It’s a solution that works from every perspective – treating older people in their own homes for illnesses that ultimately don’t require hospitalisation and helping to curtail the numbers waiting in the Emergency Department in the process.

It is called Pathfinder, the national HSE programme which aims to minimise attendances to the ED for older people – and since the service was launched in Galway a year ago, in June 2023, a total of 476 older patients in the county have avoided unnecessary trips to the ED.

Richard Percy from Corrandulla is one of them – and he was full of praise after his positive experience with the Pathfinder Service.

“I called for an ambulance when I became unwell at home and the Pathfinder team came straight out to me. They did an assessment and after speaking to my GP were able to adjust my medication, which helped immensely,” he said.

“Over the next while I had four follow-up visits form the Pathfinder physios to help me with my recovery. They also referred me to the Community Health Centre in Tuam where I am attending for ongoing care. Pathfinder is a fantastic service,” he added.

Pathfinder is delivered by Advanced Paramedics in the National Ambulance Service and a clinical team of Occupational Therapists and Physiotherapists from Galway University Hospitals. The team respond to 999/112 calls for older people – as in, those over the age of 65.

Clinical Specialist Occupational Therapist Conor Keady explained that there were specific criteria for Pathfinder calls.

“These are patients who are not acutely unwell, but maybe have had a minor fall, reduced mobility, back pain or signs of infection. We also do calls to resolve issues with blocked or dislodged catheters, which would otherwise require treatment at the hospital,” he said.

“When we call to the home, the patient is assessed by both an Advanced Paramedic and Occupational Therapist / Physiotherapist and if it’s safe and appropriate for the older person to be treated at home and recuperate at home then we will support them to achieve that.

“The service covers all of Galway city and county, with the team attending calls as far as Lettermullen in South Connemara and Eyrecourt in the east of the County,” added Conor.

One year after launching the Galway pathfinder team have made 585 home assessments and successfully managed to keep 81% of these patients safe and well at home.

A key element of the Pathfinder service involves co-ordinating with local GPs, community and voluntary services to ensure the patient has access to alternative pathways of care. GPs are particularly important as they provide expert clinical guidance and are best placed to advise on their patient’s history and health.

Dr Charlie Cox is a GP in Newcastle Medical Centre – and he was full of plaudits for the Galway Pathfinder team.

“Our experience of Pathfinder is hugely positive, as is that of our patients. The service provides timely care and assessment to vulnerable patients in a holistic manner and goes above and beyond what is asked. This is the epitome of excellent, patient centred care,” he said.

John Joe Mc Gowan, General Manager Operations – West, National Ambulance Service said that Pathfinder was a proven model which offers safe, alternative care pathways for many older people.

“I’m delighted that NAS, hospital and community services are working so well together in the Galway region. We are seeing very high stay at home rates with Galway Pathfinder where 80% of the patients we have seen did not need to visit ED within seven days of assessment and intervention.”

“For frail older adults, a hospital stay may result in a loss of independence and a need for extra assistance on discharge. If it’s safe and appropriate for these patients to be assessed, treated and supported at home, that is obviously the preferred outcome,” added GUH Hospital Manager Chris Kane.

“The Pathfinder service is a positive example of how integrated working across our health system can support a reduction in ED presentations for this group of patients; helping with patient flow and relieving pressures on bed availability in the hospital,” she said.

Pictured: Richard Percy shares his homemade cake at their home in Corrandulla with Clinical Specialist Physiotherapist Máire Doyle and Clinical Specialist Occupational Therapist Conor Keady.