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Help me understand the 24/7 Heart Attack care report

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  • 08-09-2016 6:10pm
    #1
    Closed Accounts Posts: 215 ✭✭


    So here is the report that is being mentioned in the news:

    health.gov.ie/wp-content/uploads/2016/09/Dr.-Herity-Clinical-Review.pdf

    There seems to be a big difference between the Waterford Consultants and the Dr. Herity over the catchment area. One says 560k and the other <300k and this seems to be making all the difference.

    But it seems to me that most of kilkenny is not being counted as part of the catchment area for 24/7 south east heart attack care because St. Lukes sends a lot of referrals to St. James Hospital in Dublin instead of Waterford.

    There is a diagram on page 19 showing a big arrow from Kilkenny heading towards Dublin while the rest of the south east points towards waterford.

    If the arrow from Kilkenny to Dublin was pointing towards waterford would there be a totally different conclusion to the report? Could that be considered since Dublin already has a massive catchment area?

    Then, on page 38 there is a picture showing that waterford city, south kilkenny and half of wexford has no 24/7 cover within 1.5 hours but the conclusion is that emergency care should be centralised in Cork even more than it is?

    I'm genuinely baffled? Please help me out here.


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Comments

  • Closed Accounts Posts: 215 ✭✭JMT2016


    Just something else I am now wondering about.

    On page 18 it says:
    "For most counties the admission profile at UHW is very similar to that of the total admission profile with the following notable differences: lower percentage admission rates for residents of Carlow and Kilkenny and higher percentage admission rates for residents of Wexford and Tipperary South These patterns are readily explained by the professional linkages (and cath lab sessions) of the consultant cardiologists in the relevant local hospitals."

    What are these "professional linkages"? Is the region as a whole losing out as a result?

    Also, there's something of a circular argument here when they mention the cath lab sessions - the lab is already restricted and overcrowded, causing referrals to go elsewhere, and because people go elsewhere, the catchment area is lower and therefore additional resources can't be provided! Nice!


  • Registered Users Posts: 2,254 ✭✭✭Chiparus


    The cath lab is open 8 hours a day and only does 72 heart attack cases a year, it is recommended to do 100 a year, so rather than opening it more hours a day and therefore do over 100 cases, he has said it should not be doing heart attack cases at all.

    Bizarre report.


  • Closed Accounts Posts: 215 ✭✭JMT2016


    Chiparus wrote: »
    The cath lab is open 8 hours a day and only does 72 heart attack cases a year, it is recommended to do 100 a year, so rather than opening it more hours a day and therefore do over 100 cases, he has said it should not be doing heart attack cases at all.

    Bizarre report.

    And those 8 hours are Monday to Friday 9-5 and that's already with massive overcrowding and delays and stoppages for emergencies?!

    It only operates 24% of the hours in a year and manages to hit 72% of the target! That sounds like they are playing a blinder - imagine what % they would hit with more resources not less!


  • Registered Users Posts: 2,254 ✭✭✭Chiparus


    JMT2016 wrote: »
    And those 8 hours are Monday to Friday 9-5 and that's already with massive overcrowding and delays and stoppages for emergencies?!

    It only operates 24% of the hours in a year and manages to hit 72% of the target! That sounds like they are playing a blinder - imagine what % they would hit with more resources not less!


    Only open 1/4 of the hours ( 40/168) yet doing 72 cases , if it was open 24/7 it would be the busiest in the country


  • Closed Accounts Posts: 814 ✭✭✭debok


    Its a bit of a strange report and the whole moving more services to cork doesn't make sense.it seems the catchment areas numbers are being downsized on the report to me and that looks like the governments only way out of there promises to halligan and it seems to have git them off the hook. But it seems Waterford is getting shafted again. We must be too quiet down here cos its happening more and more.


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  • Closed Accounts Posts: 1,107 ✭✭✭O Riain


    We are too quiet, there should be absolute uproar over this but I'm barely hearing a whimper


  • Registered Users Posts: 36,167 ✭✭✭✭ED E


    debok wrote: »
    Its a bit of a strange report and the whole moving more services to cork doesn't make sense.it seems the catchment areas numbers are being downsized on the report to me and that looks like the governments only way out of there promises to halligan and it seems to have git them off the hook. But it seems Waterford is getting shafted again. We must be too quiet down here cos its happening more and more.

    If Im reading it correctly Herity is recommending keeping routine procedures at UHW and divert the PCI work (urgent/emergency) to CUH. Totally fits the centres of excellence policy and keeps the travel times down for repeat patients. Whats the issue?


  • Closed Accounts Posts: 814 ✭✭✭debok


    ED E wrote: »
    If Im reading it correctly Herity is recommending keeping routine procedures at UHW and divert the PCI work (urgent/emergency) to CUH. Totally fits the centres of excellence policy and keeps the travel times down for repeat patients. Whats the issue?

    . At the moment the cat lab takes the heart attack emergencies during the day (9-5) going by the report the cat lab will stop taking these emergency's. So if I'm in south Kilkenny and drop with a heart attack during the day I will have to bypass Waterford and head to cork instead. It just seems strange to drop this pci work during the day altogether. its a nice trip to cork while having heart attack.


  • Closed Accounts Posts: 215 ✭✭JMT2016


    ED E wrote: »
    If Im reading it correctly Herity is recommending keeping routine procedures at UHW and divert the PCI work (urgent/emergency) to CUH. Totally fits the centres of excellence policy and keeps the travel times down for repeat patients. Whats the issue?

    It increases the travel times for the emergency cases? The ones where time is of the essence?

    I know traffic must be bad in Dublin 14 where you are - but are you facing a 2 hour + journey to get emergency care?

    Dead on time!


  • Registered Users Posts: 2,254 ✭✭✭Chiparus


    ED E wrote: »
    If Im reading it correctly Herity is recommending keeping routine procedures at UHW and divert the PCI work (urgent/emergency) to CUH. Totally fits the centres of excellence policy and keeps the travel times down for repeat patients. Whats the issue?

    The longer the delay in getting PCI, the worse the outcome. so for people in the south east, the report says that they should get clot busting drug not PCI, but the outcomes are worse.


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  • Registered Users Posts: 3,510 ✭✭✭Max Powers


    Didn't see prime time but from reading on aertel, this briefing note issued to chap doing review looks initially like exactly what has been previously spoken of here i.e.this is what what we think you should write in your report.


  • Registered Users Posts: 2,254 ✭✭✭Chiparus


    He who pays the piper calls the tune.


  • Closed Accounts Posts: 215 ✭✭JMT2016


    Max Powers wrote: »
    Didn't see prime time but from reading on aertel, this briefing note issued to chap doing review looks initially like exactly what has been previously spoken of here i.e.this is what what we think you should write in your report.

    Not sure what exactly you're referring to but it seems the whole report turns on the catchment area.

    The man himself says: The catchment population served by the cardiology service at UHW (or any other hospital service) is a matter for interpretation. (page 13) and then he uses his interpretation to justify reducing emergency services!

    Why is the catchment a matter for interpretation? - people live in the geographic area or they don't.

    On page 20 he allows 26% of the population of Kilkenny to be part of the catchment area - I mean in all fairness that's ridiculous.

    If "professional linkages" is the reason that 74% of the population of one of the main counties in the South East is being excluded then maybe we need a South Eastern Health Board NUA to be set up to fix those linkages and start saving lives!


  • Registered Users Posts: 2,254 ✭✭✭Chiparus


    JMT2016 wrote: »
    Not sure what exactly you're referring to but it seems the whole report turns on the catchment area.

    The man himself says: The catchment population served by the cardiology service at UHW (or any other hospital service) is a matter for interpretation. (page 13) and then he uses his interpretation to justify reducing emergency services!

    Why is the catchment a matter for interpretation? - people live in the geographic area and or they don't.

    On page 20 he allows 26% of the population of Kilkenny to be part of the catchment area - I mean in all fairness that's ridiculous.

    If "professional linkages" is the reason that 74% of the population of one of the main counties in the South East is being excluded then maybe we need a South Eastern Health Board NUA to be set up to fix those linkages and start saving lives!


    Ok, to have a viable unit you need to have a catchment area of 500k, the hospital groups were based about this except Limerick with a catchment are of 380k,
    Originally Kerry fed into Cork cardiology services, however, Kerry suddenly became linked to Limerick.

    Cork now had a problem as their unit did not have the volume of cases.
    So they need Waterford patients to feed into Cork.


  • Closed Accounts Posts: 215 ✭✭JMT2016


    Chiparus wrote: »
    Ok, to have a viable unit you need to have a catchment area of 500k, the hospital groups were based about this except Limerick with a catchment are of 380k,
    Originally Kerry fed into Cork cardiology services, however, Kerry suddenly became linked to Limerick.

    Cork now had a problem as their unit did not have the volume of cases.
    So they need Waterford patients to feed into Cork.

    Why is Kerry linked to Limerick even though they are in different hospital groups? Hmm...

    I just cannot get the mindset - for once can we stop skimping on what is emergency care in one of the few medical areas where every minute counts!

    We need life equality for the people of the south east!!


  • Registered Users Posts: 2,254 ✭✭✭Chiparus


    JMT2016 wrote: »
    Why is Kerry linked to Limerick even though they are in different hospital groups? Hmm...

    I just cannot get the mindset - for once can we stop skimping on what is emergency care in one of the few medical areas where every minute counts!

    We need life equality for the people of the south east!!

    For cardiology, like Wexford is linked to Waterford even though they are in different groups.


  • Closed Accounts Posts: 215 ✭✭JMT2016


    Chiparus wrote: »
    For cardiology, like Wexford is linked to Waterford even though they are in different groups.

    Because that makes good sense!

    Interestingly the report page 20 only allows 53% of South Tipp population to Waterford catchment- surely cork aren't using that other 47% to boost their numbers as well!


  • Users Awaiting Email Confirmation Posts: 950 ✭✭✭mickmackmcgoo


    This is a regional issue but media keep it focused on Waterford and Halligan. Katie Hannons FOI for prime time showed that Halligan was screwed over on the terms of reference. The guy doing the report was given the outcome that was wanted. Kenny and Harris saying they have to abide by the report . There was a few independent reports over the years that recommended immediate university status for WIT but of course they were always ignored due to vested interests in other universities and politics and it's the same here . It's all about numbers for Dublin and Cork and keeping their budgets. Mr Herritty actually consulted with consultants in Cork hospitals about the need for second lab in Waterford. They were hardly going to recommend it were they


  • Closed Accounts Posts: 215 ✭✭JMT2016


    Mr Herritty actually consulted with consultants in Cork hospitals about the need for second lab in Waterford. They were hardly going to recommend it were they

    Why is there no mention in the report of consultation with any of the other hospitals that actually are in the catchment area?


  • Users Awaiting Email Confirmation Posts: 950 ✭✭✭mickmackmcgoo


    JMT2016 wrote:
    Why is there no mention in the report of consultation with any of the other hospitals that actually are in the catchment area?


    As far as I know the consultants in KK aligned the hospital there with Dublin a few years back but I don't know what areas were consulted about this. The population of the south east justifies the 24 hour service but it's all been divided up and aligned to Cork or Dublin already


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  • Registered Users Posts: 728 ✭✭✭Dunmoreroader


    It's the same politics that served the British Empire fir a couple of centuries; divide and conquer.