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Integrated Care Programme for Older Persons (ICPOP)

Service summary

The Integrated Care Programme for Older Persons (ICPOP) is part of Sláintecare’s Enhanced Community Care (ECC) programme. It aims to provide care for older people closer to home, reducing unnecessary hospital admissions and helping people live independently in their own communities.

Check the patient’s area

ICPOP operates across Community Healthcare East (CHO 6) covering Wicklow, Dublin South and Dublin South East. To check the specific location you should refer to, please visit HSE Area Finder

Patients are seen at home or in Integrated Care Hubs located in:

  • Bray
  • Wicklow Town
  • Clonskeagh Hospital Campus

Referral criteria

To qualify for ICPOP services, patients must:

  • Be aged 65 or over
  • Live within the CHO 6 catchment area. Check the HSE Area Finder
  • Have functional decline, mobility issues, or increasing frailty (Rockwood Scale 4–7)
  • Require input from at least two ICPOP team members
  • Have specific, achievable goals for improvement

When not to refer

Referrals are not suitable for:

  • Acute medical illness needing emergency care (EDITH, ED, MAU or LIU)
  • Patients already managed under other specialist pathways
  • Cases requiring only a single discipline (refer through existing Primary Care services instead)

How to refer

Referrals can be made through Healthlink using the National ICPOP Referral Form.

You can also refer via:

  • Public Health Nurses
  • Hospital discharge or frailty teams

Contacts by geographical area

Patient area Team Email
Wicklow Wicklow Integrated Care Team WicklowIntegratedCareTeam@hse.ie
Dublin South East Dublin South East Integrated Care Team Integratedcareteam.dse@hse.ie
Dublin South Dublin South Integrated Care Team ICPOP.dubsouth@hse.ie

What the service provides

ICPOP supports older people (aged 65+) who:

  • Are at risk of hospital admission or readmission, or
  • Need short-term specialist support after a hospital stay, or
  • Are experiencing a decline in mobility, function or frailty.

The service focuses on assessment, optimisation and discharge planning, providing a tailored care plan for each patient through a multidisciplinary team (MDT) approach.

Benefits for patients

  • Specialist assessment and treatment by a consultant-led team.
  • Coordinated care across hospital and community services.
  • Reduced hospital stays and smoother recovery at home.
  • Support for independence, mobility and wellbeing.

The ICPOP Team

Each patient is supported by a specialist multidisciplinary team, which may include:

  • Consultant Geriatrician
  • Advanced Nurse Practitioner (ANP)
  • Clinical Nurse Specialists
  • Senior Physiotherapist
  • Senior Occupational Therapist
  • Dietitian
  • Speech and Language Therapist
  • Social Work support

Dementia Support

While diagnosis is managed through Memory Assessment Services (MAS), ICPOP supports older people who have or are developing cognitive decline as part of a broader functional care plan.

Younger onset or complex cases should be referred to Regional Memory Assessment Services (RMAS)

Further information

For GPs