By serving to sufferers handle their situation in the neighborhood, the programme not solely improves lives however is aligned with the Sláintecare rules of proper place, proper time, proper particular person
Osteoarthritis is without doubt one of the main causes of incapacity in Eire, significantly amongst adults aged 50 years and older. Joint stiffness, ache, issue with useful actions, weight acquire on account of decreased mobility and work absenteeism are frequent penalties.
So far, well timed entry to first line intervention equivalent to train, training and recommendation on eating regimen has been very restricted throughout the group setting, leading to sufferers ready for extended intervals on an acute hospital Outpatient Ready Record.
The Nationwide Medical Programme for Trauma and Orthopaedic Surgical procedure in collaboration with the HSE’s Modernised Care Pathways programme have been testing an built-in care pathway geared toward managing sufferers who current to their GPs with gentle to average signs of osteoarthritis (OA).
For the undertaking interval (April 2023 – March 2025), 1,856 sufferers have been managed by way of this pathway, with 66 (3.5 per cent) requiring an OPD appointment with an orthopaedic guide and 18 (<1 per cent) sufferers required surgical procedure.
This service re-design is at the moment being examined on two websites – Our Girl’s Hospital, Navan and College Hospital Waterford/Carlow/Kilkenny with funding being secured via the Sláintecare Integration Innovation Fund (SIIF).
With the implementation of this new built-in care pathway, sufferers are referred by their GP to a medical specialist physiotherapist in the neighborhood. Following a complete evaluation, sufferers are provided personalised train plans, training on OA and diet recommendation supplied by a dietitian. Hospital referrals at the moment are made solely when completely mandatory.
The nationwide medical programme has developed an APP that’s obtainable to all sufferers taking part on this undertaking which inspires self-management over time.
Affected person Initiated Overview and entry to native sports activities amenities are all obtainable to sufferers by way of the APP which is accessible by way of the HSE’s APP retailer.
A special option to deal with a standard downside
“We used to see a excessive quantity of referrals straight to orthopaedic consultants,” explains Mr Alan Walsh, Marketing consultant Orthopaedic Surgeon. “However the reality is, most sufferers don’t want surgical procedure. What they want is assist, steerage on train, eating regimen, and how you can handle their situation. This programme is about getting the best care, in the best place, on the proper time.”
Actual lives, actual outcomes
For sufferers, the change has been life-altering and this may be considered beneath.
The associated fee-effective nature of the initiative has additionally impressed stakeholders. The complete pilot spanning 2½ years, together with app growth, was delivered for €900,000 properly beneath the preliminary €1.17 million price range.
By serving to sufferers handle their situation in the neighborhood, the programme not solely improves lives however is aligned with the Sláintecare rules of proper place, proper time, proper particular person. This pathway has improved entry to take care of sufferers and has decreased the variety of referrals which are being despatched to the acute hospitals’ Outpatient departments.
Medical leaders champion change
The clinicians main the undertaking emphasise that the event of built-in care pathways is without doubt one of the methods that must be developed and applied nationally with a purpose to meet the rising demand related to an ageing inhabitants and altering demographic.
Mr Finbarr Condon and Mr Tom McCarthy, Joint Medical Leads for the Nationwide Medical Programme for Trauma and Orthopaedic Surgical procedure, stress the significance for the HSE to proceed to mainstream tasks equivalent to this which have demonstrated vital worth, firstly for the sufferers, and secondly for the optimum utilisation of all obtainable assets in each major and secondary care settings.
Nationwide implementation will make sure that all sufferers have equal entry to essentially the most acceptable care on the proper time.
A mannequin for broader reform
Greater than only a pilot, the Hip and Knee OA Pathway is being held up as a blueprint for tackling different musculoskeletal situations that profit from early intervention and lifestyle-based administration.
“We’ve seen what’s attainable whenever you begin with the affected person, not the process,” notes Mr Walsh “And it aligns completely with the Sláintecare imaginative and prescient: earlier entry, smarter use of assets and higher well being outcomes.”
The programme’s emphasis on self-management and digital assist additionally dovetails with broader traits in healthcare innovation, significantly in rural and distant areas the place entry to in-person providers may be restricted.
With robust medical backing and overwhelmingly constructive affected person suggestions, the following section will probably concentrate on scaling the programme throughout the nation, giving extra folks the instruments they should transfer with confidence once more. 
