IrSPEN calls on Joint Oireachtas Committee
on Future healthcare to commit more resources to tackling nutritional problems
The Oireachtas Committee on the Future of Healthcare, chaired by Former Former Minister of State for Primary Care Róisín Shortall, has been set up to achieve cross-party consensus on a 10-year strategy for healthcare and health policy in Ireland, and to make recommendations on a changed model of healthcare.
In response to its call for submissions to address questions such as ‘ What are the key priorities for inclusion in a 10-year plan for the health service?’, and , ‘What actions are needed to plan for, and take account of, future demographic pressures (population growth, ageing population), and their impact on the health system?’, IrSPEN called for greater resourcing of services and interventions aimed at prevention and more effective treatment of undernutrition on the one hand, and complex and severe obesity on the other.
In its four part submission, IrSPEN highlighted the lack of community nutrition services aimed at prevention of malnutrition and the impact this has on scarce acute resources. It also highlighted the inadequate support services for patients that are discharged from hospital on home enteral nutrition, contrary to the principle of supporting patient self management. IrSPEN also urged immediate action to address the lack of any specialist unit in the country to manage patients with intestinal failure, contrary to all international recommendations and practice, contrasting our situation with that of Northern Ireland which has a 12 bedded unit. IrSPEN estimates that this is costing as many as 20 lives each year. It also leaves children awaiting transition from the intestinal failure specialist unit at Our Lady’s Children’s Hospital at Crumlin with no service that meets their needs, once they reach 18 years of age. (See presentation from 2015 conference and related news items here).
Last but not least, Ireland lags behind other countries in having almost no access for suitable patients to bariatric surgery. Evidence shows surgical intervention to be by far the most clinically and cost effective solution for certain patient types, offering return on investment of 2 – 3 years. In Ireland, access to bariatric surgery is less than 0.1% of the demand based on criteria established by NICE / cost effectiveness data.
Key recommendations by IrSPEN to the committee include:
- The establishment of a national malnutrition steering group or task force to develop / oversee the implementation of a national strategy to tackle malnutrition within an integrated care model.
- Appropriate resourcing of community nutrition services and support services for patients receiving home enteral nutrition across Ireland.
- Funding allocation and support for the immediate establishment of a national specialist service for adults with intestinal failure in Ireland, for which a business plan has been submitted to the HSE with the support of IrSPEN.
- As part of an overall national obesity strategy, the establishment of a public bariatric programme to allow access for 400 public patients with severe and complex obesity* in year 1, rising to at least 1000 by year ten (2026). (Subject to specific criteria)
Read full submission here