The Health Service Executive (HSE) is considering the introduction of "hospital at home" teams in response to treatment delays at A&E departments.
Prof Brendan Drumm, HSE chief executive, told The Irish Times the practice of having full medical teams treat patients in their homes was a concept that has worked well in other countries, notably Australia.
Aimed at patients with pneumonia, an exacerbation of chronic respiratory problems or worsening heart failure who would otherwise require admission through an A&E department to receive intravenous drug treatment, the teams would be fully staffed by doctors, nurses and physiotherapists.
"We believe a lot of these people could be dealt with in a 'hospital at home' programme where the GP can actually ask for their care to be taken on by a medical team and by a nursing team who will look after them in their own home," said Prof Drumm.
He indicated that should the programme go ahead it would be provided by the private sector following a tendering process.
"This is an example of where we could work very constructively with the private sector to impact on issues like the use of hospital beds and therefore the problems in A&E."
A separate A&E initiative involving community intervention teams has been operating in Cork for the last two months. Patients who would otherwise have to be admitted to hospital during an acute illness because of a lack of social support are being looked after at home by patient- care attendants, public health nurses and other carers.
"We are talking about nursing, but a lot of it is social support - who cooks your meals, who ensures you take your medication when you live alone.
"As well as Cork, two teams will be up and running in Dublin this winter and one to come in Limerick. GPs . . . have been told that if you have a patient at home call this team and they will take complete control of the situation for you and provide these type of supports."
Prof Drumm said doctors in A&E could also refer patients to the community-intervention teams.
"We have also established a winter initiative project team that will be examining issues right across the health system to ensure that the extra winter demands do not compromise services."
He confirmed that an escalation policy would be in place to meet the demands that peak during the winter.
"During the coming months we will be opening a series of admission lounges to make it significantly more comfortable for people waiting for in-patient beds, and we will be expanding our own community facilities to accommodate people who no longer need acute care."
Prof Drumm, who was appointed HSE chief executive a year ago, acknowledged that there were difficulties with A&E in particular hospitals.
However, he said "the vast majority of people who attend emergency departments get top-class service".
