Diabetes management and Prescription drug volume monitoring

Councillor Robbie Gallagher asked the following questions:-

Can the HSE give an overview of where it currently stands with regard to
its planning for a disease management programme in the area of diabetes?
Cllr. Robbie Gallagher

Prof Richard Firth has just been appointed as Clinical Lead of the National Diabetes Programme in the National Directorate of Quality & Clinical Care under Dr. Barry White. The National Diabetes Programme is beginning its work under the following prioritised headings:

  1. National Diabetes Retinopathy Screening Programme.
  2. National Diabetes Register.
  3. Implementation of Foot Care Initiatives to reduce A&E and hospital admissions with foot problems.
  4. Implementation of an Integrated Care System for Diabetes in HSE Areas to achieve better outcomes for people with diabetes.
  5. Strategies to improve diabetes control and risk reductions to prevent diabetic complications (e.g. to rationalise Insulin Pump Therapy particularly in young children).

This work will be implemented in each of the HSE Areas by the Diabetes Service Implementation Group (DSIGs). Currently there is a DSAG Diabetes
Service Advisory Group in the HSE Dublin North East, however this is being
currently reconstituted to be more geographically representative and its role will be implementing rather than advising as was heretofore.

The rollout of a National Retinopathy screening service as set out in the
National framework for diabetic retinopathy screening will be one of the
immediate priorities. The Retinopathy Sub group is a Dublin North East Sub
Group and is being lead out by Dr. Fatima Hamroush, who has met with all
the Ophthalmologists in North Dublin and are in the process of preparing a
Business case with them for a Dublin North East Retinopathy Screening service.


Does the HSE have any plans to improve or streamline prescription protocols and the communication between hospital consultants, GPs and pharmacists with regard to prescriptions as there is strong anecdotal evidence that people discharged from hospital with prescriptions often have these prescriptions filled in addition to their previous prescriptions resulting in people having large stashes of medication which can be confusing for them and their carers and which in some cases may possibly be contra-indicated and what are the likely cost savings or implications of same?


This is a multifaceted issue that challenges most healthcare systems. In August 2009, the HSE appointed Dr B. White as its first National Director of Clinical Care. This new Directorate is designed to drive clinical governance, quality and risk, national standards and protocols and to provide clinical leadership within the healthcare system. Clinical leads are being appointed within various chronic disease programmes.

These programmes will describe optimum clinical care pathways and protocols. It is anticipated that this work will address some of the issues
raised in this query.

The multi-agency, multi-stakeholder Medication Safety Forum has been
designated by the Department of Health and Children as the Implementation
Body for the medication safety recommendations of the Commission on Patient Safety and Quality Assurance report ‘Building a Culture of Patient Safety’. It is also considering a number of issues identified.