Providing a ‘safety valve’ in Covid-19 battle

THE Covid-19 community assessment hub has provided an important safety valve in keeping numbers down, Intensive Care beds free and Letterkenny University Hospital from being overwhelmed.

The facility at Kilmacrennan Road was one of the first hubs in the country to open on April 14. Over the past thirty days 165 people have had appointments at the hub.

It’s the busiest centre in CHO region, which covers Sligo, Leitrim, Cavan, Monaghan and Donegal, and fourth busiest in the country. Almost twenty per cent (19pc) have been referred to hospital with the balance of patients managed in the community.


Doctor Paul Armstrong is Clinical Lead at the facility that was established by the HSE to reduce the numbers attending hospitals.

“The hub has been a welcome addition and I think that patient feedback has been positive. Infection control is a high priority for staff and patients who attend the community hub and this has helped us to keep the Covid numbers down in Donegal,” Dr Armstrong said.

The idea behind the service is to offer suspected or confirmed Covid-19 patients the support and reassurance on how to manage their illness at home – or pick up on cases where hospitalisation is needed. Patients who attend the hubs are either asked to return home, to stay at a self-isolation facility if they can’t self-isolate successfully where they live or are sent to an acute hospital.

“The hub is open from 12 noon to 6pm and is staffed by a team of doctors and nurses and care attendants who are seeing anything from four or five up to twelve or thirteen people per day. If the surge comes the capacity is there to see quite a lot more but the numbers are quite manageable at the moment,” Dr Armstrong explained.

All medical staff wear full PPE when seeing patients.

“When you go to the hub you’re seen like you would in any GP practice. Its cuts down on the number of people going unnecessarily to casualty. About twenty per cent, on average, end up being referred to the hospital across the road for further assessment,” he said.

“The hub will see anyone over the age of sixteen years who has been referred by their GP. It’s for someone who’s got a chest infection that their GP is worried about. A lot of people do have other illnesses like COPD, chest problems or diabetes or heart problems– they’re the at risk groups that we were worried about.


“GPs manage a lot of problems over the telephone at the moment but there are some issues that can’t be sorted over the phone and have to been seen face to face and the Covid hub is the safest place to see them and to manage any potential risk of infection,” he added.

The Letterkenny community assessment hub has a clinical staff of eight on duty at any one time. These include two GPs on duty working with two nurses, a care attendant and office staff all seconded from routine work cancelled during the Covid-19 crisis.

“It’s a very safe place for staff to work in and for patient to attend in terms of cross infection. The nurses are doing an excellent job,” he said.

Acknowledging that numbers attending the hub has been quite low so far, Dr Armstrong said that Letterkenny remains the busiest hub in the North West ahead of similar facilities in both Sligo and Monaghan.

“They’re talking about extending the service in case a surge comes and possibly into the early party of the flu season so patients can be managed safely and have a safe place to go,” he said.

In Donegal, where people have difficulty in accessing transport, the Civil Defence has been providing an excellent transport service.

“The initial aims of the hub have been met. It’s helped suppress the illness and reduced demand. It’s kept IC beds and the hospital from being overwhelmed. What we don’t know is whether it will keep coming back until eighty per cent of the population has it of if we’ll have to wait until there is a vaccine. We will probably get more cases as restrictions lift and people starting moving around once again,” Dr Armstrong said.

“It is important people know we are here so people don’t travel to hospital without being seen first,” he added.






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