after they may have had to drive around a hospital car park searching for that rare animal – a space – and then being charged an exorbitant hourly fee for the honour of using it.

But what if these patients could receive some of the care they required outside of the hospital setting? Point of Care are community based private clinics which aim to provide specialist nursing and infusion services for patients affected by a range of chronic and critical illnesses. Infusion refers to the administering of medications by an intravenous (IV) drip.

Point of Care has just opened its second clinic in Tyrrelstown in west Dublin and speaking to, its CEO, Jim Joyce (pictured), explained that the aim is to open 20 clinics nationwide.

“This will lead to 85% of the population being within a one-hour drive of a clinic,” Mr Joyce explained.

So how does the clinic work and who can avail of its services? According to Mr Joyce, a patient has to be referred by their hospital consultant. From here, a therapy care coordinator will confirm the referral and arrange the patient’s appointment(s). The patient then attends the clinic for their appointment.

“The therapy care coordinator liaises between the consultant and the patient. This is the key to our success. The consultant has to be kept informed and be confident about what is happening to their patient away from the hospital,” he said.

In the case of, for example, rheumatoid arthritis, a patient may typically have to attend every four to six weeks for infusion. The actual infusion may take one hour and then they will be kept in for an hour of observation.

Mr Joyce insisted that patients will be seen at their appointed time and their infusion materials will be ready when they arrive, ensuring no delays.

“It means that your whole day isn’t taken over by this appointment. Hospital appointments can be time consuming so it allows patients to reclaim that part of their lives,” he explained.

Anybody can attend any Point of Care clinic as long as they have been referred by a consultant. It is not restricted to certain catchment areas.

“While most queries have been from the nearest hospital, Connolly Hospital in Blanchardstown, we have had queries from other hospitals, including Tallaght Hospital,” Mr Joyce said.

The Tyrrelstown Point of Care clinic has space for four patients at any one time. At full capacity, this would allow for up to 14 patients to be treated daily, or 70 in a five-day week. In other words, 70 less patients per week having to queue up in hospital for the same service.

Originally from the US, Mr Joyce explained that he came to Ireland in 2004 while working with a pharmaceutical company. He was surprised to find that the reason some Irish people could not access certain products was ‘not for the typical reasons, such as they could not afford it, but because the specialist nursing services and infrastructure were not there’.

He noted that while patients with chronic illnesses were attending hospitals on a relatively regular basis, often, they had to ‘fight for bed space’ every time they went.

“I saw the dependence on the public system and I saw a big demand for this type of thing but nobody servicing that demand,” Mr Joyce said.

However he pointed out that Point of Care would not have been possible even a few years ago. This is because two things were needed, the existence of private healthcare, which was already well established here, but also the existence of primary care centres.

Primary care centres usually offer a number of services, such as GP, dental, physiotherapy and counselling services, all under the one roof. While these are becoming increasingly common in this country, they were largely unheard of a few years ago.

The Tyrrelstown Point of Care clinic is located in the Tyrrelstown Medical Centre. This offers a number of advantages, Mr Joyce pointed out.

“There is lots of free parking around. It is a new building with plenty of light and our clinic is on the ground floor so this helps people with mobility issues. We have already had our first patients and they have all remarked on the convenience of the setting,” Mr Joyce said.

As Point of Care is a specialty nursing service, being located in a primary care centre also means that there is always an on-site physician available.

Point of Care is a private enterprise. Currently, VIVAS (which will be known as Hibernian Health from July 1) has confirmed that it will cover the cost of services at Point of Care clinics. According to Mr Joyce, he ‘expects the other health insurers to follow suit’.

Meanwhile Point of Care is also in discussions with the HSE to make the service available to public patients. Mr Joyce describes these discussions so far as ‘positive’.

“Point of Care allows the HSE to progress its ‘Transformation Programme’, it is cost effective and it will help reduce dependence on the public health system, therefore we are confident the HSE will see the benefits of our service,” Mr Joyce said.

The next Point of Care clinic is expected to open in Mullingar by the end of July. While regular opening hours currently apply – Monday to Friday, 9am to 5pm – Mr Joyce said that the option will be there to extend these hours if there is the demand.

“Patients are fighting for these services and we want to improve the experience for them. For many people, it is very appealing not to have to go to hospital,” he added.

More information is available at…

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