“Reduced” palliative care services for new patients in the North East


Palliative care services have been “cut back” for new patients in four counties in the northeast of the country, to cope with a large backlog of referrals accumulated due to the absence of Covid-19 staff.

The Health Service Executive (HSE) said the decision would affect services in Louth, Meath, Cavan and Monaghan.

Health officials have written to general practitioners in affected counties in recent days, saying the HSE would be “unable to respond” to any new patient referred for specialized palliative care.

The correspondence said the decision followed an “unprecedented” increase in referrals from general practitioners, alongside an “increase” in referrals from hospitals as well.

The letter said the increase in referrals from hospitals was “likely as they try to discharge patients in preparation for the fifth wave of Covid-19.”

“Considering the volume of referrals at this time, combined with the staff who are self-isolating due to Covid-19, I regret to inform you that we will not be able to respond to any new referrals with effect. immediate, until our backlog is dealt with, “the letter said.

HSE correspondence indicated that if family physicians had an “urgent” case, they should contact a palliative medicine consultant.

Dr Ilona Duffy, medical director of the out-of-hours general practice at North East Doc, said the pause in referrals was “shocking”.

The service was intended for patients who had reached the “dying phase of their life in the community,” who wanted to stay at home and “die comfortably and easily,” she said.

The impact of Covid-19-related absences, as staff were infected with the virus or self-isolating as close contacts, had shown the weaknesses of the system, which was “understaffed and understaffed ”She told RTÉ News at One.

The ‘premise’ of community-based palliative services “meant that people did not have to die in hospital like they did many years ago,” she said.

“You can die anywhere, but it’s about dying comfortably and knowing that all of your symptoms will be managed and treated, so shortness of breath, pain, anxiety, all of those things; not only for the patient himself, but also for the relatives who watch him, ”she said.

Reducing specialist support around Christmas time would mean patients would either be more likely to stay and die in hospital or die at home “without their symptoms being fully controlled and fully managed.” , she said.

In a statement, an HSE spokesperson said palliative care services had been ‘cut back for new patients’, due to a high number of referrals in the past 10 days and the impact of Covid -19 on staffing levels.

Palliative medicine consultant Professor Dominic Ó Brannagáin said the service had received “more than a month of referrals over the past week”, with a number of staff isolating themselves at the same time. time.

“But there is nothing to indicate that we do not provide a palliative care service and I would like to reassure the patients that we continue to operate,” he said.

“We will continue to provide palliative care in the community to existing service users and we will prioritize these over new patients,” he said.

If new patients needed to be seen urgently, GPs could contact their relevant on-call hospital consultant to discuss the case, he said.

“We ask our fellow general practitioners not to refer new patients without first contacting the service consultant,” he said.


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