Chronic Disease Programmes

1. What and how many chronic disease programmes have commenced in the
HSE DNE so far this year and in what settings?
There are several programmes for Chronic Diseases included in the list
of National Clinical Care Chronic Disease Programmes listed for
commencement of implementation in 2011 namely COPD, Heart Failure,
Diabetes Footcare, Asthma and Stroke.

Full details of selected acute sites is available on the following link;
Also in the community setting several Pilot sites are in place in the
DNE Region:
For Diabetes Care -3 Sites – Meath (2) and Louth(1).
For Asthma Care – 2 Sites – Meath (1) and Dublin North Central(DNC)(1).
Early Discharge for Stroke is currently being progressed from
hospitals to primary care and a pilot programme is underway involving
the Mater Hospital the Dublin North Central Local Health Office Area.

2. What resources and staff have been assigned to the programmes?
Resources were assigned to the Chronic Disease programmes as per the
HSE National Service Plan 2011 (Appendices 2b and 2c)
Also Project Managers have been assigned nationally to each programme.
New clinical posts have been processed/ advertised by the HSE National
recruitment service for statutory hospitals and by individual
voluntary hospitals as per normal processes.

3. Are any more programmes expected to commence before the end of the year?
No, only Chronic disease programmes listed in the 2011 National
Service Plan will commence this year.
4. How are the programmes progressing and how are they helping patients?
The programmes are progressing well in the acute setting and have the
full support of management and staff.
Each programme has key deliverables identified under the headings of
Quality, Access and Cost and details are available by selecting the
particular chronic disease on the following link;
Central to the process for Chronic Disease Management in the community
is the formation of Primary Care Teams (PCTs) and Health and Social
Care Networks (HSCN) as this structure provides a coordinated
multidisciplinary approach. There were 53 PCTs established during
2010, totalling 79 PCTs in place in the Dublin North East Region at
the end of 2011. The remaining 38 PCTs for the region will be
developed by the end of 2011. This will benefit all clients requiring
a multidisciplinary response through the provision of an Agreed
Multidisciplinary Care Plan.

5. What chronic disease programmes are expected to commence next year?
The details of additional chronic disease programmes for
implementation in 2012, will be provided in the 2012 National Service
Plan in due course.