More than 17,000 people from Northern Ireland, Ireland and Scotland have benefited from a cross border healthcare project aimed at assessing and treating higher volumes of patients more effectively through improvements to and modernisation of current service delivery models.
The €10m Cooperation and Working Together (CAWT) Acute Hospital Services Project – ‘Connecting Services, Citizens and Communities’ – which will be concluding in the coming months, was enabled by funding from the EU’s INTERREG VA programme managed by the Special EU Programmes Body, as well as funding from the Departments of Health in Northern Ireland and Ireland and Scottish government support.
This EU funded project has improved access to health service facilities and enhanced care for those people living within the border corridor of Ireland / Northern Ireland and the West Coast of Scotland. It also provided valuable support during the Covid-19 pandemic.
There were a number of elements to the project including the establishment of a cross-border paramedic pilot initiative, in partnership with the three national ambulance services. Seeking to improve access to healthcare in rural regions, the project established four pilot locations in order to provide primary healthcare and preventive services in a home and local community environment, helping to reduce pressure within emergency services and front-line ambulances across the three jurisdictions, particularly in the midst of the pandemic. The enhancement of paramedic services has also been particularly beneficial to older patients with limited mobility, who may have difficulty travelling to a healthcare centre or acute hospital.
The project also sought to inform how key hospital services could be developed to enhance outcomes for patients. Urology and vascular consultants collaborated on a cross border basis in both Northern Ireland and Ireland in the provision of services, enabling outpatient and day case patients to access services closer to where they live. Dermatology services were provided in specific locations within the three project jurisdictions and digital technologies were used to support the assessment and treatment of patients both within and outside of acute hospital settings. In addition, a bespoke educational programme was developed by Scottish nurses to support the standardisation of future dermatology nurse education across all three project areas.
New infrastructure was also created, with the establishment of discharge lounges in Sligo University Hospital, Letterkenny University Hospital and South West Acute Hospital in Enniskillen. The lounges enabled patients to prepare for discharge from hospital in a safe environment, whilst simultaneously supporting staff to create more efficient patient flows, allowing an increased number of patients awaiting bed allocation to be transferred to a ward.
A Clinical Decision Unit (CDU)/Direct Access Unit was established at Daisy Hill Hospital in the Southern Trust area. Conveniently located in Newry, the CDU, during the EU funding phase, was accessible to patients from Armagh and South County Down as well as cross border patients in counties Louth and Monaghan. Fast and efficient access to assessment and diagnostics was facilitated by the CDU via direct referrals from GPs and other health care professionals. This enabled greater efficiency for emergency admissions for those patients with high acuity conditions.
In Ireland, community-based specialist respiratory and cardiology services were provided to patients in local towns and villages throughout Counties Sligo, Leitrim and Donegal. These services resulted in fewer presentations of respiratory/cardiology patients to hospital emergency departments and enabled patients to keep well in their own homes.
An important achievement for the project has been the provision of training to 875 staff in a broad range of areas including paramedicine, mentoring development, patient flow, dermatology specialist practice, leadership etc. This staff skills enhancement will benefit the health services beyond EU funding.
Like any initiative breaking new ground, the CAWT Acute Project dealt with many challenges, not least the Covid-19 pandemic, to deliver valuable additional services to people living in rural border areas. Furthermore, cross border relationships and networks have been created and strengthened which will support future cross border, north/south and all-island activity.
Northern Ireland Minister for Health Robin Swann MLA, said:
“The scale, reach and outcomes of the Acute Hospital Services’ Project are impressive. During its five-year life-cycle three new cross-border pilot frameworks for patients accessing acute services were established. An initial target of 15,000 beneficiaries has also been exceeded with over 17,000 patients in scheduled and unscheduled care pathways benefitting from innovative new healthcare delivery models.
“A significant factor in facilitating the project’s achievements has been the excellent partnership working with colleagues in Ireland and the West of Scotland. Input and support from patients and service users have similarly played a vital role in the project’s success. I look forward to ongoing cooperation with partners through the PEACE PLUS Programme which will enable us to build on the admirable legacy of previous PEACE and INTERREG programmes.”
Minister Swann’s address – https://youtu.be/Ww-iky_XDk8
Ireland Minister for Health Stephen Donnelly TD, commented:
“As the Acute Hospitals Services Project ‘Connecting Services, Citizens and Communities’ concludes, it is good to reflect on how it has adapted cross-border delivery of acute services to
respond to the pandemic. In challenging times this project has highlighted the added value of cross-border working in the delivery of acute services; one example involved providing a new form of community-based healthcare which allowed paramedics to assess patients and provide appropriate treatment there and then. This approach aligns well with our Sláintecare Strategy to deliver the Right Care in the Right Place at the Right Time. Often the right place to provide and receive care is in a community setting. Having benefitted over 17,000 people, this project shows what can be achieved when we work together and support North South co-operation.
“The value of this project is further underlined by the recent, tragic events in Creeslough, Co. Donegal, where the responses by medical staff and institutions both North and South is recognised. I wish to thank all involved.”
Minister Donnelly’s address https://youtu.be/XO7ohRGvcMU
Margaret Whoriskey, Deputy Director – Head of Technology Enabled Care and Digital Innovation, said:
“As we mark the end of the Acute Hospitals Services Project, it’s an opportunity to celebrate its achievements and reiterate the importance of our continuing to work on such valuable initiatives. When the project started we knew we faced similar rurality and accessibility challenges across our nations, but also recognised huge opportunities from the collaboration and learning that the project offered.
‘The project provided new pathways of education and networking opportunities across Scotland and Ireland, and delivered our shared ambition of improving the health of our citizens and empowering them to take more control over their own health and wellbeing. Along with our partners, the Scottish Government recognises the importance of working across borders to share expertise and improve outcomes, demonstrated by our participation in the Acute Hospitals Services Project and ongoing commitment to the Scottish Irish Health Collaboration.”
Dr Whoriskey’s address https://youtu.be/4m8M8maPBiY
Commenting on the project closure, Gina McIntyre, CEO of the Special EU Programmes Body (SEUPB), said:
“Unfortunately on a daily basis we see how borders can impede the delivery of health services for citizens across Northern Ireland, the border counties of Ireland and Western Scotland. At times of emergency a few miles can have such massive impact.
“The Acute Project has proven what a significant difference can be made, when services are able to combine and collaborate across borders. This cross-border collaboration has improved access to healthcare services, and without doubt improved the health of our citizens and saved lives.”