Dr Seamus O’Dea, who carried out very important providers for sufferers with rabies, botulism and diphtheria on nationwide degree for a number of years, retired in July
The method of transferring providers for treating rabies, botulism and diphtheria to well being areas poses dangers for potential gaps that will result in weak sufferers being missed, the HSE’s chief scientific officer has stated.
In a letter despatched to govt officers and scientific administrators throughout the HSE areas final month, Dr Colm Henry stated there have been ongoing discussions round how these providers might be carried out at a neighborhood degree, after the retirement of a Dublin-based clinician who had handled sufferers with these circumstances for a number of years.
“There are dangers, whereas these discussions are happening, of gaps in service, and subsequently potential for an individual with a rabies-prone publicity being missed, misplaced to follow-up or inappropriately managed,” Dr Henry stated.
Dr Seamus O’Dea, Senior Medical Officer (Retired) at Cherry Orchard Hospital
On July 4, the retirement of Dr Seamus O’Dea, Senior Medical Officer at Cherry Orchard Hospital, meant {that a} service he delivered, which was chargeable for the evaluation of sufferers and supply of vital biologics used for acute post-exposure remedy/prophylaxis for rabies, botulism and diphtheria, ceased to function.
In a letter dated July 3, Dr Henry stated: “Whereas this service had by no means been commissioned as a nationwide service, it had, in impact, offered recommendation and remedy on administration of doubtless or truly uncovered sufferers for a few years from everywhere in the nation.
“Recognising the significance of this service, the Nationwide Well being Safety Workplace (NHPO) by a Activity and End Group, has been working with key companions and stakeholders at nationwide and regional degree to help implementation of a brand new regional service mannequin.”
Dr Henry stated that consensus had been reached on the function of EDs in the way it will assess new displays of rabies, botulism and diphtheria. Regional public well being groups may also help scientific colleagues in endeavor danger administration and managing any wider group dangers. A brand new generic care pathway for rabies, essentially the most impactful when it comes to calls for for care and evaluation, has additionally been developed by NHPO.
Nevertheless, the letter outlined numerous points nonetheless up for dialogue. This contains the regional provision of on-call providers for infectious illnesses for weekends and financial institution holidays, with none at the moment accessible exterior of Dublin’s Mater hospital.
Settlement on a single regional designated centre has additionally not been reached. The function of main care is up for debate, as, based on the letter, the Irish Faculty of GPs have requested ‘that GPs shouldn’t be included within the pathway initially as there may be at the moment no mechanism for them to be paid for this additional service.’
The method has raised considerations that very important medicines won’t be instantly accessible in pressing circumstances, with healthcare suppliers not sure the place to supply therapies whereas the switch of providers is underway.
As reported final week, Eire’s Well being Merchandise Regulatory Authority is intently monitoring the potential use of unlicensed Botox-like merchandise right here after well being officers within the UK have been notified of individuals affected by iatrogenic botulism linked to beauty procedures.
This week the Well being Safety and Surveillance Centre (HPSC) revealed pointers on the method for ordering antitoxin medicines for botulism and diphtheria.
Whereas the Nationwide Chilly Chain Service might be contacted concerning orders throughout regular enterprise hours, out-of-hours queries might be handled by regional public well being groups.
Orders out-of-hours are mediated by an on-call advisor on the Nationwide Well being Safety Workplace who can prepare emergency supply.
In a press release issued to Irish Medical Occasions, a HSE spokesperson stated that the switch of this service to the areas will ‘higher meet the wants of native populations and construct a resilient nationwide service’.
They stated that implementation teams have been established regionally enact a brand new care pathway developed by a nationwide working group, and the existence of each groups will ‘mitigate any danger regarding entry to evaluation and look after sufferers, probably created by the standing down of a beforehand accessible service, which had been in place for a few years.’
The spokesperson added: “The HSE maintains a nationwide inventory of rabies vaccine and immunoglobulin for post-exposure prophylaxis, according to nationwide pointers, and shares for this objective stay accessible.”
