GUH waiting lists for Respiratory Airway Disease cut significantly through new Integrated Care Hubs positioned in the community

Patients seeking treatment for the respiratory conditions COPD and asthma have seen their hospital waiting lists cut dramatically as a result of the new Integrated Care Hub in Galway.

Where once patients would face waits of up to three years to access services, the Integrated Care Hub, part of HSE Enhanced Community Care programme, is ensuring full access to services within a matter of weeks.

Dr Sinead Walsh, Respiratory Consultant and Respiratory Lead for the Galway City Integrated Care Hub welcomed the new services as a major step forward in reducing wait times for patients.

“This has been an absolute game changer for patients. Previously they were waiting a number of years to even access a respiratory specialist. Now they know they’ll be seen within a number of weeks,” she said.

Since commencing the Consultant-led diagnostic clinic in a community setting, almost 250 patients have been reviewed by Dr Walsh and her Integrated Respiratory Specialist team in various community locations throughout the county. GPs refer directly to the Integrated Respiratory clinic, thereby avoiding the acute hospital waiting lists. 36% of referrals are taken from the existing affiliated acute hospital respiratory waiting lists.

The mean wait time for review in the Respiratory Integrated clinic is now 6 weeks. 

When patients come to the service they have their breathing test done first by a physiologist. This checks the level of air they can breathe in and out of their lungs. Following this they see the respiratory consultant.  After reviewing the test and a clinical assessment of the patient, a diagnosis of COPD or Asthma can be made.

During the same appointment the patient can then see the respiratory clinical nurse specialist and the respiratory physiotherapist, should this be required.

“Prior to this, GPs would refer patients with the query diagnosis of COPD or asthma to the acute hospital services. Patients were often waiting three years to avail of that breathing test and then access services. Now GPs can refer directly to us here in the Integrated Care Hub. We triage the referrals and if the patient meets inclusion criteria we arrange for that patient to be seen in the coming weeks within a diagnostic clinic located in the community,” added Dr Walsh.

Noel Downes has been accessing the hub for his Asthma since last summer. He praised the easy access.

“I came to the service in early summer. I’m asthmatic and have been for the last 15 years. It has been an excellent service. I’ve been able to have one-to-one service with the professionals. Just the convenience of being able to come out here as well with the traffic and the anxiety about parking at the main hospital.

“The follow up plan when I left was absolutely brilliant. I left here not having to return, having the proper inhalers, the proper technique and the proper equipment to use.

“From attending this service I am on the right path with my Asthma. Overall it has been an excellent service,” he added.

During their visit, patients can also meet with the Respiratory Nurse Specialist at the hub.  Phillipa Needham, one of the respiratory nurse specialists, describes her role:

“My role here is to ensure patients fully understand their diagnosis following their consultation with the consultant. I go through the patient’s treatment plan in detail. I look at their inhaler techniques and ensure they are doing it correctly. I also answer any questions they might have,” she explained.

Niamh Duignan, Clinical Specialist Physiotherapist educates patients in airway clearance techniques, breathlessness management, restoring normal breathing patterns and prescribing individual exercise programmes.

Assoc Prof Stanley Miller, National Clinical Lead for Respiratory, comments how the work in Galway is to be commended. “Our new Integrated models of care for COPD and Asthma have had a significant impact in improving GP access to specialist care for COPD and Asthma patients. The service is delivered by consultant-led multidisciplinary specialist respiratory teams and provides care closer to home, within Integrated Care Hubs, in line with Sláintecare. In addition, the reduction in the existing waiting lists in Galway is commendable and is also evident in other areas across the country.”