Health Matters Autumn 2022 by Ashville Media Group

STAFF MAGAZINE OF THE IRISH HEALTH SERVICE MATTERS YOUR BEST SHOT Get the flu vaccine this autumn

6 Tallaght to host second Health Hackathon

Mum-of-two Emma Doyle speaks to us about her brush with death, experiencing a sudden cardiac arrest as she sat feeding her newborn son George at her home two years ago.

6 St Luke’s launches first strategy

This year, an amazing 720 volunteers co-ordinated 4,373 participants during the five week programme and, like previous years, it was challenging for some to walk together, due to remote working. Despite the challenges most of our team co-ordinators found their task motivating, fun and would do it again. One of those determined participants shares her experience of the challenge with us.

Joanne Weston Editor

38 Class of 2022 show strength in face of adversity

A MESSAGE FROM

Welcome to the latest edition of Health Matters. In this edition, we speak to outgoing CEO Paul Reid as he shares his highlights and low points of an unprecedented three years at the helm of the HSE. Not long after we first spoke to Paul Reid in 2019 -as he settling into his new role, the health service was hit by the global pandemic, putting all regular business on the back burner.

4 CEO bids farewell to staff

10 Steps to Health Challenge Initiative supports communication between parents and babies Tallaght team are the winners Young mum Emma owes her life to first responders Breaking barriers with Rainbow Badge

2 Get your flu vaccine

38 Job experience programme

Framework

6 Innovative blood pressure procedure

40 ‘You Never Know’ who is at risk of COVID-19 NUIG and HSE collaboration Trust and Confidence Cancer therapy programme Meitheal programme for palliative care Midwifery updates Better together for digital health Interprofessional education key to preparing students

1 Award for NAS

39 Mater wellness programme for critical care staff

7 Minister visits CAMHS facilities

Meanwhile, as we move into the autumn and winter months, we are reminded that it is more important than ever that healthcare workers get the flu vaccine to protect themselves and others from flu this autumn.

9 Multilingual videos make healthcare accessible

CONTENTS

35 Nurse-led clinics improve care Azure programme uses art to help those with dementia Smart pump piloted in Mayo New replacement orthopaedic theatres

55 Three new cancer units to be opened Spark Summit Individual Health Identifiers Patient safety: learning, sharing and improving together World Patient Safety Day Patient Improvement Programme AMRIC launches Competency for infection control New clinical guidelines Preferred Drugs Initiative Data protection HR recruitment improvement Better with NEIS Benefits of My HSE Self Service Sustainability in Limerick New e-learning modules for Making Every Contact Count Healthy Communities Healthier Food Environment Mayo Mental Health Association information centre Men’s Health Week Short film highlights resilience of young Travellers

The annual Steps to Health challenge continues to promote workplace physical activity, getting us up and out to meet those steps goals.

Three years later, he is leaving the HSE and delivered a message of thanks to staff, saying that meeting healthcare workers around the country in their workplaces has been the most rewarding thing from his three years in charge.

15 HSE staff show their Pride Residents hail winning chef Nora St Joseph’s is nursing home of the year Values in Action HSE donates life-saving equipment to Ukraine Diversity in the ambulance service Enhanced Community Care launches HSE Communications teams win top awards Annual Report and Financial Statements HSE and the Art of Being Healthy End-of-life clinical care recommendations for diabetic patients New biochemistry lab equipment leads to faster turnaround New programme for people with Type 1 diabetes Ground-breaking app for chronic pancreatitis sufferers ANP in Paediatric Diabetes appointed Diabetes centre at Sligo unveiled Lympodema Regional Hub for Women’s Health in Nenagh Virtual vascular clinic in primary care

OUR EDITOR

48 Smoking still major cause of death UL Hospital Quit service Environmental service expansion at Port Vaccine updates Assisted Decision-Making Social prescribing Early Diagnosis of Cancer e-learning programme

8 Infection control manual launched Taoiseach opens 60-bed extension

We should do everything we can to prevent the double burden of both flu and COVID-19 on our health services. This means getting both your flu and COVID-19 vaccine.

9 UL Hospital performs well in survey

I hope you enjoy the stories and updates from your colleagues around the country and thanks to all who have contributed their initiatives and efforts.

The fact that Emma is still happy and healthy and with her family today is thanks to the first responders from the National Ambulance Service, which has just launched a new nationwide campaign for additional volunteer Community First Responders to support the work of the Emergency Services in local communities.

7 Dementia social club reopens Fishing Futures in Wicklow

NATIONAL AMBULANCE SERVICE EARNS TOP AWARD FOR DISPATCH EXCELLENCE

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Internal

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IAED is the standard-setting organisation for emergency dispatch services worldwide. Accreditation (and subsequent re-accreditation) from the IAED is the highest distinction given to emergency communication centres, certifying that the centre is performing at the established standards for the health sector.

Pictured with the Award for Dispatch Excellence are members of the National Emergency Operations Centre, Quality Improvement Unit: Patrick O’Brien, Control Manager; Philip Robinson and Aoife Nugent, Quality Improvement Auditors; and Paul Cryan, Manager for Audit and Accreditation.

THEMEETTEAMHSE

he HSE National Ambulance Service has been recognised by The International Academies of Emergency Dispatch (IAED) as an Accredited Center of Excellence (ACE) for emergency dispatching.

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All rights reserved. Every care has been taken to ensure that the information contained in this magazine is accurate. The publishers cannot, however, accept responsibility for errors or omissions. Reproduction by any means in whole or in part without the permission of the publisher is prohibited. © Ashville Media Group 2022.

The call taking/dispatch function is operated by the National Ambulance Service National Emergency Operations Centre (NEOC) which operates across two sites, Dublin and Ballyshannon. NEOC utilises Advanced Medical Priority Dispatch System (AMPDS) using international standards in triaging and prioritising emergency calls. NEOC dynamically deploys resources to areas where cover is required or to respond to incidents as they arise to ensure the nearest available resource responds to emergencies. All 112/999 calls are clinically triaged based on the patient’s condition. The nearest available and most appropriate response is dispatched, with the most urgent calls prioritised.

Tel: (01) 432 2200

“The National Ambulance Service is delighted to have been recognised by IAED as an Accredited Center of Excellence for emergency dispatching. This recognition demonstrates the high standards to which our service operates and is a testament to the hard work and dedication shown by our staff as we strive to provide a caring and professional service to the public at times of need,” said Robert Morton, Director of the HSE National Ambulance Service.

MediaAshvilleGroup

Ann

Head of Internal Communications Emma Finn

Editor Joanne Weston Art Director Áine Duffy Creative Director Jane Matthews

Kim Rigden, Associate Director of Accreditation, IAED explained, “This process is undertaken by communications centers who desire to be the best of the best. Achieving ACE confirms it. The National Ambulance Service should be very proud of this achievement and the wonderful service they provide to the community and their emergency responders.”

ISSN: 0332-4400

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The IAED said centres that earn ACE status are the embodiment of dispatch done right, and have demonstrated strong local oversight, rigorous quality processes, and a commitment to data-driven continuous improvement.

Communications Team

IAED will present the National Ambulance Service with an Accreditation plaque that commemorates their achievement. IAED Accreditation is the culmination of a lengthy, arduous process that includes the completion of the 20 Points of Accreditation, a detailed evaluation of performance by industry experts, and a final review and ruling by IAED.

“Healthcare workers are 10 times more likely to get the flu. This year, we should continue practicing hand hygiene, cough etiquette and do everything we can to prevent the spread of flu. If you work in healthcare that also means getting the flu vaccine.”

“The flu vaccine gives you protection and may also protect people around you,” she said.

“Flu occurs most years during autumn and winter. But it is not possible to know whether there will be a mild or a severe season in each year.

“Flu is a very infectious and unpredictable virus. It can have serious and sometimes life threatening consequences for those who get it,” said Dr Keegan.

t is more important than ever that healthcare workers get the flu vaccine to protect themselves and others from flu this autumn, says Dr Aparna Keegan, Specialist in Public Health Medicine at the HSE National Immunisation Office.

2 |

FLU CAN BE SERIOUS AND UNPREDICTABLE

Most people with flu are sick for 5 to 7 days with a high temperature, sore throat, muscle pains, fatigue and headache. But some people won’t develop symptoms and can then spread it to other people, like vulnerable patients, or their own families, without knowing they have it.

Get the flu vaccine to protect yourself and others this flu season

YOURBESTSHOTthisautumn

HEALTH MATTERS AUTUMN 2022

FLU AND COVID-19

LEARN MORE

“The flu vaccine is your best shot to protect yourself and those around you this autumn.”

“In the last 10 years, almost 5,000 children were admitted to hospital with complications of flu. If your child has had the flu vaccine and they come into contact with the flu virus, the vaccine stop them from getting sick. If enough children are vaccinated fewer people will need treatment in hospital. This is very important for our health services,” said Dr Keegan.

If you are due a COVID-19 vaccine at the same time as your flu vaccine, it has been deemed safe to receive both together if offered by your vaccination site.

It may be difficult to tell the symptoms of flu apart from COVID-19. Flu and COVID-19 can both cause serious illness. The flu vaccine does not protect against COVID-19 because they are caused by different viruses.

MIDDLE: Martina Queally, Chief Officer, Community Healthcare East (on the left) and Aisling Heffernan Head of Service Health and Wellbeing, Community Healthcare East (on the right).

“If you had the COVID-19 vaccine, you should still get the flu vaccine. We should do everything we can to prevent the double burden of both flu and COVID-19 on our health services. This means getting both your flu and COVID-19 vaccine”.

TOP LEFT: L:R - Mary Mahon, DON; Carmel Lawlor, Cait Murphy and Marie Sinclair, vaccinators and Maura O’Connell ADON.

Vaccinating children against flu protects them, and the people they come into contact with, like their siblings, parents or grandparents. It comes in the form of a nasal spray and is available at your GP or pharmacist.

WHO SHOULD GET THE FREE FLU VACCINE?

| 3HEALTH MATTERS AUTUMN 2022

There are e-learning modules available on HSeLanD. We would encourage everyone to complete them to get the facts about why it’s important to get the flu vaccine. Visit hse.ie/flu in early October to find out where you can get vaccinated.

“Getting your free flu vaccine will stop you from getting very sick if you come in contact with the flu virus. This is particularly important for young children who are more likely than adults to get severe complications of flu, like pneumonia.”

This flu season, two vaccines will be offered: the nasal flu vaccine for children and the flu vaccine for all other at risk groups, including those aged 65 and over, healthcare workers, those who are pregnant and those who have certain long term medical conditions. Visit hse.ie/flu for a full list of those recommended to get the free flu vaccine.

BELOW: Martina Queally, Chief Officer, Community Healthcare East receiving her vaccine last year.

When he took on the role of CEO in 2019, he said it was an organisation ‘at“It’swar’.no criticism of the previous leadership but we were at war with the Government, with the Minister, with stakeholders, with the trade unions, with our sta . I knew I had to invest a lot of my personal time in building back up that trust. I think I can honestly look back and say we brought that all to a much better place through the response of sta , not just through my actions, particularly through the response of sta to build that trust and conﬁdence with government and our stakeholders. It was one of the top three objectives of the board and was one I gave a lot of personal attention to,” he noted.

“I have been pushing myself every day not to go home and sit down but do at least one activity like a walk through the local park or some gardening."

“There were so many positives – how we built the trust and conﬁdence of the public and became a trusted source; how we won the support of the key stakeholders the government and all the other government agencies; how we responded by any benchmark to any country of mitigating the impacts of COVID through mortality, through illness, our ICU, we benchmarked really well against other countries and our vaccination programme too. There’s so much that the health service can and should be proud of. Also the way we galvanised and worked across acutes and communities.”

CEO Paul Reid reflects on an extraordinary three-and-a-half years leading the HSE

HEALTH MATTERS AUTUMN 20224 |

“That was a tough time, talking to many of the families that lost loved ones and that will always stay with me. It is something I will never forget, particularly because families wanted to relate to me how much they loved the health service, how much they wanted to go to work during COVID. That was the ultimate sacriﬁce that they made. That stands out probably above everything,” he said.

He said there are several things that will live long in his memory from his time in the HSE.

“Meeting sta has deﬁnitely been the most inspiring part of my career. I get great energy from what I see happening around the country. It’s where I get my inspirationgoing in on site with no big plans, just meeting sta , walking the ﬂoors, walking around the services, meeting patients, meeting people who use their services. I'll miss that. Nothing you can get from any job you could ever do can be greater than making people's lives better. It will never be matched,” he explained.

The COVID-19 pandemic and the cyber-attack may have changed many of his original plans for the health service but, through his regular visits around the country, he succeeded in building a connection with sta that played no small part in restoring trust and conﬁdence in the health service.

It is di cult to imagine a tougher set of circumstances than COVID-19 and the cyber-attack on the HSE to deal with during his tenure but Paul insisted that there were more positives than negatives.

“Some things were memorable for positive reasons and some were memorable for not so positive reasons. The hardest part was losing sta through COVID, people getting sick and dying through giving their service to the health service.

“People have said to me that they now know what they are doing made a di erence. That is the classic connection you want to make as a leader. People know what they do, they aren't doing it remotely, they're doing it connected to the wider organisation. Ultimately, from a public perspective, we have data that the public trust and conﬁdence has increased over the past three years and that is important.”

MEWITH‘MEETINGSTAFFHASMADEABETTERPERSON’

“Another memorable thing certainly was the cyber-attack. We had been through a really tough time and we were just getting better after COVID. May 13th Thursday - I always remember it. I got a call at 2 o’clock

“I'd also like to think I brought a bit of order, a bit of organisation, a bit of clarity, a good sense of direction of where we're trying to get to, what our line of ﬂight is. It is not just our strategy but where are we trying to get to and what the steps are to getting there. Going back to the stakeholders, we've brought them to a much better place. We've become a trusted partner of Government too.”

aul Reid was adamant when he took up the role of HSE CEO back in 2019 that meeting frontline sta was one of his main priorities.

“We briefed around what was going to be needed and certainly that time stands out for me as we felt we had the whole of government, the whole state behind us. It felt like a big responsibility but we felt we had a big weight off our shoulders with the support behind us. That gave us confidence going into it that we had the full weight of the government behind us,” he said.

“She'll be three and we'll be there for her birthday for the first time ever. My daughter and her husband are coming as well so it's the first time we've had all the family together. It will be lovely. We will probably do some other travel, take stock during that time. I'm still young enough and I will do more but I have nothing in the pipeline, no hidden announcements,” he said.

“Certainly what worked for me were family and friends. They were

“You need to show them that you have a road map, that this is what we have to do. You have to give people light, you have to give people a vision and confidence that you know your way out of this even if you are taking it day by day.”

The outgoing CEO said that it was vital for the future of the health service that stakeholders are continued to be valued.

“That will be key because if you lose your stakeholders, you're back again in a frenzy and people are throwing rocks at each other. There are no winners there, certainly patients don't win out. If there's one thing that we learned during COVID is that operating as one big health system, and I don't just mean the HSE, is vital. If you look at what that did to build that trust and confidence, it made a huge impact.

“We worked with General Practitioners, we worked with pharmacies, we worked voluntary and statutory organisations, with Section 38 and Section 39 groups, we worked with private hospitals. People experienced a much more coherent health service. That is one thing to be built on. If you unravel all of that, it's very difficult to put Humpty Dumpty back together again. It's not perfect but it's in a much better place.”

Despite the stress of leading during COVID-19 and then the cyber-attack, Paul said he never felt like he wanted to walk away.

In a closing message to HSE staff, he said, “I want to thank them. I actually think they have made me a better person which is no mean feat in itself. It is the best compliment I can give them. I think differently now, your value system is recalibrated based on what you've seen in the health service. I feel better for it and I hope they do too.”

He credited his family and friends for helping to switch off on the rare breaks from the relentless work of managing the organisation through the“Therepandemic.were

times that all of us in leadership across the organisation did it the wrong way. We worked throughout the night, we stayed here in the office once or twice as we were negotiating with China for PPE. They were on different time zones so you worked all through the day and all through the night and straight back to the next day. It's not good for you, it's not good for your own welfare but when you're in it, you're in it. It's very hard to say no,” he said.

“During the tough times, we all had to show resilience that we didn’t think that we had. During the worst of it all that’s just what you do, you dig deep. You know the responsibility that you have. You have to keep reinforcing for staff ‘here is a way out of this, this is what we have to do, it’s going to be tough’ whether it was COVID or the cyber-attack.

On the positive front, he said one stand-out moment was during the early stages of COVID when he was briefing Government, the Taoiseach, the CEOs of the major government agencies.

a really good sounding board, telling you when you didn't look well, that you need to take some time get your act together, what are you at, or you're driving too much, taking too much risk. That was good but equally I have a grandchild in the US. I've always said that 15 minutes on a FaceTime call with her for me during that kept me going for two weeks. It was just brilliant, I have a good social network of friends and they keep me grounded. You just have to stay grounded, don't get lost in what you’re doing, just keep focused on who this is about. I had to remember that this is not about the HSE, this is about the public, the patients, the people who use the services. Keep yourself grounded about why you're here.” He said that visiting his granddaughter in Austin, Texas will be the first thing on his list after he bids the HSE farewell in October.

in the morning to say we had a cyber-attack. I come from a technology background so I knew how bad it was, I knew what we had to do and I knew the impacts that we were facing. It really was a body blow. It was 2 o’clock in the morning. I was briefing the chairman at 6am. I was on the Claire Byrne Show on RTE Radio at 10 o’clock so we were definitely on it in terms of communications. They are two that stand out for very different reasons and for not so positive reasons.”

“But the main positive for me was response of staff through COVID and through the cyber-attack. That is something that is remarkable, something that you would never see in many organisations for such a relentless period of time.”

| 5HEALTH MATTERS AUTUMN 2022

“Certainly what worked for me were family and friends. They were a really good sounding board, telling you when you didn't look well, that you need to take some time get your act together, what are you at, or you're driving too much, taking too much risk.

PRESSUREUNCONTROLLEDADDRESSBLOODINTRODUCED

St Luke’s Radiation On cology Network (SLRON) has launched its first five-year strategy. The document identifies three pillars of optimised can cer care, all underpinned by the patient experience.

Galway University Hospitals (GUH) is the first hospital in the country to introduce a new minimally invasive day case procedure to reduce blood pressure in patients. This means that patients arrive in the hospital in the morning, have the procedure and are able to return home the same day.

TALLAGHT UNIVERSITY HOSPITAL AND TU DUBLIN TO HOST SECOND INNOVATIVE HEALTH HACKATHON

Professor Clare Faul, SLRON’s Clinical Director said, “Having introduced modern techniques such as intensity-modulated radiation therapy, stereotactic body radiation therapy and image-guided radiation therapy, SLRON has ambitious plans for further development. Our new strategy sets out how we will expand our clinical trials and research partnerships with leading national cancer bodies, as we introduce the latest technologies to ensure our patients receive the best quality cancer care.”

Consultant Cardiologist Prof Faisal Sharif who has introduced a day case procedure to address uncontrolled blood pressure at Galway University Hospitals.

“Renalattack.artery denervation is now being carried out as a day case procedure. This has huge benefits for the patients in terms of reduced disruption to their lives, recovery at home and we are not dependent on the availability of beds for an overnight stay which can be a challenge with the current demands on inpatient care.”

Professor Risteard O’Laoide, Director of National Cancer Control Programme, addressing the launch, said, "The National Cancer Control Programme welcomes the development of the first ever St Luke’s Radiation Oncology Network (SLRON) Strategy. We look forward to continuing our strong working relationship with SLRON, on the delivery of the National Cancer Strategy and the further development of radiotherapy services in the St Luke’s Network."

The three pillars include a pledge from SLRON that their staff will be the finest cancer workforce. There are also commitments to engage in further research and introduce new technologies as well as key strategic partnerships with other specialist agencies, to continually improve care for patients. SLRON is dedicated to being a leader in cancer treatment, patient care, research and education.

INNOVATIVE DAY CASE PROCEDURE TO

“Approximately 35% of the adult population in Ireland have hypertension and around one third of these patients are taking medication but their blood pressure is still uncontrolled. If we are able to control blood pressure we are able to reduce the risk of debilitating side effects. Even a small reduction in blood pressure can lead to a significant reduction of the risk of stroke or heart

In 2011 SLRON expanded its services and opened two new centres on the campus of Beaumont Hospital and St James’s Hospital. In 2015 SLRON was the first public radiation oncology facility in Ireland to introduce SABR (Stereotactic Ablative Radiotherapy), an innovative new therapy that focuses a very intense dose of radiation on cancer tumours, with greater accuracy. Typically SABR patients can complete their radiotherapy in one to five days, much quicker than normal.

St itsNetworkOncologyRadiationLuke’slaunchesfirststrategy

Caption: Professor Risteard O’Laoide, Director of National Cancer Control Programme; Professor Clare Faul, SLRON’s Clinical Director; Trevor O‘Callaghan, CEO of the Dublin Midland Hospital Group.

From left to right at the announcement of the 2nd Hackathon were David Wall, Chief Information Officer, TUH; Lucy Nugent, Chief Executive, TUH; Dr. Barry Feeney, Head of Computing, TU Dublin; Joanne Reynolds, Community Engagement Officer, AWS and Thomas Stone, Vice President for Partnerships at TU Dublin.

Prof Faisal Sharif, Consultant Cardiologist at GUH said, “We are probably the only hospital anywhere carrying out this procedure as a day case. Certainly we are the only hospital in the world carrying out the procedure, which is called renal artery denervation, using a product manufactured by Medtronic here in“WeGalway.areusing renal artery denervation to help patients with high uncontrolled blood pressure or hypertension which is a major risk factor for stroke, heart attack, vascular disease and chronic kidney disease.

HEALTH MATTERS AUTUMN 20226 |

Dementia social club reopens after COVID break

Please do not hesitate to contact 089-4936982 for any club queries. Alternatively email limerickdementiasc@gmail.com

Minister Butler was briefed on the ongoing work of the CAMHS team based in Arden House. Services are being provided every day at the facility for scores of children and their families, including the ongoing carrying out of multi-disciplinary assessments – in relation to which there is no waiting list for such GP referrals.

The minister spent time discussing the work of the CAMHS team at Arden House, which features a Consultant Child and Adolescent Psychiatrist, NCHDs (Junior Doctors), Psychologists, Clinical Nurse Specialists, Social

Tallaght University Hospital (TUH) and TU Dublin have announced the second health hackathon will take place September 30th and October 1st this year. This will be the second Hackathon run by the organisations with the support of Amazon Web Services.

Taking place over two days, the health hackathon brings together healthcare professionals from TUH and students from across TU Dublin with the aim of developing innovative solutions to real life healthcare challenges.DavidWall, Chief Information Officer at TUH, said, “Our recent experience with

The Limerick Dementia Social Club plans to resume its monthly activities from September 2022. It opened its doors in November 2018 to persons with dementia and their carers across Limerick. Membership is open to all with a diagnosis of or suspected dementia. It is led by Garda vetted volunteers with a background in health and social care who have a specific interest in Dementia care. The club proved to be very beneficial and was very well attended. Unfortunately, COVID-19 enforced an untimely temporary closure to the Heldclub.onthe first Wednesday of every

COVID further demanded a lot of innovation to ensure the continuing delivery of healthcare during extremely challenging times. There were solutions developed quickly to solve challenges our clinicians were facing. This has left both a greater appreciation and demand for technology and how it can help in the delivery of healthcare. This event could well lead to technology breakthroughs in healthcare for patients as our medical professionals work alongside students and leaders in digital technology.” Clinicians will set out the challenges at 5pm on Friday, September 30th and answer any

Since moving to Arden House in May 2020 and with the welfare of clients and their families in mind, the facility’s modern surrounds have been more conducive to the specialist work CAMHS staff engage in.

month from 6.30pm to 8.30pm in Our Lady of Lourdes Community Centre, Rosbrien, Limerick, the club aims to provide a dementia-friendly space for persons with Dementia and their carers/ family members. The club aspires to reduce stigma and social isolation. It promotes open discussion, interactive fun activities, acceptance and new learning. Studies have shown supports like this relieve carer strain and support people to continue living well with Dementia in the community.Noreferral is necessary, and people can attend on any club night as they wish. In the first hour informative talks and presentations are given by guest speakers and therapists. Dementia related information is shared by guests

Among the initiatives within the CAMHS services in Wexford of late has been a two

Workers, Occupational Therapists, Speech and Language Therapists and administrative support. Arrangements are also in place for emergency weekend Psychiatry cover for the services in Wexford.

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day song writing workshop for young people. Organised in conjunction with Music Generations Wexford (as part of Ireland’s National Performance Music Education programme), the project was nationally initiated by Music Network and co-funded by U2, the Ireland Funds and the Department of Education and Skills. Locally, the programme is co-funded by the Waterford and Wexford Education and Training Board (ETB) and Wexford County Council.

MINISTER OF STATE FOR MENTAL HEALTH VISITS CAMHS FACILITIES IN WEXFORD

with an understanding and experience of Dementia care. In the second hour, attendees enjoy social activities such as singing, dancing, card games, arts and crafts, raffles, peer support and conversation. Ideas for activities come from the feedback and suggestions of attendees.Clubattendance is free to all. The Limerick Dementia Social Club psychosocial activities are an ideal form of social prescribing that has proven benefits for Persons with Dementia and their carers. They look forward to welcoming previous members back and also meeting new members.

The HSE/South East Community Healthcare’s South Wexford Child and Adolescent Mental Health (CAMHS) team were pleased to welcome Minister of State at the Dept. of Health with responsibility for Mental Health Mary Butler TD to their facilities at Arden House, Whitemills, Wexford.

questions the participating teams may have. The Hackathon will conclude on Saturday October 1st with a presentation of the shortlisted finalists at the TU Dublin Tallaght Campus.Commenting on the event Lucy Nugent, Chief Executive of TUH, said, “I am looking forward to the innovative solutions proposed to solve very real world challenges we face here in the Hospital every day. The ultimate aim for the solutions proposed is to continue with their development, test and ultimately use them for the benefit of our patients and their healthcare.”

• The project is supported by Community Healthcare East Mental Health Services. It also owes a huge debt to Wicklow Travellers Group CLG (WTG) which has provided ﬁnancial governance and storage for the substantial amounts of angling equipment, as well as rooms for activity and planning meetings.

In late June, Fishing Futures hosted a group of men from the Loughlinstown, Ballybrack and Shanganagh (LBS) Men’s Shed project. The group were given a four-hour introduction session to beach ﬁshing on the Murrough beach in Wicklow town. The novice anglers learned how to set up gear, bait hooks and cast lines. They even had some beginners luck with seven dogﬁsh and four sand-dabs being caught by the group! The local Community Gardaí supported the day by providing transport and a NowBBQ.inits fourteenth year of operation, Fishing Futures is a volunteer project led by both the settled and Traveller community.

To ﬁnd out more about the Fishing Futures project contact Peter.Oreilly2@ hse.ie or IanandSheilaDaly@gmail.com.

This document can be accessed online at http://hdl.handle.net/10147/631787

The main objectives of the project are to promote ﬁshing as a healthy social and leisure choice by:

• Teaching angling skills and techniques (awareness of sea and variety of fish and habitats, trace-making, collection of various baits for fishing venues, casting reeling and catching fish cooking of fish).

• Providing onsite coaching and supervision during angling events.

The manual was developed by HSE Community Operations and IPC Nursing Teams. The NIPCM provides Community Health & Social care services with an easy to use manual to guide IPC practices within their facility or services. It will be beneﬁcial to the management of IPC within various healthcare settings in the community and will be a great resource for all trained IPC Link Practitioners.

Where can we get hand rub posters? How often should a piece of equipment be cleaned or disinfected? How do I manage a service user with MRSA in the dressing clinic? Just some of the queries that have come to the IPC team at CHW. With access and reference to this user friendly easy read manual, services will be provided with the information to guide practice, access resources such as links to posters and form the basis for risk assessment by reference.

The team work together to provide an angling experience to groups and individuals, particularly to those who are marginalised or from di erent ethnic backgrounds. O ering angling as a social and leisure activity not only helps to promote a healthy lifestyle, but it also facilitates social interaction between di erent groups. This helps build conﬁdence and friendships among various groups, thereby avoiding marginalisation of members.

• Providing all necessary equipment to ﬁsh (rods reels’ line weather proof clothing lamps buddies).

The Infection Prevention and Control (IPC) team, Community Healthcare West (CHW) were delighted to launch the National Infection Prevention and Control Manual (NIPCM) – A practical guide to implementing Standard and Transmission Based Precautions in Community Health and Social Care Settings in Galway, Mayo and Roscommon.

INFECTION CONTROL MANUAL LAUNCHED

Fishing Futures catches on in Wicklow

• Organising ﬁshing events at a variety of locations and providing the time and space to ﬁsh,

HEALTH MATTERS AUTUMN 20228 |

Left: Ina O’Brien, IPC Nurse Specialist presenting the manual to Tina Geraghty, IPC Link Practitioner, Belmullet District Hospital, Co. Mayo.

This document does not replace the National Clinical E ectiveness Committee Draft Guidance on Infection Prevention and Control 2022 (NCEC). The NCEC document and any further updates provide a robust overarching guide to IPC core practices. With the development of IPC/Anti-Microbial Stewardship (AMS) teams within all of the CHOs, it was recognised that a document supporting the NCEC Guidance on IPC that would outline the fundamental concepts of standard and transmission based precautions would be beneﬁcial.

Right: Angela Moore, IPC Clinical Nurse Specialist, Community Healthcare West; Theresa Powell, Person in Charge Áras Rónáin Community Nursing Unit, Kilronan, Inis Mór, Aran Islands and Maureen O’Connell, IPC Link Practitioner.

• Demonstrating how to cook ﬁsh.

The Taoiseach toured the building before giving an opening speech, and admired the impressive views over Cork city from many of the buildings rooms.

Left to right is Dr Zahika Shah, Global Health Specialist, Irish Cancer Society, Graham Clifford, Translate Ireland; Dr Margaret Fitzgerald, Public Health Lead for Vulnerable Groups, HSE National Social Inclusion Office; Minister for Health Stephen Donnelly;Dr Stella Burska, GP in Dublin; and Dr Kateryna Kachurets, GP in Tallaght, at the recent launch of the ‘My Health, My Language’ video series.

THE results of the fourth National Inpatient Experience Survey have found more than four in five patients across UL Hospitals Group described their overall experience as good or veryJustgood.under 1,000 patients have provided their feedback and the results from the 2021 survey are already being used to drive improvements in quality across the five participating hospitals.

Multilingual videos make healthcare more accessible

would not have been possible without the healthcare staff who took time out of their busy schedules during the COVID-19 pandemic and the recent Ukrainian crisis to participate in the videos – thank you.

videosThe are available to view atmylanguagewww.hse.ie/myhealth

| 9HEALTH MATTERS AUTUMN 2022

Many people come from countries with very different healthcare systems to Ireland, and navigating an unfamiliar health service on arrival in a new country has been shown to be stressful experience and can result in a lack of access to essential services.

Top: Noreen Kennedy, Quality & Patient Safety Manager, St John’s Hospital; Kay Caball, Patient Council Member, UL Hospitals Group; Paul Reid, CEO, HSE; Angela Fitzgerald, Chief Executive, HIQA; and Paula Cussen Murphy, Director of Quality & Patient Safety UL Hospitals Group

HSE National Social Inclusion Office recently launched a suite of multilingual videos on the Irish health service to make health advice more accessible to Ireland’s migrant community.

The survey also assigns as overall rating of hospital experience, with a national average of 8.2 out of 10 in 2021. In UL Hospitals Group, UHL scored 7.8 out of 10; Nenagh 8.6 out of 10, Ennis 8.7 out of 10, St John’s 8.8 out of 10 and Croom 9.2 out of 10.

Every patient who had spent at least one night in an acute hospital during September 2021 was asked for their feedback through almost 60 detailed questions.Patients are asked for their feedback and observations on each stage of their journey through hospital and the survey is broken down into sections on Admissions, Care on the Ward; Examination, Diagnosis and Treatment; and Discharge/Transfer.

TAOISEACH OPENS 60-BED EXTENSION AT NURSING UNIT

Residents of the existing Heather House and their loved ones were integral to the opening ceremony, and the ribbon at the Heather House extension was held by residents Michael O’Donovan and Finbarr O’Donovan, both long-term residents of the existing 50-bed unit.

It is expected that new residents will move in before the end of 2022.

OVER 80% OF PATIENTS SATISFIED WITH HOSPITAL EXPERIENCE ACROSS UL HOSPITALS GROUP, SURVEY FINDS

Taoiseach Micheál Martin recently cut the ribbon on the 60-bed extension to Heather House in Gurranabraher, on the Northside of Cork city.

The videos, which have been produced in 17 different languages, offer clear information on important health information such as how the Irish health system works, accessing different types of health care, services that are free and information on pregnancy and new-born and maternal health.

The videos are presented by doctors, nurses and other healthcare workers, who live and work in Ireland but moved here from abroad, speaking in languages such as Arabic, French, Ukrainian, Polish, Slovak and Mandarin Chinese (Simplified). People are often assured when they see a member of their own community delivering factual, trustworthy health information in theThisvideos.initiative

Michael Fitzgerald, Chief Officer of Cork Kerry Community, said, “These extra beds will help us as we respond to the considerable demand in the Cork region for residential care for older people. We must acknowledge the hard work of many staff in bringing this project to fruition in a very tight timeframe, and we look forward to welcoming residents to this extension as soon as possible.”

According to the 2016 Census, there are over 600,000 people in Ireland - 13% of the overall population - who are multilingual, speaking a language other than Irish or English every day at home.

A €30 million 60-bed extension to a Community Nursing Unit in Cork will provide much needed extra residential accommodation for older people in the Cork city area.

The extension has 60 single rooms, all of which are en suite, as well as bright, spacious areas for dining and recreation, and it will make Heather House one of the largest providers of residential accommodation for older people in Cork. While construction work is complete, the internal fit-out of the building is currently being completed and the building must be registered with HIQA before new residents can move in.

Above: Edel Keavey, Staff Nurse and Emma Meehan, CNM2, Burren Ward, Ennis Hospital, with Joe Cassidy, Director of Nursing, Ennis Hospital.

All five – University Hospital Limerick, Ennis Hospital, Nenagh Hospital, St John’s Hospital and Croom Orthopaedic Hospital – are now encouraging patients who are discharged from hospital during May 2022 to participate in this year’s National Inpatient Experience Survey.

Within UL Hospitals Group as a whole, 82% of surveyed patients rated their overall experience as good or very good in September 2021, compared to a national average of 83%. In University Hospital Limerick

78% of patients described their overall experience as good or very good, as did 88% of patients in Ennis Hospital; 90% in Nenagh Hospital; 95% in St John’s Hospital and 94% in Croom Orthopaedic Hospital.

Jennifer Dowdall from Tallaght University Hospital explained that she and her colleagues have been doing the steps challenge over the past few years but this year’s challenge took on a new signiﬁcance for her“Thispersonallyyearhowever, we decided that we would set time away from our desks and get more fresh air and the aim was to improve our physical and mental state especially after the last two challenging years,” she said.

“Since this challenge has started I have felt more healthy in so far as not as breathless when walking, doing more adventurous walks that I haven’t done in years, watching what I am eating and ensuring getting the right balance between work/home life.

“I have been pushing myself every day not to go home and sit down but do at least one activity like a walk through the local park or some gardening."

articipating in workplace physical activity initiatives reduces sedentary behaviour and prolonged sitting and increases physcial activity. Providing pedometers along with standing desks, pilates/yoga videos and initiatives such as steps challenges is also e ective in assisting sta to be physically active in the work place. Our annual Steps to Health challenge is one initiative that supports HSE employees and other healthcare organisations to get active during work hours.

This year, 720 volunteers co-ordinated 4,373 participants during the ﬁve week programme and like previous years it was challenging for some to walk together, due to remote working. We also introduced a new online registration and leader board app, which changed some of our previous practices. Despite the challenges most of our team co-ordinators found their task motivating, fun and would do it again.

STEPS TO CHALLENGEHEALTH2022

Antenatal: Jennifer Moynihan, Bernie Darcy, Rachel Reid and Siobhan Ryan.

“The step challenge this year has been extremely important for me both physically and mentally. Since January I have myself like many

Fiona Barrett and colleagues stepping out at University Hospital Kerry The Mayo winners, Leg It, from Mayo University Hospital

Nurse Shane Martin used to be a regular runner. He lost his motivation during COVID-19 and didn't run at all some weeks. The HSE’s Steps Challenge got Shane back running and up to 10k.

Annual Steps to Health challenge continues to promote workplace physical activity

HEALTH MATTERS AUTUMN 202210 |

“I have been pushing myself every day not to go home and sit down but do at least one activity like a walk through the local park or some gardening. Also doing this challenge has make me more aware that you have to take 30 minutes to yourself. If you don’t look after yourself how can you look after everyone around you? It is ok to say “no” sometimes and remember it will beneﬁt all around you if you are healthy both physically and mentally.

“If anyone wants to kick start their healthy lifestyle I would highly recommend doing the step challenge as part of your day to day life as I Manyhave.”teams recorded their weekly step count on our online leader board and you can see from the table below, that frontline sta take many more steps than their o ce-based colleagues:

The Galway winners, All About the Pace, from Portiuncula Hospital, Ballinasloe. Back: Lorraine Mason; Eimear Gri n; Lisa O'Looney, Team Coordinator; Front: Mary Coen; Aoife McElligott. Missing: Caroline Layng and Marie Finn.

other women have been experiencing menopausal symptoms and the step challenge came at the right time to kick start my healthy routine and in turn improved my mental wellbeing. It is not just for the young but for everyone who is young at heart to get involved no matter what your ﬁtness level is. The step challenge is an amazing programme and even if you don’t reach the target steps on the ﬁrst week (remember it is not just about the steps) you will improve as you go along.

THE TABLE BELOW PROVIDES A SUMMARY OF PARTICIPANTS FROM EACH COMMUNITY HEALTH ORGANISATION, HOSPITAL GROUP, CORPORATE AND ORGANISATIONS.HEALTHCARE

Jennifer Dowdall

| 11HEALTH MATTERS AUTUMN 2022

Speech and Language Therapist Manager Catherine Cunningham; mum Eilís; baby Leo; Minister Mary Butler; Dr Ike Okafor Clinical Director, CHI. INAUGURAL WINNERS OF NATIONAL SONOGAMES

TALLAGHT TEAM ARE

Speech and Language Therapist Manager Catherine Cunningham, who led the development of the project with colleagues Eilís McClory and Christina Cotter, said, “We know parents and caregivers who tune into the messages which their baby is sending are laying the foundations for their baby’s speech, language and communication development. We also know that babies and children benefit from language rich experiences and this benefit is seen in the school years and beyond, right into adulthood. We hope that this resource can make a substantial di erence to the parent/caregiver who finds themselves in one of our hospitals for a longer than average stay.”

HEALTH MATTERS AUTUMN 202212 |

The TUH Trinity supersonic team trained tirelessly within the team at TUH Emergency Department and were worthy winners of the trophy! Pictured from left to right are medical students Sara Sotirakos, Claire Doherty, Niamh Dunne, Erin Visser, Dr. Victoria Meighan, Consultant in Emergency Medicine, National lead for ICEMT Ultrasound training and trainer for the Supersonic Team. In absentia is team member Siobhan Lee. The group are pictured above with their trophy which they received as the inaugural winners of the National Sonogames Competition. “Training the students really helps them to learn and achieve competencies that will be so useful when then qualify as doctors. These skills will help them to provide excellence in patient care. It was a pleasure training Trinity Team Supersonic in the TUH ED team. Very well done to all the teams competing and looking forward to next year already,” said Dr Victoria Meighan, Consultant in Emergency Medicine and Irish Committee for Emergency Medicine Training Ultrasound Lead.

Dr Ike Okafor, Clinical Director in CHI, explained, “The foundations for infants' future health and wellbeing are laid down in the ﬁrst years of life. Approximately 1,800 infants are admitted every year to the Neonatal Intensive Care Units of Children's Health Ireland and many more to the infant wards and emergency departments. We are seeing the results of the isolation of the pandemic and the e ect that had on children, through our Emergency Departments over the last year. It’s important we do all we can to support mental health at every stage of life. Early recognition, prevention and intervention for infant mental health is key and is also cost e ective.”

Children's Health Ireland initiative supports communication between parents and babies in hospital

The Tallaght University Hospital Emergency Department Team represented Trinity College Dublin and the hospital in the ﬁrst national point of care ultrasound competition for medical students. The competition was held in the Mater Hospital in Dublin where medical student teams from the RCSI, UCD, UCC and UCL competed against one another demonstrating their technical skills, ability and knowledge of point of care ultrasound.

hildren’s Health Ireland welcomed Minister of State for Mental Health and Older People Mary Butler to launch a new resource for parents of babies who spend time as inpatients in Children’s Health Ireland, marking Infant Mental Health Awareness Week 2022.

The booklet, entitled My Little Voice, which was produced by the Speech & Language Therapy Department in Children’s Health Ireland, aims to support parents and caregivers in developing responsive relationships with their baby while in hospital. Birth to three years is a critical period in childhood and research has shown that what happens during infancy can have substantial e ects on both short- and long-term outcomes in learning, behaviour, and both physical and mental health.

VOICELITTLEMY

My Little Voice booklet is available for parents whose babies stay in CHI at Connolly, Crumlin, Tallaght or Temple Street, through the Speech and Language Therapy departments in CHI.

her husband Damien and children Henry and George. Left: with her son George.

Emma RespondersCommunitycampaignlaunchpicturedDoyleattheofanewforFirstwith

ife couldn’t have been happier for mum-of-two Emma Doyle as she sat feeding her newborn son George at her home two years ago.

A new wenttheFionawithherelaunch.toldsurvivorCardiacbeenRespondersCommunityforcampaignnationalvolunteerFirsthaslaunched.arrestEmmaDoyleherstoryattheSheisseenatthelaunchsonGeorgeandTormey,oneofparamedicswhotoherrescue.

| 13HEALTH MATTERS AUTUMN 2022

SURVIVOR

She said she wanted to make her story public to highlight the vital service that ﬁrst responders provide.

Speaking at the launch, Meath woman Emma, who is in her thirties, explained, “I was a ﬁt and healthy person before I su ered my cardiac arrest which was totally unexpected. I am so grateful for the telephone instructions from the ambulance service which enabled my husband Damien to start CPR on me and for the speedy arrival of the ambulance and its crew.

“I would encourage anyone interested in becoming a Community First Responder to visit www.becomeacfr.ie and get in touch. There is currently a need for additional Community First Responders right around the country and you will be given the essential training required. We would also like to see additional Community First Responder Schemes established where they are needed.”

“I want to share my story and what I have learnt since that day in April 2020 about the importance of learning CPR and establishing Community First Responder groups in every community in Ireland.,” she said.

The campaign, which features a new promotional video and

Young mum Emma owes her life to first responders after cardiac arrest

website, www.becomeacfr.ie was launched by Cathal O’Donnell, Medical Director of the National Ambulance Service, at an event in Dunboyne Castle, Co CommunityMeath.First

Speaking at the launch, Mr O’Donnell said, “We currently have 250 Community First Responder schemes operating in Ireland, but our goal is to ensure that every patient who needs treatment across Ireland gets access to a community response, so this promotional campaign forms part of this.

Responders are an integral part of dealing with an emergency in the community in that they provide vital lifesaving CPR and deﬁbrillator treatment to patients while an ambulance is en route.

But it all changed in an instant as she su ered a sudden cardiac arrest.

The fact that Emma is still happy and healthy and with her family today is thanks to the ﬁrst responders from the National Ambulance Service, which has just launched a new nationwide campaign for additional volunteer Community First Responders to support the work of the Emergency Services in local communities.

“One moment I was holding George chatting to my mother-in-law Annmarie and the next I was gone. My mother-in-law Annmarie initially thought I had fallen and rushed to check if we were ok. It was then she realised that I had really gone. Without any warning whatsoever, I had a cardiac arrest – my heart just stopped….I had no underlying medical conditions and did not feel unwell in any way prior to the event. It is often reported in the media when sports stars, typically male, su er a cardiac arrest but in fact it can and does happen to anyone at any time.”

Dr Ike Okafor, Children’s Hospital Ireland; Craig Hyland, Billy McHugh, Jimmy Lawless and Anthony Carey of Dublin Fire Brigade; Naoise Collins, Jay Gibson, Jonathan Lynch, Liam Stewart, Aidan Quinn of the National Ambulance Service; Sheelagh Cave and John Doyle, Children’s Hospital Ireland; at the launch of the Rainbow Badge initiative by the National Ambulance Service and Dublin Fire Brigade, supported by Children’s Health Ireland.

The badge is intended to be a simple visual symbol identifying its wearer as someone an LGBTQ+ person can feel comfortable talking to about issues relating to sexuality or gender identity. It shows the wearer is there to listen without judgement and signpost to further support if needed.

Also welcoming the initiative Dennis Keeley, Chief Fire O cer of Dublin Fire Brigade, said, “Dublin Fire Brigade is delighted to support this initiative to promote a positive message of inclusion for LGBTQ+ people, families and colleagues. Simple symbols, such as the rainbow, are an e ective way to signal to LGBTQ+ people that they are in a positive, inclusive, safe environment, and encourage them to talk about things they may otherwise have felt unsure or uncomfortable disclosing. They also encourage conversations amongst sta themselves about the importance of being aware of issues of equality, diversity and inclusion, and help to reinforce the shared responsibility we all have in this regard.”

Various organisations have implemented this badge since 2019 including Linn Dara Child & Adolescent Mental Health Services (CAMHS) and CHI. Despite improving social attitudes in general towards LGBTQ+ people in Ireland, negative attitudes such as homophobia, biphobia, transphobia still remain.

he National Ambulance Service and Dublin Fire Brigade joined the Children’s Health Ireland (CHI) Hospital Group recently to embrace the Rainbow Badge as a way to show that their services o er open, non-judgemental and inclusive care for people who identify as LGBTQ+.

Those committing to the project are emphasising that they will promote an environment that is open, tolerant and inclusive. The aim of this initiative is to actively break down barriers which LGBTQ+ people may still face.

HEALTH MATTERS AUTUMN 202214 |

make signiﬁcant di erences to LGBTQ+ people’s experience, and, in turn on their physical and mental health.

Jimmy Lawless, Dublin Fire Brigade; Naoise Collins, NAS; Billy McHugh, Dublin Fire Brigade; and Jonathan Lynch, NAS, at the launch of the Rainbow Badge initiative by the NAS and Dublin Fire Brigade, supported by Children’s Health Ireland.

BARRIERSBREAKING

Jimmy Lawless, Dublin Fire Brigade; Naoise Collins, NAS; Billy McHugh, Dublin Fire Brigade; and Jonathan Lynch, NAS; at the launch of the Rainbow Badge initiative.

Sta who elect to wear the badge are given an overview of the challenges that LGBTQ+ people can face in relation to accessing healthcare and negative attitudes which can sometimes still exist. When an individual signs up to wear a badge, they acknowledge why the project is needed and what their responsibility entails.

The initiative was launched during the Dublin Pride Festival to bring about increased awareness among sta of the issues surrounding LGBTQ+ people when accessing healthcare. Such awareness can

Welcoming the initiative Robert Morton, Director of the HSE National Ambulance Service, said, “Mental health issues such as depression and anxiety are signiﬁcantly more common in people who identify as LGBTQ+ . Research has shown that negative attitudes towards LGBTQ+ people still remain; as a result, LGBTQ+ people can be reluctant to disclose their sexual and / or gender identity to healthcare workers, a ecting the quality of the care they receive. We hope this initiative will make a di erence for them.”

Eilish Hardiman Chief Executive, Children's Health Ireland, said, “12 months after implementing the badge across CHI, we see the value this small symbol can bring in terms of positivity and inclusivity for our services and patients. Wearing a badge is only one step towards overcoming healthcare inequalities but with increasing awareness and education we can start to overcome barriers to healthcare for LGBTQ+ young people in Ireland.”

| 15HEALTH MATTERS AUTUMN 2022

“We also had over a hundred sta join, from di erent divisions and teams within the HSE.”

The HSE’s pride activities kicked o with a colourful photoshoot involving Paul Reid, CEO of the HSE alongside the Executive Management Team, members of the Reach Out Network and the Diversity Equality and Inclusion team, on the steps of Dr Steevens’

The Reach Out Network is the HSE's national sta network for LGBTQIA+ sta and allies. The Network, which has been in existence since 2017, has brought a lot of beneﬁts to HSE sta . “The Reach Out Network acts as a representative voice for LGBTQIA+ employees, a forum where we can discuss experiences and share insights in a safe space, and a resource on LGBTQIA+ topics” said Reach Out Network member Ronán Brady, Senior Speech and Language Therapist in the Dublin North West Adult Speech and Language Therapy Service. Membership of the Reach Out Network has sky-rocketed in recent months, with allies and sta from across the LGBTQIA+ community joining up.

If you would like further information on the Reach Out Network or other sta networks in the HSE, including the new Sta Network for People with Disabilities and the planned Sta Network for sta from ethnic minority backgrounds, contact diversity.HR@ hse.ie. LGBT+ Awareness and Inclusion training is available on HSeLanD.

Colour, fun and friendship as staff network celebrates biggest ever HSE participation in Dublin Pride

Maria ﬁnished by adding, “The future is certainly bright for all Sta Networks in the HSE, with plans for much further growth, activity, and sta engagement going forward. The success of the Reach Out Network shows what can be achieved.”

Hospital.TheHSE

“The Reach Out Network has been a great resource for the HSE’s involvement in Pride around the country”, said Maria Barry, Diversity Equality and Inclusion Manager in the HSE’s National HR division. “For the ﬁrst time, we’ve been able to support marches from Inishowen in the far north of Donegal, to Mayo and Cork, and many more in between. The level of participation from HSE sta is amazing.”

PRIDE

sta and allies from all over the health service to get involved in the Reach Out Network. Marching in Pride is one of the ways that colleagues can support us and celebrate the contribution we make to healthcare across Ireland.”

was able to publicise and support Pride activities around the country as well as in Dublin.

The feedback from the public, governmental department colleagues, and the Reach Out Network was incredibly positive, with signiﬁcant media coverage of HSE presence at Dublin Pride. Cal McDonagh (He/ Him), Clinical Psychologist with the Coolock Community Mental Health Team and Reach Out Network member said that “We want LGBTQIA+

The Dublin march took place on June 25th, and the representation from HSE sta and allies was unprecedented in size. “We had four vehicles from the National Ambulance Service, and they really provided the backbone for the HSE group,” Maria said.

une brought in the riot of colour and noise that is Pride Month for the ﬁrst time since 2019, and the HSE was at the centre of the celebrations thanks to the Reach Out Network, the HSE’s sta network for employees who are Lesbian, Gay, Bisexual, Transgender, Queer, Intersex or Asexual (LGBTQIA+).

The management, sta , residents and families of St Joseph’s CNU are immensely proud of what this award signiﬁes and represents and while St Joseph’s CNU has come a long way, the focus remains on continuously striving for improvement, ensuring the centre and service are responsive to the ever changing needs of the community in Trim and Co Meath that it serves.

Community Nursing Unit residents hail chef Nora

“Tá Áras Rónáin CNU thar a bheith bhródúil as Nora agus an éacht atá bainte amach aici don chócaire is fear in Ionaid Sláinte na tíre. Cuireann Nora agus an foireann ó Aramark béilí aláinn ar fail gach lá san Ionad.”

Nora O’Malley in receipt of her Aramark Ireland’s Healthcare Chef of the Year 2022

The award itself is an acknowledgment of the commitment and dedication of the management and sta in the Centre, particularly given the challenges faced over the course of the COVID-19 pandemic.

The Future Visioning Project commenced in 2012 in St Joseph’s following a number of very damming HIQA reports. The management team, together with HSE Estates, commenced working in consultation with residents, families, sta and with the support of their registered charity The Friends of St. Joseph’s CNU, they have now created an environment which is warm and welcoming and an ethos and culture which keeps the resident and their needs at the centre of the service they provide.

‘IT IS NOT EVERYONE WHO HAS CHEF OF THE YEAR COOKING THEIR DINNER EVERY DAY’

Theresa Powell, Person in Charge, said it was a ‘great achievement and clear recognition of all of Nora’s hard work throughout the year’.

ST JOSEPH’S IS NURSING HOME OF THE YEAR

Rónáin Community Nursing Unit, Kilronan, Inis Mór and HSE Community Healthcare West are very proud of Nora O’Malley on winning Aramark Ireland’s Healthcare Chef of the Year 2022. Nora, a native of Leitir Móir, who looks after the nutritional needs of all residents in the only o -shore Residential Nursing Home in Ireland, took home gold with her gluten free Deconstructed Mikado consisting of a coconut crumb, a raspberry marshmallow, and a raspberry gel.

HEALTH MATTERS AUTUMN 202216 |

St Joseph’s CNU had been shortlisted along with nine other Nursing Homes/Residential Centres from around Ireland in the category and were delighted to come out successful on the night. Unfortunately St Joseph’s management and sta were not there on the night to accept the award, but were absolutely delighted with the win.

Áras

Nora commented after the event, “I am thrilled to have been named Aramark’s Healthcare Chef of the Year 2022. This is the ﬁrst culinary competition I have ever taken part in, so to come away with a win is a proud moment for me.”

“All the residents are super excited; it is not everyone who can say that ‘the chef of the year’ is cooking their dinner every day,” she said.

The Irish Healthcare Centre Awards were held in Dublin recently where the winners in a variety of categories were announced. HSE representation was high with Midland Louth Meath Community Healthcare Organisation’s very own St Joseph’s Community Nursing Unit in Trim taking home the award for Nursing Home/ Residential Centre of the Year.

“At the opening of the Integrated Care Hub in Bray Minister Donnelly acknowledged the work of healthcare sta , clients and the wider community in Ireland in meeting the challenges of the pandemic. Acknowledging the work of colleagues and the collective response of clients and the community to COVID and the Cyber Attack demonstrated the symmetry with ViA.”

“The opportunities for informal engagement across relaunch week including the launches and a Primary Care audit, reinforced weaving our shared values and behaviours into the support for each other to achieve collective goals and showed that ViA is part of who we are and how we work in Community Healthcare East.”

VALUES IN ACTION

Inset: Community Healthcare East Chief O cer Martina Queally and Minister for Health Stephen Donnelly meeting with sta and service users at the opening of the Integrated Care Hub in Bray.

Some of the feedback included:

Relaunch in Community Healthcare East

The ViA re-launch week coincided with the o cial openings of the Primary Care Centre and the new Integrated Care Hub in Bray.

Pictured from left to right at a Values in Action 'Colleague Dimension Day' in Bray Civic Centre are Rebecca He ernan, Katherine Cardi , Debbie Aston, Louise Lacey and Andrea Koenigstorfer.

Some of these included ViA co ee breaks, a story-gathering hub, a colleague dimension day to celebrate cultural diversity and behaviour workshops.

Values in Action team in Community Healthcare East recently re-launched their social movement for culture change following a pause during the COVID-19 pandemic.

A Champions Webinar / Virtual Co ee Morning took place earlier in the summer and o ered a great opportunity to re-connect with the Champions community while also rea rming the commitment to putting our Values into Action.

A shared learning and networking (in person) event for Champions is planned for the end of September. If you would like to hear more about Values in Action, please email ValuesinAction.CHEAST@hse.ie to book your place!

Following this, the Community Healthcare East Values in Action Champions and Project Team regrouped to support a Relaunch Week. During this week various activities took place across Community Healthcare East to shine a spotlight on Values in Action's nine behaviours.

The

“The message of ‘Be Kind’ echoed by both Martina Queally and Anne O'Connor at the Enhanced Community Care Launch Event resonated with all those present and reinforced the role of ViA for me.”

| 17HEALTH MATTERS AUTUMN 2022

Values in Action is about putting the values of care, compassion, trust and learning at the core of everything we do in the health service. As one of our Champions likes to say, “It’s for ourselves and it’s for our patients.” Values in Action Champions are nominated by their peers to lead the social movement in their workplaces through living and spreading the 9 behaviours.

As one Champion observed, “The behaviours are alive in the area and have sustained us all over the challenges of the last two years.”This is certainly true and the team now plan to build on current momentum to spread the social movement for culture improvement for everyone across Community Healthcare East.

If you are interested in ﬁnding out how you can get involved with the Values in Action movement; or if you have a Values in Action story to share, feel free to email the ViA National Team at info.valuesinaction@hse.ie; and join the conversation on twitter @HSEvalues, using the hashtag #WeAreOurValues.

Community Healthcare East Chief O cer Martina Queally and Minister for Health Stephen Donnelly meeting with sta and service users at the o cial opening of the Integrated Care Hub, Bray in May.

NEXT STEPS

HSE DONATES AMBULANCES AND OTHER LIFE-SAVING EQUIPMENT TO UKRAINE

These donations were delivered thanks to collaboration between partners working across the health sector including the HSE, Medical Help Ukraine, Lifeline Ambulance Services and others and with support from volunteers and transport arranged by Lifeline Ambulance Services. In addition, many other items have been donated by HSE sta and institutions, private health services, and various health and non-health suppliers.

These donations bring to over €4.3 million the total value of medical donations to Ukraine from Ireland, and which have been coordinated by the HSE and other health agencies.

The donations are in direct response to the Government of Ukraine’s appeal for medical assistance. The HSE provides this

The donations are delivered to a Ukraine government licensed distribution hub in Lviv, Ukraine. Ambulances, equipment and supplies are then checked for safety and suitability and are sent to where they are most needed in Ukraine.

2022, 19 decommissioned HSE ambulances have left Ireland for Ukraine, having been repurposed and equipped for use in Ukraine. The HSE and its National Ambulance Service organised these donations and were supported by the relevant government departments. The ambulances being donated have been decommissioned for use in Ireland, in accordance with the HSE Ambulance Replacement Programme. Although they are not suitable for continued use in Ireland, they can be used in other situations and are appreciated by those receiving the vehicles.

Dr Iryna Rybinkina, Director at the distribution hub in Lviv, Ukraine, has said the ambulances are very well equipped for their needs, are comfortable for drivers and, as a relatively new ambulance, could last for another 10 to 15 years.

This donation of ambulances follows a number of recent and ongoing donations of medical equipment, appliances and consumables. These provide practical and life-saving assistance to the people of Ukraine who continue to live through this humanitarian crisis. Donations have consisted of: PPE, medical consumables such as needles, syringes and bandages; critical care devices including life support, diagnostic, therapeutic, infant care, ventilators, deﬁbrillators and patient monitors; and aids and appliances.

Ciara Norton, Programme Manager, HSE Global Health Programme, outlines the vital role the HSE has played in helping the war-torn coun try

HEALTH MATTERS AUTUMN 202218 |

ince March, the HSE has donated essential medical supplies, equipment and ambulances to Ukraine with a value of more than €4.3 million. This support has helped hospitals and health services in Ukraine to provide essential and emergency health care in the face of the conﬂict. The donations were made by possible by the e orts of many sta across the health service.

The HSE has worked closely with Medical Help Ukraine, Lifeline Ambulance Services and teams of volunteers to prepare and send theSincedonations.March

The HSE Global Health Programme, led by the Director Dr David Weakliam, serves as the focal point for the HSE humanitarian assistance response. It is part of its broader objectives to develop and implement initiatives to improve health in less developed countries, while also learning from other countries to improve healthcare in Ireland.

These donations would not have been possible without the unwavering support, generosity and commitment of HSE sta . Since the onset of this humanitarian crisis, sta have not ceased in their e orts to support donations to Ukraine. Up and down the country, from large hospitals to small community centres, from central warehouses to small store rooms, from the CEO to sta on the ground, everyone has made a contribution.

Signiﬁcant support, advice, expertise and hands-on help came from Medical Help Ukraine, a group of Ukrainian doctors in Ireland, who worked with the HSE to organise these donations, engage volunteers and raise funds to transport them.

| 19HEALTH MATTERS AUTUMN 2022

Lifeline Ambulance Service also worked with the HSE, Medical Help Ukraine and volunteers to prepare and load items for transport and raised funds and organised their safe transport and delivery.

humanitarian assistance as part of the coordinated Government response and as part of the wider EU e ort, in close cooperation with Department of Health and Department of Foreign A airs (Irish Aid). Ireland has demonstrated its commitment to the health of the people of Ukraine by providing these donations. This is just one aspect of the response of the Irish health sector to the Ukraine crisis and a part of the extensive Irish government response to ensure support to Ukrainians in Ukraine, neighbouring countries and those arriving in Ireland.

As the Ukraine crisis continues, the HSE Global Health Programme continues to explore opportunities to donate surplus and decommissioned items that are no longer of use in the HSE.

If you would like to ﬁnd out more about how you can contribute to the donations programme, please email globalhealth@hse.ie.

A plan is under way for ongoing donations arising from the HSE Equipment Replacement Programme and the National Ambulance Service Replacement Programme. The HSE will continue to respond to requests for urgent medical supplies from Ukraine.

Among its functions are to support the Government in responding to global health emergencies and to coordinate the HSE’s response to requests for humanitarian assistance, in line with Ireland’s International Development Policy, ‘A Better World’.

Sta worked tirelessly and also gave of their own time to prepare items for donation. Items were brought to and collected from the various locations by transport personnel and volunteers and brought to a central location for inspection and delivery to Ukraine. HSE procurement and logistics, the National Ambulance Service, the Clinical Engineer Lead for Medical Devices, HSE Pharmacy, Acute Operations, Community Services and Estates management all came together to coordinate, inspect and clear products for donation, collection and delivery to Ukraine.

ALEX POCCI

“I enjoy helping people and having an impact on their lives. My brother was involved in a car crash when we were teenagers back in the States and that also got me interested in the work of the Emergency Services. Recently I’ve been doing a lot of work with refugees and people in Direct Provision.

Alex has a degree in Journalism and originally came to Ireland by participating in a study abroad programme.

It was back in 2005 when Vasile enrolled in the National Ambulance Training School as it was then. Based in the Phoenix Park in Dublin he successfully completed the programme becoming a Qualiﬁed Paramedic.“Itwasdi erent then. Now there are a lot more procedures and medications. We do a lot more now than we could do back then.”

HEALTH MATTERS AUTUMN 202220 |

he National Ambulance Service recently launched a new phase of its campaign this year to boost the recruitment of new sta and student paramedics.Theﬁrstphase of the campaign, early in the year, highlighted that people from all walks of life are joining the National Ambulance Service building careers and playing an important role in their local communities.

JOINTEAMOUR

During the ﬁrst phase, a number of members of sta participated in a campaign advertising photoshoot to help spread the message that the ambulance service is open to people from all walks of life. They included emergency medical technicians, emergency call takers and an advanced paramedic.

Alex Pocci, a native of Chicago, is working as a Qualiﬁed Paramedic in Ballinasloe and lives in Athenry. Some years ago Alex volunteered with Civil Defence in Roscommon and it was this involvement that prompted him to apply to become a Student Paramedic with the NAS College.

The next phase of the campaign, which ran on social media during most of August, highlighted diversity within the service.

Recruitment campaign highlights diversity in the National Ambulance Service

Vasile worked at the St James’s Ambulance Base and the ambulance station in Swords before becoming an Advanced Paramedic in 2011. He works in the Dublin and Kildare areas mostly but the job can take him to other places as well.

Among them were two intern paramedics, two qualiﬁed paramedics and an advanced paramedic. Paramedics play a vital role in the provision of emergency care to the community and are involved in life saving work at the scene of incidents and while working on ambulances.

The next phase focused on attracting student paramedics and qualiﬁed paramedics. A number of sta , who joined the ambulance service after coming to Ireland from their native countries, participated in a new photoshoot to help highlight diversity within the service.

VASILE LUNG

“Every day is a challenge. Di erent experiences help you build up your conﬁdence, skills and abilities to deal with people. We meet all kinds of people from lots of di erent backgrounds on the job and we are trained to treat each individual with the same care and professionalism. This is what makes the job so interesting and attractive. ”

Vasile Lung originally studied Vetinerary Medicine in his native Romania so he had a knowledge of science, medicine and pharmacology when he decided to apply to become a student paramedic.

“People in Ireland are very friendly. You very quickly feel part of the team.” His knowledge of languages helps him to care for patients as he can speak Polish and Russian.

Tomasz originally qualiﬁed in Poland as a Paramedic and was able to start working for an ambulance service on arrival here.

FEDOROWICZTOMASZ

Born in Poland Tomasz Fedorowicz has lived in Ireland since 2006. He originally intended staying in Ireland for a year but he decided to settle here.Tomasz has been working as a Qualiﬁed Paramedic for the National Ambulance Service now for three years having previously worked for a private ambulance service. He has been based in the Dublin South Central Ambulance Base working mainly in the city.

A native of Latvia, Anna applied to become a Student Paramedic with the National Ambulance Service and is now working as an Intern Paramedic.Annaisliving and working in Loughrea, Co Galway and can speak Ukrainian, Russian and Latvian which is a great help to her in her work.

BOISKOANNA

Nora Bodnar’s husband died in a tragic accident in her home country of Slovakia leaving her motivated to help others.Sheoriginally thought of nursing as a way of serving others but a stint as a volunteer with St John’s Ambulance prompted Nora to complete an Emergency Medical Technician course. After working with a private ambulance company Nora began working with the National Ambulance Service as an Intermediate Care Operative.Shelater transferred into the Paramedic Degree Programme and has now completed her ﬁrst year in the NAS College Tullamore campus and is a Post Graduate Paramedic Intern.Nora is now looking forward to becoming a Qualiﬁed Paramedic in December and then completing her Paramedic Science Degree Programme with University College CorkLiving(UCC).inKells, Co Meath Nora is working from the Monaghan Ambulance Station. Her knowledge of languages is a great help to her in her work as she is able to speak Hungarian, Slovakian, Czech and Polish as well as a little Russian and German.“It’sacomfort for people when you can speak their language, even if it’s only a few words. It’s a big plus.”

Tomasz and his wife have recently purchased a home in Portlaoise and he is in the process of transferring to work and live there now.

“We are very happy and looking forward to living in the midlands with our two boys aged four and eleven years.”

A friend encouraged Anna Boisko to join St John’s Ambulance in Limerick as a volunteer and she quickly found out that she really enjoyed the experience.Annalater completed an Emergency Medical Technician course and worked for a private ambulance company.

NORA BODNAR

| 21HEALTH MATTERS AUTUMN 2022

HEALTH MATTERS AUTUMN 202222 |

HEALTHCARECLOSERTOYOURHOME

This new ICPOP service will support people to live independently in their own homes, through the early diagnosis and prevention of the progression of health issues. This will help older persons to continue living well in their homes and communities for as long as possible It provides the older people of North Tipperary with rapid access to

comprehensive assessments which are provided by a Community Consultant-led multidisciplinary team. People can be referred to ICPOP by their own GP. Since it became operational in December of last year, 120 people from across North Tipperary have been seen by the service.

“The Integrated Care Hub at Cavan General Hospital will help us progress the ECC vision of providing accessible, integrated, and high-quality services closer to people’s homes. It can give fast access to specialist services in the community for older people."

The new Hub is part of the Enhanced Community Care (ECC) programme which is developing a new, integrated model of care that is responsive to the needs of local communities. This requires strong leadership and ownership at local level, bringing the relationship between General Practice, primary care and specialist community care into a much more patientfocused and integrated model of care in each locality. More than 80 Community

ENHANCED COMMUNITY CARE

eveloped as part of implementing Sláintecare, the goal of the Enhanced Community Care (ECC) programme is to ensure all primary and community care services work in an integrated way to meet population health needs across Ireland. The ECC programme is already making progress, aiming to reduce pressure on services and dependence on the hospitalcentric model of care through enhanced and increased community services Minister Stephen Donnelly recently opened a number of Integrated Care Hubs and Primary Care Centres around the country as part of the nationwide €240 million ECC programme in Wicklow, Cork andMinisterTipperary.Donnelly visited the HSE’s ECC Integrated Care Programme for Older People (ICPOP) Care Hub, North Tipperary on the grounds of the Community Hospital of the Assumption, Thurles. He also met with residents and sta of the Community Hospital of the Assumption and visited the newly built Thurles Primary Care Centre.

After contracting COVID-19, Sally needed help with her balance and with mobility, and the sta at the home have supported her. I came home to Ingrid, my daughter. I was very happy to be home. Ingrid and myself felt relaxed, we knew we had the very best of care and we knew what we were doing,” she said.

The services at the St Finbarr’s hub help older people (aged 65 and over) to stay safe and well in their own homes for as long as possible, and Minister Stephen Donnelly met several older people attending the hub for assessment during his recent visit.

“Being at home helped me to recover, because I felt happier at home. The service was fantastic, and I never expected it. I was at home and the outreach team visited me three days a week.

The Cork Kerry Community Healthcare Integrated Care Hub for older people is based at St Finbarr’s Health Campus in Cork City. Sta at the hub help older people (aged 65 and over) to stay safe and well in their own homes for as long as possible.

“The new Primary Care Centre in Bray accommodates a range of primary care, mental health and community services within a single integrated, modern facility, and will improve access to a broad range

| 23HEALTH MATTERS AUTUMN 2022

“Collaboration and shared governance is pivotal to the successful implementation of our ECC programme. I would like to acknowledge the GP and Consultant leads and our colleagues in Ireland East Hospital Group, St Vincent’s, St Michael’s and St Colmcille’s hospitals for the time and commitment they’ve provided to the development of the ECC programme in Community Healthcare East so far. I would also like to thank the large number of people involved in the development of the physical infrastructure required to support this programme, as well as those supporting the reorganisation of patient pathways of care.”

I FELT HAPPIER AT HOME’

The Cork South Older Person’s Hub is part of the Enhanced Community Care Programme and is one of two such hubs in Cork city.

An integrated care hub for older people in Cork city is helping at least 2,500 older people every year to avoid hospital and stay well at home for longer.

“I’m so thankful, so happy to be home and to be so well,” she said.

One of the people the Minister met was Sally Clarke, 82, from Wilton in Cork city. She is one of the thousands of Cork people who have been able to say well at home thanks to the services at the hub.

In Wicklow, speaking at the o cial opening of the Bray Primary Care Centre and Integrated Care Hub, Martina Queally, Chief O cer of HSE Community Healthcare East, said, “The new Primary Care Centre and the Integrated Care Hub in Bray help us advance the ECC vision of providing accessible, integrated, and high quality services closer to people’s homes It shows that the move towards more primary and community care is becoming a reality in Community Healthcare East.

This hub is home to both physical clinics and an outreach team.

Continued overleaf >>

Minister Donnelly also met Patrick (Paddy) Corcoran, 89, from Togher in Cork city. Mr Corcoran spent three weeks in hospital after a bad fall, and the team at the hub helped him to get back to his own home.

In Cavan, Minister Donnelly visited the Cavan/Monaghan Community Healthcare Integrated Care Hub for older persons (ICPOP hub) at the Lisdarn Unit for the Elderly. He also visited the site of the planned Chronic Disease Hub. These hubs are based at Cavan General Hospital Campus and are part of the national ECC programme. Dermot Monaghan, Chief O cer of HSE Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo said, “The Integrated Care Hub at Cavan General Hospital will help us progress the ECC vision of providing accessible, integrated, and high-quality services closer to people’s homes. It can give fast access to specialist services in the community for older people. I want to thank the sta who have worked to get this team up and running, and who are already making a di erence to the lives of thousands of older people in Cavan and Monaghan.”

Healthcare Networks (including two covering North Tipperary) and 32 Community Specialist Teams have already been established nationally, with over 2,000 sta already recruited or at an advanced stage of employment, and the recruitment of a further 1,700 sta planned during 2022.

of services to the local community. The Integrated Care Hub in Bray o ers access to specialist services in the community for older people and people living with more complex chronic disease.

Utilising a Multi-Disciplinary Team approach, combining geriatric and other specialist care services from University Hospital Waterford (UHW), a range of community and social care professionals from HSE/South East Community Healthcare and the input of GP and primary care services in the Waterford and South Kilkenny areas, the Waterford Integrated Care for Older People (WICOP) Centre aims to support clients living in their homes and communities for as long as possible and to avoid hospital admission.

Over 30 sta will be employed across the range of services provided once it is fully operational CENTRE FOR OLDER ADULTS UNDER WAY AT ST PATRICK’S HOSPITAL, WATERFORD

The service sees approximately 2,500 patients each year, with 200 new patients taken on each month. Urgent referrals are seen in the same week, and referrals to the rapid access clinic are seen within two weeks.

An integrated project in line with the government’s Sláintecare health strategy, the WICOP Centre will accept referrals for patients discharged from hospital (including from the Emergency Dept.) and from GPs. Clients are already being seen at the new Waterford Centre and as further sta join the services and additional cohorts of referrals are seen, an outreach WICOP day hospital service will also be established at premises in Dungarvan Community Hospital.

All referrals received by WICOP are triaged by the Multi-Disciplinary Team and are scheduled for assessment. UHW’s Consultants in Medicine for the Elderly are on site and are working as part of a Multi-Disciplinary Teams including physiotherapists, occupational therapists, a dietitian, medical social workers, a psychologist, nurses and administrative sta .

The service is currently a ﬁve-day-a-week service and recruitment of additional sta , budgeted for as part of the HSE’s 2022 Operational Plan, and the completion of currently ongoing internal constructions works on the Research and Training unit, will add to the capacity of the service.

Conﬁrming the progress in the HSE/South East Community Healthcare (SECH) and the WICOP Centre’s plans to be operational in 2022, Neville Coen, Operational Team Lead, WICOP, said, “From its foundation some years ago through co-operation by UHW, ICPOP and SECH, the WICOP has been an ambitious project and this new development at St. Patrick’s will help the HSE to streamline health and social care for the most complex cohort of older adults.”

The St Patrick’s Hospital building in Waterford is being developed as a new centre for services for older adults.

HEALTH MATTERS AUTUMN 202224 |

It provides services to older persons over 65 years of age with complex needs and frailty, and gives them access to specialist multidisciplinary assessment for older people. The hub gives people access to a range of clinics, including rapid access clinics; falls clinics; clinics that assist with memory or dementia; frailty clinics and several nurse-led and therapy-led clinics.

The outreach team provides a “ward at home” service and sees 45 patients a month, in their own home. It provides for crisis intervention and assessment and case management is led by an Advanced Nurse Practitioner. There are currently 45 patients on the outreach team’s caseloads and this will increase as the team grows.

Upon residents and sta of St Patrick’s Hospital having been transferred to the adjacent new Waterford Residential Care Centre in 2020, €750,000 of reconﬁguration work began on the new WICOP centre. The project is inclusive of moving services previously provided by the programme at premises in UHW. The new WICOP Centre will also feature a unit specialising in research and training in Medicine for the Elderly and as a resource for others involved with the care of older people. When fully operational at WICOP in St Patrick’s and Dungarvan, over 30 will be employed across the range of services provided.

Those being referred to the WICOP service already include older adults who have fallen, are frail, are encountering memory impairment or may have movement disorders.

Across a national structure, it has comprehensive plans to ensure it delivers timely communications that are authoritative andThetrustworthy.”teamprimarily focuses on delivering news events happening daily across the vast range of the health services under its remit. Through media engagement and proactive campaigns, they highlight health and social services available to the public, publicise important public health messages, and share inspiring work carried out by staff across the country every day.

Building on the familiarity with online platforms, the team introduced a quarterly all-staff webinar as a new mechanism to connect face-to-face with senior leaders. The IC team directly influenced senior leaders to not have a set topic for each webinar but instead to have a panel, Q&A format that would be exclusively employee-led.

• The virtual event meant we could reach a wider audience.

Between March 1st 2021 and February 28th 2022, the team arranged 39 press briefings, arranged 605 national broadcast media interviews and dealt with 4,726 media queries.

Decisions being made centrally by senior leaders were having an immediate impact on frontline staff. The IC team needed to quickly develop a channel where staff could access senior leaders directly and in real-time, and hear their thoughts and insights on the challenges the HSE faced and how they saw us coping with those challenges.

The team capitalised on weekly press briefings given by HSE leadership to national media outlets. Streamed live on HSE Twitter, the leadership team gave detailed corporate, operational, and clinical updates on our response COVID-19. They also used the information given in the weekly press briefing to produce an 800-1000 word news update, focusing on operational and clinical information.

This approach had a number of benefits:

When appropriate, they broadened it out to include the COO and CCO if the update was more clinical or operationally focused.

HSE communications teams take home two top awards WINNERTHE IS....

• Gave senior leaders real-time information about issues on the ground.

• Gave staff direct access to senior leaders at a time of crisis.

The Internal Communications (IC) team took top prize for best internal communications campaign during COVID-19 and the HSE cyber-attack, while the National Press and Media team were best in-house PR Team.

All of the organisational objectives were supported through the delivery of a dynamic, agile press office function operating during the global pandemic and a cyber-attack whilst continuing to promote positive HSE services, stories and people. They worked closely with CHO/HG colleagues, the Department of Health, Government Information Service and many other stakeholders, and continue to do so.

| 25HEALTH MATTERS AUTUMN 2022

Four webinars were held across 2021. Staff could submit questions before or during the webinar using the chat function. There was no set agenda, no presentations, and no set topics for discussion. HSE senior leaders put themselves before staff, in a live format, to address their questions.

The mobile video format allowed the team to respond quickly to last minute developments, publishing video updates within hours. The mobile video, unscripted approach recreated a more natural face-to-face feel and the videos increased the visual presence of senior leaders internally.

Given the time constraints on staff, the IC team utilised virtual platforms already in use. Frontline staff used WebEx to collaborate with colleagues and for virtual appointments with patients. Staff working from home used WebEx or MS Teams for virtual meetings. The IC team saw an opportunity in staff already being familiar with online platforms.

The first objective was that staff would have accessible and consistent updates from senior leadership. They needed information focused on operational changes, COVID-19 vaccinations for staff, and the messaging for patient queries. The IC team wanted to establish a consistent single source of truth, tailored for staff, giving more operational detail.

The third objective of the communications plans was to give staff an opportunity to raise concerns or issues directly with HSE senior leadership.

AND

wo HSE communications teams scooped awards at the prestigious PRCA/PRII Excellence in Public Relations Awards.

The second objective was to maintain and build trust between staff and senior leaders. To mitigate against COVID-19 restrictions becoming a barrier to staff trust in senior leaders, the IC team increased the virtual presence of senior leaders on internal digital channels.

“Our strategic plan was to position www. hse.ie as the most reliable source of accurate, factual and informed information on COVID-19 and vaccination programme for the general public and other stakeholders whilst continuing with non-COVID proactive health campaigning. We also kept the public informed during the cyber-attack despite it leaving the press office with no work devices, access to ICT network or email,” said Mary Gleeson of the Press team.

The IC team, responsible for internal and corporate communications, spent 2020 in crisis mode, responding to the information needs of staff as the pandemic unfolded. There was limited time to plan, measure, and review during this period. In 2021 they developed a clear plan for senior leadership communications based on the collective experience of events in 2020.

• Gave insights into information gaps for frontline staff which informed short-term planning.

Pre COVID-19 the CEO did a monthly, high level, video update for all staff. This was produced in-house, and filmed on location during CEO visits to health services. Utilising this established format, the team increased the frequency from monthly to weekly, focused the message to COVID-19 updates.

• The format demonstrated the openness of senior leaders, it was clear the webinar was not about pushing a corporate agenda.

The second HSE win of the evening went to the National Press and Media Team. The judges noted, “This very hard-working team operates in a highly challenging and complex stakeholder environment. It manages day-to-day and emerging issues, alongside proactive public awareness campaigns.

The Health Service Executive Annual Report and Financial Statements 2021 was published on 20 June 2022.

departmentemergency

Over 1.3 million people attended an

Effects of the cyber-attack

90.2% of children aged 24 months received the measles, mumps, rubella

135 people with a disability transitioned from congregated to community settings

Over 590,000 inpatients were from

Over 1 million

Key Activity in 2021

COVID-19 pandemic and HSE response

Over 25,200 adults were seen by mental health services

In 2021, our key focus continued to be the provision of safe health and social care services against the backdrop of COVID-19. The ongoing implementation of Sláintecare reforms provided the opportunity to address long-standing challenges including waiting lists for scheduled care in hospitals and long waits in emergency departments.

HEALTH MATTERS AUTUMN 202226 |

THE HSE ANNUAL REPORT AND FINANCIAL STATEMENTS 2021

Responding to COVID-19 continued as a key priority throughout 2021 and due to the success of our national vaccination programme, we are moving progressively away from a crisis response. By the end of 2021, 95.1% of the adult population and 77.8% of the total population had received their primary vaccination with, in addition, over 2.25 million booster doses administered. As the number of serious cases reduced, we continued to be guided by the advice of our public health teams, while always remembering those we have lost and those who continue to suffer as a result of the pandemic.

Over 1.54 million people have a medical card and almost 526,000 people have a GP visit card.

contacts with GP out of hours services 77.1% screeningBreastCheckuptakerate

he Annual Report describes the performance of the Health Service Executive (HSE) during 2021. It sets out what we accomplished to meet our objectives described in the National Service Plan 2021 and the HSE Corporate Plan 2021-2024. The reports details how services were provided in 2021 while dealing with the challenges posed by both COVID-19 and the cyber-attack. It includes an overview of governance and accountability within the organisation and provides detailed financial information about our organisation through the Annual Financial Statements.

vaccine

Over 20 million home support hours (excluding hours from Intensive Homecare Packages) were provided to over 55,000 people

(CAMHS)services

departments

hospital

Over 3.2 million people attended hospital outpatients

Over 1 million people received

Over 12,600 children / adolescents were seen by mental health

In his review, the Chief Executive Officer highlighted that despite the unrelenting pressures faced since the onset of the pandemic, “the sustained response is only possible because of the extraordinary commitment, tenacity and courage of an outstanding workforce, fostering trust and confidence across our wide range of services”.

discharged

Widespread disruption to our health services was caused by an unprecedented cyber-attack in May 2021, compounding the pressures already being experienced.

day treatmentcase

The HSE Annual Report and Financial Statements 2021 is available at: https://www.hse.ie/eng/services/publications/corporate/hse-annual-report-and-ﬁnancial-statements-2021.pdf

• The Sláintecare Healthy Communities Programme was launched and work progressed on establishing the programme in 19 community areas

• Of 1,146 additional permanent acute beds planned to be delivered in 2021, 813 were open by the end of the year with the remainder to be delivered in 2022

adoption and laying the foundation for progressing the reporting strategy which is a key chapter within the Financial Management Framework that underpins the IFMS. The IFMS and other key projects referenced above, many of which are key enablers for Sláintecare, bring real hope that sustainable improvements in how ﬁnance and procurement can support our health services will be achieved in line with our projections. The year 2021 represents the third consecutive year where the HSE has managed its overall ﬁnances within expected overall parameters as discussed with the Department of Health (DoH) and Department of Public Expenditure and Reform (DPER).

Notwithstanding the ongoing pandemic and crippling cyber-attack, there was considerable activity across the delivery system throughout 2021 thanks to the volume of work undertaken by a committed and dedicated workforce.

• Implementation continued of an enhanced public health service delivery model

• Cancer services were progressed including the implementation of a stereotactic ablative radiotherapy service, establishment of a peptide receptor radionuclide therapy (PPRT) service and chimeric antigen receptor T-cell (CAR-T) treatment. PRRT and CAR-T were previously only accessible through the Treatment Abroad Scheme

Financial management

• Five new community intervention teams and three enhanced teams were established, with national coverage secured in 2021 for the ﬁrst time

FURTHER READING:

• Work continued, through the Enhanced Community Care Programme, on the establishment of 96 Community Healthcare Networks and 30 Community Specialist Teams for older people and people with chronic diseases, providing integrated services for people nearer to home

This event caused a catastrophic disturbance in our ICT infrastructure which underpins the e cient functioning of health and personal social services. Our sta showed remarkable resilience and ingenuity to ensure the continued delivery of essential care while work was ongoing to stop and minimise the e ects of the cyber-attack. We will continue to develop, implement and monitor improvements in the security and resilience of critical national infrastructure for the provision of essential services, ensuring an improved rapid response is available to these threats when they occur.

| 27HEALTH MATTERS AUTUMN 2022

• A home support pilot for older persons commenced to inform the ﬁnal design of the new Statutory Home Support Scheme

• A signiﬁcant milestone in the reform of children’s disability services was achieved with the reconﬁguring of 91 Children’s Disability Networks, ensuring that children with complex needs have access to a team close to their home

Corporate Plan 2021-2024 corporate-plan-2021-24.pdfpublications/corporate/hse-https://www.hse.ie/eng/services/

Service delivery in 2021

• To improve capacity, a new Child and Adolescent Mental Health Service telehealth site was operationalised, sta numbers for Community Mental Health Teams were increased and additional acute mental health beds were procured

• An additional 42 critical care beds opened on a permanent basis

• Investment and expansion continued across a range of maternity and neonatology services in line with the National Maternity Strategy including foetal assessment, perinatal pathology services, specialist midwifery services, dietetics, physiotherapy and perinatal mental health.

If you would like further information on the HSE’s Annual Report, please contact the Planning Unit, O ce of the National Director, Strategy and Research at planning.ddg@hse.ie or telephone 021-4923549. A PowerPoint presentation, that includes slides on the infographics for healthcare activity in 2021 has been prepared as a resource for sta to use in presentations and reports and this is also available from the Planning Unit.

During 2021 there was a significant additional focus on financial reporting, including analysis and forecasting, and related ongoing interim improvements in the areas of COVID-19, working capital and cash. Significant energy and focus has gone into progressing the Integrated Financial Management System (IFMS) and into a number of key related programmes of work. This included planning for the expansion of shared services, integration with the National Integrated Sta Records and Pay (SAP HR) programme, engagement with the voluntary sector around IFMS

• A targeted action plan to reduce acute waiting lists was implemented in the last quarter of the year, resulting in a reduction of 40,644 in total numbers waiting across all waiting lists

National Service Plan 2021 service-plan-2021.pdfpublications/serviceplans/national-https://www.hse.ie/eng/services/

HEALTH MATTERS AUTUMN 202228 |

The Art of Being Heathy and Well, a national symposium took place during the summer highlighting the positive benefits of creativity and the arts to health and wellbeing on www.creativeireland.gov.ie. This symposium gave policy-makers and practitioners from health, arts and culture sectors the opportunity to discuss how best to harness the powerful contribution creative engagement can make to our health and wellbeing.

ARTS FOCUS FOR HSE STAFF BEREAVED DURING COVID

EXPANDING ARTS IN HEALTH PROJECT

The Irish Hospice Foundation (IHF) Arts Programme is engaging four artists to develop a new creative process or practice that supports the health and wellbeing of health care staff in the HSE. The HSE employs about 110,000 people, many involved in emotionally demanding work in the four corners of the country. The project aims to support the role of creative practice for people affected by death, dying, grief and loss. The nature of the creative process is collaborative between the artists and HSE staff with ideas and concepts emerging. The artists have been selected and workshops with HSE staff are under way.

This project which is being led by Waterford Healing Arts Trust (WHAT), is working on delivering a programme of networking and professional development supports for health and social care supports. They are also developing a national picture of arts and creative activity taking place in HSE led, and funded, settings.

HELIUM ARTS PROJECT

Speaking at the event, both the Minister for Health, Stephen Donnelly and the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media, Catherine Martin gave full commitment to the current arts and health projects and also pledged to support additional pilot funding. Within the HSE with Paul Reid, Chief Executive Officer highlighted the importance of creating more awareness of utilising creative arts to benefit the wellbeing of service users and staff.

New

HSE and the Art of Being Healthy and Well

Studies show creative expression helps maintain our immune systems and that art is clinically proven to reduce stress, elevate mood, and lower blood pressure. The concept and application of the arts for health and wellbeing in Ireland has been evolving over the past 30 years. In recent years, the evidence to support the benefits of arts and health is growing and strengthening.

This project is being led by HSE Health & Wellbeing and the National Office for Social Inclusion. The aim of this initiative is to pilot three projects focused on promoting traveller health and wellbeing through the delivery of three creative arts project. This is an exploratory pilot initiative and as such the process undertaken by the successful projects should have potential to be replicated in other areas across the country and with other socially excluded groups such as the Roma community.

Being Healthy

arts in health initiatives have been recently funded as part of a HSE collaborative initiative with Creative Ireland, Department of Health (Healthy Ireland) and the Arts Council. The RENEW partnership, was established in 2020 to explore options for collaborative working to further development arts and health in the HSE. The group’s work has recently culminated in the development of a number of new arts and health programmes evidenced by the fact that a total of €591,000 was provided for a number of projects for delivery in 2022 and a recent symposium.

TRAVELLER WELLBEING THROUGH CREATIVITY

There was a great sense of optimism at this inaugural cross departmental arts and health symposium. Other projects being delivered through this partnership include:

Helium Arts is Ireland’s children’s arts and health organisation, supporting children facing lifelong medical conditions to realise their creative potential. As part of the RENEW partnership, funding is being provided to Helium Arts to support the development of a national scale a creative programme connecting between hospitals and community settings for children with lifelong conditions and also to offer ongoing activities to develop and enable creative potential that supports children to feel less isolated, with better wellbeing, and that supports resilience in impacted families.

Front - Cassandra Campion, Diabetes Nurse MRH Tullamore; Demelza Dooner, Advanced Nurse Specialist Diabetes, MRH Tullamore; Joan Bourke, Director of Nursing Public Health; Louisa Burke, Director of Nursing MRH Tullamore.

Mairead Walsh, Clinical Nurse Specialist Diabetes, at the Regional Hospital in Mullingar, said, “We are proud to present these recommendations which we feel will greatly enhance the quality of life of patients with diabetes and a terminal illness, and will also give healthcare professionals greater conﬁdence in dealing with such patients.”

Michael Cushen, Consultant in Palliative Care Medicine at the Midland Regional Hospitals in Tullamore and Portlaoise, said, “In Ireland, diabetes care towards the end of life is an area lacking in quality standards and guidance on best clinical practice. In the past we have used UK guidelines to direct care. These new recommendations will place an emphasis on less stringent blood glucose and HbA1c values for glucose approaching end of life, while at the same time avoiding the patient struggling with blood sugars that are too high or too low.”

Top: From the launch at MRH Tullamore were: Back - Elaine Bannon, Clinical Nurse Specialist Diabetes Laois; Mairead Walsh, Clinical Nurse Specialist Diabetes Westmeath; Michael Cushen, Consultant in Palliative Care Medicine, MRHT.

Above: From the launch at MRH Portlaoise were: Back - Margaret McEvoy, CNS Diabetes; Caoimhe Kenny, Senior Dietician; Georgina Doyle, ANP Diabetes; Dr Michael Cushen, Consultant in Palliative Medicine; Front - Michelle McCormack, CNS Diabetes; Dawn Healy, Podiatry; Regina Healion, CNSp Diabetes.

To learn more about the Biochemistry Department in Mayo University Hospital watch this short video: com/647391150/5bac017b82https://vimeo.

“For example, when processing tests for GPs we have improved the turnaround time by one third. We are also able to carry out certain tests now in MUH that had previously been sent out to external labs, which means we can get the results back to patients much quicker. The next development for the lab in MUH is to repatriate Vitamin B12, Ferritin and Folate tests, which is something GPs have been requesting for some time.” BIOCHEMISTRY LABORATORY EQUIPMENT LEADS TO FASTER TURNAROUND TIMES FOR TEST RESULTS

Demelzamoment.”Dooner,Advanced Nurse Practitioner in Diabetes at Midland Regional Hospital Tullamore, said, “Being given a terminal diagnosis is usually a seismic shock to patients and their families, and they will need a huge amount of support. We are certain these recommendations will help to make their ﬁnal days more comfortable, and that they will be able to accept less strict control of their diabetes where appropriate.”

million tests annually. The investment in this new state-of the-art equipment was necessary to ensure we can continue to maintain the highest of standards but also enables us expand our services without compromising e ciency.

Ray Divilley, Chief Medical Scientist at Mayo HospitalUniversity

The recommendations have been produced jointly by the Midlands Diabetes Nurse Specialist Group and the Midland Palliative Care Services.

New end-of-life clinical care recommendations for diabetic patients launched

Siobhan Meehan, Clinical Nurse Specialist in Diabetes for Longford and Westmeath and Chair of the Diabetes Steering Group, said, “This important new advice will help us ensure our patients who are at palliative have the best quality of life possible. Our goal moves from prevention of long term complications to symptom control, as patients with diabetes approach their end of life. Our key concern, is always what’s in the best interest of the patient, at that particular

The recommendations are the ﬁrst of their kind in Ireland. They provide guidance on the principles of high-quality diabetes care for patients who are palliative, by liberalising the goals of care, simpliﬁcation of treatment and reduction of medication burden.

Ray Divilley, Chief Medical Scientist, said, “The Biochemistry Department in MUH has developed into a sophisticated and technologically advanced laboratory, processing approximately 3

NEW

Over the last two years the biochemistry laboratory in Mayo University Hospital (MUH) has undergone enormous development with an ambitious project to install a revolutionary automated track analytical system.

ew recommendations on caring for patients with diabetes who are approaching their end of life, have been launched jointly by the Midland Regional Hospitals in Tullamore, Portlaoise and The Regional Hospital in Mullingar together with the Community Diabetes Nurse Team covering Longford, Westmeath, Laois and O aly.

Georgina Doyle, Advanced Nurse Practitioner in Diabetes at the Midland Regional Hospital Portlaoise, said, “The aim of the recommendations is to promote a consistent high-quality approach to diabetes care towards the end of life. The new guidelines suggest this should be achieved with the least invasive testing and minimum e ective amount of medication.”

The busy laboratory in MUH analyses clinical samples to assist in the diagnosis, monitoring and prognosis of a wide range of diseases. The team of medical scientists process 1,500 samples per day, providing a vital diagnostics service to support doctors and nurses in making clinical decisions within the hospital and the many GP practices in the region.

The new track system was installed in June 2021 after significant internal construction works and reconfiguration within the Biochemistry Department. The track analyser machine automates the processing of samples that is usually done by hand, and the main benefit to patients is a much improved turnaround time for test results.

| 29HEALTH MATTERS AUTUMN 2022

An innovative mobile phone app will empower patients with chronic pancreatitis to take control of their condition, and will improve communication with the hospital team.

symptoms, severe ‘brittle’ diabetes and poor wellbeing for the patient. Patients with chronic pancreatitis lose weight and become malnourished; many develop vitamin deﬁciencies and osteoporosis. Patients' needs are complex and di cult to manage. These patients need treatment from multiple specialists.

Michael Knowles, General Manager, MRH Portlaoise, said he was ‘delighted that we are now providing this well-structured course that allows people with type 1 diabetes to experience the incredible quality-of-life improvements reported by those in other countries who have attendedAnyoneDAFNE’.agedover 17, under the care of the diabetes service at MRH Portlaoise, can register to attend the Remote DAFNE programme by letting their consultant, nurse or dietitian know.

The new SmartCP app will enable patients with chronic pancreatitis to report red ﬂags like worsening malabsorptive symptoms and signs of new diabetes so that doctors can intervene earlier to achieve better outcomes. Those who su er from this particular condition have a higher-than-normal risk of developing pancreatic cancer, and therefore

he Midland Regional Hospital (MRH) in Portlaoise is o ering patients with type 1 diabetes a DAFNE (Dose Adjustment For Normal Eating) course. It aims to teach participants how to manage their blood glucose levels by accurately calculating their insulin dose needs for meals, exercise and a changing lifestyle.

Top photo, standing: Michael Knowles, General Manager; Sandra McCarthy, Director of Nursing; Regina Healion, CNSp Diabetes; Caoimhe Kenny, Senior Dietician; Dr Connaughton, Clinical Director; Dr Sharma, Consultant Endocrinologist; Seated: Karen Delahunty, Clerical O cer; Michelle McCormack, Sta Nurse; Dr Kyithar, Consultant Endocrinologist; Lorraine Kelly, Senior Dietician; Georgina Doyle, ANP Diabetes.

Lorraine Kelly, Senior Dietician at the MRH Portlaoise, said, “The DAFNE course teaches participants crucial diabetes-management skills. DAFNE has been shown to improve control of blood glucose and to reduce the incidence of acute complications of diabetes such as severe hypoglycaemia (82% reduction) and diabetic ketoacidosis (62% reduction).”

Chronic pancreatitis is a chronic, incurable condition in which the pancreas is inﬂamed. This leads to constant, unmanageable stomach pain, di cult-to manage gut

Professor Conlon said, “Our hospital is very well placed to take a lead on the development of this technology, we run the only dedicated chronic pancreatitis service nationally, providing care for over 300 patients. This new digital tool will improve patient access to specialist care, no matter where they live in the country.”

Karen Delahunty, Clerical O cer; Michelle McCormack, Sta Nurse; Georgina Doyle, ANP Diabetes; Lorraine Kelly, Senior Dietician; Regina Healion, CNSp Diabetes; Caoimhe Kenny, Senior Dietician.

Dr John Connaughton, Clinical Director, MRH Portlaoise, said, “This is a very positive development for anyone with type 1 diabetes attending MRH Portlaoise. DAFNE allows patients to ﬁt diabetes into their lives rather than ﬁtting their lives into diabetes and in addition, it improves glycaemic control for them.”

PROGRAMME GROUND-BREAKING NEW APP TO HELP CHRONIC PANCREATITIS SUFFERERS

The organisers hope that given the course is being run online it might ﬁt in better with participants work and home commitments. By the end of the year, the diabetes team in Portlaoise hope to o er a choice of remote or face to face DAFNE courses.

The SmartCP app at Tallaght University Hospital (TUH) will provide patients with more direct and timely access to the team, and allow the provision of clear, appropriate, accessible and accurate information. The announcement follows a successful application for funding to the Department of Public Enterprise & Reform Innovation Fund.

the detection of red-ﬂag pancreatic cancer symptoms would allow for crucial early diagnosis and treatment.

HEALTH MATTERS AUTUMN 202230 |

well as online learning from home which participants can complete in their own time and at their own pace. There will also be weekly small group video support calls.

Regina Healion, Clinical Nurse Specialist in Diabetes, explained that the Remote DAFNE course takes ﬁve weeks to complete and consists of pre and post-course appointments as

A first for Portlaoise hospital as it offers a new programme for those with Type 1 diabetes

The project will be coordinated by Professor Kevin Conlon, Consultant Surgeon at TUH and Professor of Surgery at Trinity College Dublin, and Dr Sinead Duggan, a Senior Research Fellow in Trinity College Dublin.

Endocrinologist; Regina Healion, CNSp Diabetes; Dr Connaughton, Clinical Director; Dr Sharma, Consultant Endocrinologist.

DIABETES

The project involved the construction of a new

“Young people who engage with their diabetes have better clinical outcomes and quality of life.

“It’s very exciting to be the ﬁrst Registered ANP in the children’s Ark. My role is primarily designed to help young people to self-manage their diabetes, to become empowered to make their own healthcare decisions,” said Alison.

HOSPITAL OPENS

300sq/m single storey, standalone building on the hospital campus. Building works began in October 2019 and were completed in March 2021. The centre has been fully operational since May 2021.

From left: Alison McCa rey, Advanced Nurse Practitioner in Paediatric Diabetes; with Dr Orla Neylon, Consultant Paediatric Endocrinologist; and Prof Clodagh O’Gorman, Consultant Paediatrician.

oung people with diabetes are being supported in transitioning to adult services through the appointment of the ﬁrst paediatric advanced nurse practitioner (ANP) at University Hospital Limerick.

Grainne McCann, hospital manager at Sligo University Hospital, said, “There are over 5,000 people diagnosed with Diabetes Mellitus in the Sligo/Leitrim, West Cavan area.

The new centre allows for a more timely access to consultant clinical expertise and will reduce the admission and length of stay at Sligo University Hospital. Specialist clinics have been introduced including transition and young adult clinics, which are running alongside existing services, allowing patients to access multidisciplinary endocrinologist, dietician, and clinical nurse specialists in a one-stop-shop.

“Through structured education, engaging with families, and addressing risk-taking behaviours, the hope is that by the time our patients are leaving the paediatric service and going on to university or starting a job or apprenticeship that they are able to mind their own diabetes in a safe way and that they live life to the full in terms of lifestyle, exercise, travel and all the things we enjoy doing at that age,” said Alison.

structured education, building competence in managing diabetes, growing conﬁdence in their own decisions and advocating for themselves in clinic,” Alison added.

Regina Ward and son David O’Callaghan, who has been a patient of the diabetes service since he was a baby, with Minister for Health Stephen Donnelly; Cllr Dónal Gilroy; Minister of State with responsibility for Public Health, Frank Feighan; patient representatives Donal Conway and David O’Callaghan; and Paul Gillespie and Caroline Barrett of the Donegal Diabetes Association.

The paediatric diabetes service at UHL currently manages 220 young patients. Every year, between 20 and 30 patients will transfer to the adult service and part of Alison’s role adds a new dimension to this service.

NEW DIABETES CENTRE AT SLIGO UNIVERSITY

The new Diabetes Centre, which consists of ﬁve multi-purpose clinic rooms including podiatry clinic room and an education room, was o cially opened by Minister for Health Stephen Donnelly TD in May.

Prof Clodagh O’Gorman, Consultant Paediatrician with a special interest in Diabetes and Endocrinology, explained, “Transitioning to the adult services is a process that can take a couple of years. This is one part of Alison’s role but a very important one because there is really good literature to show that young people who disengage from the adult service following a transition that did not meet their needs will represent with signiﬁcant complications at young“Thisages.”iswhat we are zoning in on. Alison is working with those kids and young people to see what they need as they transition so we can e ect a better service. We are also actively working with the young people and their families to ﬁnd out what is important to them in their health service and their transition process, and we are keen to align the process as much as possible to meet their needs. We want to make sure they remain as healthy as possible for as long as possible.”

PAEDIATRIC DIABETES

| 31HEALTH MATTERS AUTUMN 2022

Alison McCa rey’s appointment as ANP in Paediatric Diabetes will empower young people to self-manage their condition, improve health outcomes and general quality of life.

“I am privileged to be working with children and young people with diabetes aged 12 years old and upwards. I help provide

SUH is one of the six national designated centres of excellence under the National Clinical Care programmes. The new centre provides a bright, calm, relaxed, and conﬁdential environment for people with diabetes attending this service. We are in a position, since the opening of the centre, to provide enhanced facilities to educate patients and their families, which is a key component of the service.”

Appointment of first Advanced Nurse Practitioner in Paediatric Diabetes at UHL

Pilot project focuses on the early detection of cancer-related lymphoedema

HEALTH MATTERS AUTUMN 202232 |

EARLY FOCUS

“We hope the project will also improve the experience and outcomes for patients as well as improve the quality of care for people already living with cancerrrelated lymphoedema. We are hopeful that this pilot project will one day become part of a larger model of cancer care for patients across the country.”

• Those with a BMI of > 30

The programme also o ers education & information sessions, online resources and support to patients throughout their involvement with the project.

prevent more serious long-term issues. It will also provide great support for patients who develop this very di cult and often challenging complication.”

• Those with a history of cellulitis

Early detection of lymphoedema can reduce your risk of developing lifelong lymphoedema by 95%.

Raheen local Emer Barry, a cancer patient undergoing monitoring as part of the project, said, “Following a cancer diagnosis and the treatment that follows, there is a lot of information to digest which can be overwhelming. Thankfully the lymphoedema service in University Hospital Limerick removes the stress and worry related to the development of lymphoedema. I know that I’m being monitored closely and can ask any questions in my follow up appointments. The service provides reassurance and conﬁdence that I am receiving the best possible care to prevent or catch any signs of lymphoedema at an early stage."

Initially all breast and gynaecological cancer patients receiving treatment in University Hospital Limerick that are deemed high risk for lymphoedema will be referred to the service. Each patient will then have their Lymphoedema Index score measured by a certiﬁed lymphoedema therapist in the physiotherapy department of the hospital pre and post treatment. If required, patients will then be treated with compression garments, skin care and tailored exercise programmes and monitored for up to two years.

Dr Denis O’Kee e, Consultant Haematologist and Director of Cancer Services for UL Hospitals Group, said, “We are delighted to see this project being opened in UHL. The early detection of lymphoedema in high-risk patients will provide the opportunity to treat and

Clockwise from top left: Sinead Cobbe, Senior Physio, on the new Bioimpedance Spectroscopy equipment in the gym at University Hospital Limerick at the launch of the new Lymphoedema Early Detection service as Donal Buggy, Head of Services, Irish Cancer Society, and Shirley Real, Group Lead Allied Health, UL Hospitals Group, look on; Back row, left to right, Mary Liston, Assistant Director of Nursing, Cancer Services; Shirley Real; Colum Moloney, Acting Physiotherapy Manager, UHL; and front row, Anne Quinlan, Cancer Nurse, Irish Cancer Society; Kathy Nugent, Senior Physio; Donal Buggy; Sinead Cobbe and Niamh O’Grady, Directorate General Manager, Diagnostics Directorate, UL Hospitals Group; Sinead Cobbe, with Donal Buggy, and Kathy Nugent; Shirley Real; Donal Buggy; and Kathy Nugent and Sinead Cobbe.

Anyone with concerns or questions about cancer can contact the Irish Cancer Society Support Line on Freephone 1800 200 700 and SupportLine@IrishCancer.ie

he Irish Cancer Society has announced the launch of a three-year pilot project in University Hospital Limerick focusing on the early detection of cancerrelatedLymphoedemalymphoedema.isaswelling that can occur in the arm, hand or trunk after cancer treatments including surgery, radiotherapy, chemotherapy and endocrine therapies. These treatments can compromise the lymphatic system and lead to a build-up of lymph ﬂuid which causes pain, skin changes and reduced function. This can be very distressing and adversely a ect quality of life.

WHO IS AT RISK OF DEVELOPING LYMPHOEDEMA?

• Those who have recently had their lymph nodes removed

• Those with reduced mobility of their upper limbs

Speaking at the launch of the service, Donal Buggy, Director of Services Delivery & Implementation at the Irish Cancer Society, said, “Over the last number of years, it has been repeatedly highlighted that there are a lack of services for lymphoedema patients in addition to a more general lack of focus on the education, prevention and early detection of lymphoedema. Therefore we are delighted to be investing in this project which will support the Irish Cancer Society’s commitment to drive innovation in cancer services through new initiatives.

• Menopause clinic

• Subfertility service

The ambulatory gynaecology service commenced in March 2022, one of a number of such units opened around the country under national plans to improve outcomes for women through a new model of care.

A specialist menopause clinic will open in Nenagh as the regional hub for women’s health continues to take shape. This will initially entail one consultant clinic and one GP clinic per week. A clinical nurse specialist in menopause is also being recruited for thisTheservice.final element of the new service in Nenagh will see the opening of a subfertility clinic later this year. This has been identified as a key component in the development of fertility services around the country by the National Womens and Infants Health Programme.

TOP: Staff Nurse Danielle Freeman; Clinical Nurse Manager 2 Breda Needham and Multi-Task Attendant Neil Kevin at the new Regional Women's Health Hub in Nenagh

Dr Naro Imcha, Clinical Lead for

BELOW: Dr Naro Imcha, Clinical Lead for Obstetrics and Gynaecology, UL Hospitals Group, and Dr Cathy Casey, Consultant Obstetrician/Gynaecologist pictured at Nenagh Hospital as the new Regional Hub for Women's Health for the MidWest commences operations

• An ambulatory gynaecology unit

This service will also be consultant-led and the appointment of a specialist in fertility services will is expected later this year.

he establishment of a regional hub for women’s health at Nenagh Hospital will improve access to diagnostics and reduce wait times for specialist care for women in the MidWest.

Obstetrics and Gynaecology, UL Hospitals Group, said: “The entire team in Nenagh and in the hospital group is very focused on improving the patient experience. This regional hub for women’s health will improve the patient pathway, reduce the number of visits, thereby optimising the patients’ time and reduce their costs. For a majority of cases, the consultation, investigation, and treatment can all be carried out during the first visit. This is a vital and unique opportunity to reduce waiting times and to enhance quality of life for these patients in the MidWest.”

Among the investigations available to women in the MidWest with the establishment of the new service are pelvic ultrasound, diagnostic hysteroscopy and endometrial biopsy. Treatments and minor procedures available in the clinic include both cervical and endometrial polypectomy and intrauterine device management.

Pictured as the new Regional Hub for Womens Health in Nenagh opened its doors were staff nurse Danielle Freeman; Claire Hartnett, Directorate General Manager, Maternal and Child Health, UL Hospitals Group; Cathrina Ryan, Director of Nursing, Nenagh Hospital; Dr Cathy Casey, Consultant Obstetrician/Gynaecologist; and Bernie Nolan, Assistant Director of Nursing, Nenagh Hospital

Located in the new €1.4m extension to the outpatients department in Nenagh, and supported by the Women’s Health Taskforce and the HSE National Women’s and Infants Health Programme (NWIHP), the initiative includes:

These services are being established as one-stop, “see-and-treat” gynaecology clinics in which women can be assessed and treated following a GP referral. This new model will improve access to diagnostics and treatment, resulting in fewer hospital visits and reducing overall wait times for women.

Coming under the clinical governance of University Maternity Hospital Limerick, the new ambulatory gynaecology service at Nenagh will provide a range of services to women in the MidWest. These include abnormal intrauterine bleeding, chronic pelvic pain, evaluation of adnexal mass, vulval issues, sexual minority health and amenorrhea in adolescence.

REGIONAL HUB FOR WOMEN’S HEALTH AT NENAGH HOSPITAL WILL REDUCE WAIT TIMES AND IMPROVE ACCESS

| 33HEALTH MATTERS AUTUMN 2022

Moving to this new model of care will also have benefits for the hospital system, freeing up clinic and theatre capacity for the management of more complex gynaecological patients by managing less complex investigations and procedures in the new clinic in Nenagh.

Following discussion and collaboration between Dr Costello, Dr Mary Paula Colgan, Associate Professor in Vascular Disease, St James’s Hospital, and Bernadette Hannon, CNS in Venous Disease St James's Hospital, a proposal was drafted to commence a virtual vascular clinic.

On February 8th 2021, the ﬁrst virtual clinic was conducted with great anticipation and some anxiety surrounding this new platform of communication. Three patients were reviewed at the ﬁrst virtual“Quicklyclinic.we

“We now have a caseload of 38 patients, median age of 82 years (range 52 – 87 years) who have access to this virtual vascular clinic. The average duration of the review appointment is 10 minutes for the virtual consultation and a further 15 minutes to redress the ulcers. Previously, patients reported spending up to four hours travelling to and from their outpatient appointment from the midlands to Dublin. The virtual clinic runs every two to three weeks. The impact of this initiative includes reported patient satisfaction due to local access, signiﬁcantly reduced travel time and most importantly a timely review.

“A readiness assessment was completed and our proposal was approved by primary care senior management. The proposal included all patients from the Laois/O aly PHN service who were referred to Dr Colgan in St James’s Hospital for vascular assessment. The initial consult would be completed in St James’s Hospital and all review appointments would be conducted virtually with the ANP within the PHN service,” said Dr Costello.

Using secure videoconferencing technologies, this tested model of telemedicine has replaced lengthy traditional clinic visits, it has saved patients’ time and travel and results in more e cient use of medical, nursing and facility

“This proposal for a virtual vascular clinic was strongly supported by Yvonne Delaney; Interim Director of Public Health Nursing Laois/O aly. This partnership between primary care and acute partners resulted in enhanced collaborative practice and put the wheels of true

“Essentially,resources.the sustainability of this innovative vascular clinic requires on-going collaboration and integration between acute and community primary care practitioners. The health economic beneﬁts will be measured in time. Evidently for the PHN service, the economics translates as patients attending the PHN service for shorter duration as healing is quicker due to scheduled and timely access to medical vascular expertise and nursing led tissue viability care. For the acute service, this represents more e cient use of OPD scheduled care. In the future we propose to use this clinic to provide enhanced teaching opportunities for PHN and acute teams,” she added.

In response, the media platform of ‘Attend Anywhere’ was introduced to the PHN service in Laois/O aly as a method of delivering remote vascular telemedicine for online patient consultations.

Dr Mary Costello, registered Advanced Nurse Practitioner (ANP) Tissue Viability/ Lymphoedema Care Laois/O aly, explained that for their patients in the PHN service, this included a delay in the diagnosis and treatment of venous and arterial disease and subsequently a reduction in patients’ quality of life due to wounds and associated pain.

he COVID-19 pandemic had a massive impact on acute hospital services. From a vascular perspective, this acute service impact transferred into the primary care Public Health Nursing (PHN) service.

‘integrated care’ in motion between PHN service Laois/O aly and the acute vascular service in St James’s Hospital.”

The patients show great interest in the technology and are eager to engage. An additional beneﬁt includes more e cient use of the appointment allocation in the outpatient setting, which would have been occupied by the review patient. This time slot is now being given to a new referral thus assisting in reducing the vascular waiting list. Most importantly, the measurable outcome is that 75% of our patients have progressed to complete wound healing and maintenance hosiery.”

Dr Mary Costello, Advanced Nurse Practitioner, Tissue Viability and Lymphoedema Care, Laois/O aly, and Martina Ryan, PHN Portarlington.

A Virtual Vascular Clinic in Primary Care

identified problems surrounding camera clarity, sound, the timing of appointments and the need for an additional nurse from within the PHN service to assist with the flow of patients. With funding support from primary care, we introduced a webcam and a sound booster; both clarity and sound improved significantly. At no additional cost, the existing PHN sta from Portarlington Primary Care assisted our ANP with wound dressing and the escorting of patients on virtual clinic day,” she said.

takeover HEALTH MATTERS AUTUMN 202234 |

Furthermore, the waiting list for vascular intervention was further lengthened as only urgent out-patient clinics proceeded in the acute setting.

Telehealth

THE OBJECTIVES OF THE CLINICSCONTINENCENURSE-LEDCAREINMAYOARE:

urse-led Continence Care Clinics were launched in Mayo in 2009 to improve standards of continence care for patients in Co Mayo through the provision of educational and clinical support and advice, treatment and management for patients, carers and healthcare professionals. This Nurse-led service, the ﬁrst of its kind in Ireland, is located in the Continence Clinic in Castlebar Primary Care Centre o ering a clinical room with an en-suite toilet, an adjacent o ce and waiting area. Out-reach Continence Clinics are also provided in Westport, Claremorris, Ballina andReferralsBelmullet.tothe service are received from the person themselves, their carer or family member, Tertiary centres (Urology, Obstetrics, Gynaecology, Emergency Departments (ED)), community rehabilitation facilities, GP, Public Health Nursing, Allied Healthcare Professionals, teachers, Special Needs Assistants and voluntary agencies sta .

• To improve access to appropriate care, by o ering a rapid assessment, advisory and treatment service to local General Practices and Community Services.

• To provide an equitable and cost-e ective service for the provision of disposable and reusable absorbent containment products for those patients with intractable problems.

University College Hospital Galway (UCHG) and ED MUH. Patients have received their care either in the Continence Care Clinic or their own home depending on their ability to travel.

The service has expanded with the development of a Nurse–led Trial without Catheter Clinic in Mayo which commenced in February 2020 supported by the development of a clinical care pathway in consultation with Urology Advanced Nurse Practitioner (ANP)/Urologist/ED Consultant Mayo University Hospital (MUH). The provision of this service reduces the Urology Clinic waiting list in tertiary care settings for patients who reside in Mayo and facilitates care close to the patient’s home.

• To maintain close relationships with Consultants /ANP in Urology and Gynaecology in order to ensure quality of care, accuracy of diagnosis, and appropriateness of therapies.

The service is provided to community-

Feedback from patients receiving this service has been extremely positive. Patient M O’N revealed, “For me, I will be forever grateful to have been referred via my Urologist in Galway to Fidelma and her service. It is a fantastic resource for me in that it is local, it’s in a community setting and is very professionally presented. It is such a bonus, especially now in the pandemic, that I don’t have to be in a crowded hospital situation. Given her very considerable workload, Fidelma is always very warm, welcoming and extremely professional during my appointments.”

• To prevent duplication or omission of services by facilitating the e cient and managementappropriateofpatients with urinary continence problems.

A parent spoke about the benefits for her daughter. “Our daughter Emily was referred to the service from our GP. We were at a loss of how to help our little girl and had tried everything but as soon as we had our first appointment with Fidelma we were given information, a treatment plan was made and follow up appointments. We didn’t have to wait very long for our first appointment before we were called to the clinic. This was very reassuring to us. I was encouraged to phone or email if I was having di culty and this extra support was very welcoming. The sta were so kind and understanding. It was a di cult time for our little girl but with all the kindness, encouragement and help we received, we got through this time. We cannot thank them enough. It has changed our lives and our little girl.”

• To improve standards of continence care for local patients through the provision of educational and clinical support, advice, treatment and management to patients, carers and allied healthcare professionals in the primary care setting.

IMPROVENURSE-LEDCLINICSCARE

• To build extra capacity for continence services, reducing the need for hospital care, and reducing waiting times in secondary care.

based patients within a clinic or domiciliary setting across all ages within the county including Paediatric services, Antenatal and Postnatal services, Disability services, Mental Health services, Public and Private Nursing Homes, District hospitals and Voluntary services including Cheshire Homes Ireland, Western Care, Dementia Ireland, Irish Wheelchair Association and school-based supports. This is in line with the Sláintecare Strategy and action plan which aims to deliver a universal health service o ering the right care at the right time as close to the patient’s home as possible. The focus is on providing a rapid assessment, advisory and treatment service to patients with bladder and bowel dysfunction. This prevents hospital admissions to acute hospitals by facilitating the e cient and appropriate management of patients with continence issues in the primary care setting.

On a recent visit to the Mayo Nurseled Continence Care Clinic, Castlebar Primary Care Centre; Paul Reid, HSE CEO; with Breda Crehan-Roche, Chief O cer Community Healthcare West; Anne Marie McDermott, Director of Public Health Nursing Mayo; Fidelma Mullarkey, Continence Advisor; Valerie Kilcourse, Clerical O cer; Aileen Tierney, Registered General Nurse and Edel Deane, Assistant Director of Public Health Nursing

| 35HEALTH MATTERS AUTUMN 2022

This is a growing service with patients been referred from Urology services in

T he Azure programme is an initiative designed to create opportunities for dementiainclusive art viewing and participation for persons living with dementia and their carers.

institutions in 2015 and were delighted to have developed a small network of 15 facilitators in 10 arts institutions with the capacity and interest in offering Azure experiences. In the last two years they received funding from Creative Ireland which allowed them to offer more training and we now have a network of 70 facilitators in 31 locations. The COVID-19 pandemic presented challenges to most arts providers and some of our colleagues were successful in delivering online versions of the Azure Bairbre-Anntour. described how the Azure programme is currently running at IMMA.

“Azure is a key part of IMMA’s Art & Ageing programme. Slowing down and making space for art and conversation is at the heart of all of our Art & Ageing programming and the Azure programme is no different,” she said.

“We encourage people with dementia to come along, with family or friends, to talk about work from IMMA’s exhibitions and collection together with our trained facilitators, followed by a complimentary cup of tea or coffee in IMMA’s Flying Dog café. Some of our regulars have had a lifelong interest in the arts, but many come along to try something new. We encourage everyone to take part, no experience or knowledge necessary, just curiosity and an open“Today,mind!IMMA offers Azure tours at the museum on the first Friday of each month. We also have a monthly programme, Armchair Azure, delivered online over zoom for people who cannot come to IMMA in person. Groups of people can book bespoke tours at a time that suits them, many nursing homes avail of this option for groups of their residents.”

During the COVID-19 lockdowns, IMMA received funding from Creative Ireland’s Creativity in Older Age programme. This funding enabled us to develop resources and experiences that people could access at home, including virtual slow art visits to the museum, PDF packs inviting people to explore works from IMMA’s Collection through conversation and online zoom conversations about IMMA’s Collections and“OnlineExhibitions.delivery enabled us to reach and connect with people from all over the country, even some outside of Ireland. It also gave access to IMMA to those who, for reasons of illness or personal circumstance, couldn’t travel to the museum itself. We have learned a lot from this experience. We continue to offer a hybrid of online and in-person programming at IMMA in order to open up greater access to our Collection, exhibitions and conversations,” she added.

HEALTH MATTERS AUTUMN 202236 |

The arts can also enhance the quality of life of individuals affected. This is because of its capacity to engage emotions and facilitate communication (including non-verbal communication). They can also foster greater involvement in communities by people living with dementia. Through the arts, a space can be created for interaction and sharing between people with dementia and those close to them in a non-medicalised environment.

Art action

The arts can play an important role in the lives of people with dementia in a number of ways, contributing to changes in awareness and to developing thinking about issues like dementia.

Azure programme brings inclusive art participation to people living with dementia

to explore ways of involving more people with dementia and of addressing some of the barriers that hinder participation,” explained Bairbre-Ann Harkin, Curator, Art and Ageing at IMMA.

They began delivering a foundation training to colleagues in other arts

“We all recognised the profound effects of arts participation in our lives, how it contributes to our sense of wellbeing, agency and pleasure. Some of us are fortunate to have had lifelong opportunities for arts participation, while for others it might be something we encounter later in life. We recognised that there is an ongoing challenge to ensure that harder-to-reach older groups are involved in the country’s arts and cultural life. Our collaboration in Azure enabled us

The initiative began in 2012 based on existing collaboration between Age & Opportunity, Alzheimer Society of Ireland, Butler Gallery and the Irish Museum of Modern Art.

ABOVE: Agata Orlowska, Staff Nurse; Muhammed Nasih Puthenpeedikakkal, Staff Nurse; Kate Lynch, Staff Nurse; Mary Keane, Clinical Nurse Manager 2. Front row from left: Yvette Belandres, Staff Nurse; Dr Mishal Khan, Anaesthetics; and Caroline Pryce, Staff Nurse.

Dr Michelle Duggan, Consultant Anaesthetist at Mayo University Hospital, said, “We were delighted to collaborate with Children’s Health Ireland and to become the first pilot site for the paediatric drug pumps. The system is working very well and has been used for a number of babies. As soon as we know a child needs to come to ICU, the nurses can prepare the drug infusions and can be ready to go as soon as the child gets here.”

VIEW FOR FURTHER DETAILS ON THE PAEDIATRIC SMART

Dr Moninne Howlett, Chief Pharmacy Information Officer at CHI, explained that the smart pump technology ‘adds layers and layers of safety and is the gold standard internationally for the delivery of high-risk medications’.

“In Children’s Health Ireland our hope would be that every hospital setting will use this technology, so that anywhere a child gets sick, they will have access to a standardised system.”

Dr Cormac Breatnach, Consultant Paediatric Intensivist at CHI at Crumlin, said, “The benefit of this partnership is that children in Mayo University Hospital are receiving the exact same level of technological support for their medication delivery while in MUH, while being transported to Dublin and on arrival to ICU in Crumlin. They won’t have any disadvantage by presenting to a peripheral centre; all the benefits of the paediatric hub are available to them.”

NEW ORTHOPAEDICREPLACEMENTTHEATRESFORMERLINPARKUNIVERSITYHOSPITAL

ayo University Hospital (MUH) worked with Children’s Health Ireland (CHI) to introduce use of the CHI paediatric smart pump system to the hospital. A smart pump is an infusion device which uses specific software and a drug library to deliver carefully controlled amounts of medication to a patient through a drip. This system for medication delivery is designed to reduce errors and standardise how medications are prepared and delivered. Use of the CHI smart pump drug library provides a very safe system for delivery of high risk medications to sick infants and children and is the new standard of care in Ireland. MUH is the first hospital outside of CHI or specialised neonatal services to use this technology for children in hospital.

| 37HEALTH MATTERS AUTUMN 2022

https://youtu.be/Q9iBgGHX1_cPUMP:

"The availability of the smart pump system in Mayo University Hospital will also ensure that the sickest paediatric patients who need to travel to one of the paediatric intensive care units in CHI have uninterrupted delivery of medication while in transit and when they arrive in CHI. "

TOP: Mary Keane, Clinical Nurse Manager 2; and John Galbraith, Consultant Orthopaedic Surgeon; in one of the new Orthopaedic Theatres in Merlin Park University Hospital.

Catherine Donohoe, Hospital Manager at Mayo University Hospital, added, “I am really pleased to see this collaboration with CHI which promotes patient safety and quality of care for the children of Mayo. This is one of many successful national projects that MUH staff have progressed recently towards our mission of continuous quality improvement for patients.”

THE VIDEO

Two new replacement orthopaedic operating theatres in Merlin Park University Hospital Galway, which cost €10.57m to design, build and equip, came into use in June.

The availability of the smart pump system in Mayo University Hospital will also ensure that the sickest paediatric patients who need to travel to one of the paediatric intensive care units in CHI have uninterrupted delivery of medication while in transit and when they arrive in CHI.

Construction of the 620m2 theatre building began in March 2021 following a public procurement tendering for a main contractor. The build consists of two operating theatres, two anaesthesia rooms, a recovery area and other ancillary accommodation to support the theatre suites. The theatre building is connected to the main hospital block by a link corridor which is the access point for patients and staff.

and

Aiden Devitt, Consultant Orthopaedic Surgeon, said, “The new operating theatres are a major enhancement for the hospital and for orthopaedic services in the west and I am extremely proud of everyone involved in bringing this long-awaited project to completion. We now have a state-of-the-art theatre suite which will double our capacity for surgical procedures and will reduce waiting times for patients. Our orthopaedic patients will be treated in a modern, spacious and technologically advanced facility and I am delighted to be commencing procedures in the new theatres this week.”

SMART PUMP

‘Paediatric Smart Pump’

Mayo University Hospital Children’s Health a

Ireland pilot

“We used the Mental Health Ireland theme of ‘ﬁve ways to wellbeing: connect, take notice, keep learning, be active, give’

They also created a sta wellness electronic folder for sta to access as a resource at any time going forward.

“Sta health checks (blood cholesterol and diabetes screening) were also conducted and supported by our Occupational Health Department with a follow up talk on healthy nutrition delivered by our critical care dietician.

NORMALISING STAFF WELLNESS IN CRITICAL CARE AT THE MATER HOSPITAL

he second critical care Sta Wellness Week took place in July of this year at the Mater Hospital to boost sta morale and let sta know that their hard work is always appreciated as they journeyed along the COVID-19 roller coaster, wave after wave.

Sta were surveyed after the ﬁrst Wellness Week in November 2021 and results were extremely positive to this new initiative. In the survey, sta described feeling ‘valued’ and ‘uplifted’ and most importantly, they felt ‘appreciated’ during this week. Ninety per cent of sta reported this should be a regular event.

| 39HEALTH MATTERS AUTUMN 2022

We also held mindfulness and yoga sessions, two outdoor activities including a hike around Howth and a HIIT session in Phoenix Park. A past patient visited the unit to personally thank sta for her care and a sta appreciation box was available throughout the week for sta to post peer-to-peer positive a rmations to each other,” she said.

and each day correlated with one or more of these themes. Some of our sessions included presentations on healthcare worker wellbeing delivered by an in-house psychologist, how to cope with burn out delivered by psychiatry Clinical Nurse Specialist.

The origin of Sta Wellness Week in the critical care unit began in November 2021 when it was decided to introduce a sta appreciation box. They received positive feedback in a sta survey on the Wellness Week in November 2021 and decided to formalise the initiative with the creation of a multi-disciplinary Critical Care Sta Wellness Steering Committee. This committee has representation from medical, nursing, physiotherapy and clinical psychology.

“We believe normalising and prioritising sta wellbeing into daily practice is essential to address the physical and psychological needs of our sta . In turn, this initiative will benefit our patients by energising sta in the care they provide to their patients,” said one of the committee members.COVID-19 unmasked the stressors critical care sta face on a day-to-day basis but the concepts of ‘burnout’ and ‘compassion fatigue’ have been around a long“Thetime.pandemic highlighted the demands of our role and the importance of recognising and managing our own wellbeing. As we practice in a field of service to others we may as a result, sacrifice our own self care needs,” explained one of the organisers.

Morning yoga session for night sta led by Clinical Specialist Physiotherapist Critical Care Aoife Lennon (photo of hands in the air)

Left to right: Irene Aloveros, DON CAAEST; Niamh O’Connor, sta development facilitator ICU/HDU; Mary Rose Curran, CNM III ICU/HDU; Aoife Lennon, clinical specialist physiotherapist critical care; Serena O’Brien, CNM III/ ECLS co-ordinator; and Peter Loughrey, senior healthcare assistant critical care. Missing from photo: Director of critical care Ian Conrick-Martin; Rachel Rodgers, clinical psychologist; Emma McGorman and Rani Abraham, critical care nurses.

HIIT Outdoor Activity session led by Harte and Soul Wellness. (Phoenix Park photo of sta exercising)

“After running the two Sta Wellness Weeks, our sta have become more receptive to the idea of looking after their own mental health. Now, we arrange monthly mindfulness and yoga sessions to embed sta wellbeing into our daily culture,” she added.

The campaign has been running on TV, radio and online since the end of May. The campaign is also supported by advertising on public transport, in shopping centres and cinemas.Thekey message is that we don’t always know who is at risk of COVID-19 and other viruses, but we do know how to protect them.

Dr Colm Henry, HSE Chief Clinical Officer (CCO), said:

HEALTH MATTERS AUTUMN 202240 |

The campaign was developed in close consultation with partner organisations representing people who are at increased risk of serious illness from COVID-19. In-depth focus groups with the general population and people who are at higher risk from COVID-19 (pregnant people, people who are immunocompromised and those aged over 65) further helped inform the campaign.

campaign

The TV ad was supported by radio, digital audio, cinema, out of home and online advertising. For more information, visit hse.ie

COVID-19

“They could be early in their pregnancy, about to start cancer treatment, on dialysis or have diabetes. That’s why it’s so important to keep doing what we know protects them, not just from COVID-19 but from other viruses that can put them at risk of serious illness.”

The new TV ad shows three people who are at greater risk from COVID-19 going about their daily lives, on a train, in a café and at the supermarket. Those around them do not necessarily know that they are at risk. The ad uses everyday signs as the mechanism to reveal the information that people are at risk and we still need to protect each other.

Dr Eimear Brannigan, HSE Clinical Lead for Antimicrobial Resistance and Infection Control (AMRIC), said, “Keep your hands clean and wear a mask in crowded areas, let fresh air in when you’re meeting indoors, and meet outdoors where it’s practical over the summer, get your COVID-19 vaccine when it’s due and very importantly, stay at home if you are unwell. You never know who you will come across that is more at risk than you.”

After the campaign’s launch at the end of May, a research panel provided a quick response to the advert. The research found that the campaign makes people reflect on their behaviours and gives people a rationale to continue doing the things that reduce the spread of COVID-19 and other viruses.

New research conducted in July found that over half the population recalled seeing the ads and those who recalled seeing the ads were a lot more likely to take protective measures, such as keeping hands clean and wearing a mask. This shows that the advertisements are effective in prompting the public to reconsider their actions to protect others from COVID-19 and other viruses.

‘You Never Know’ who is at risk of COVID-19

One participant said, “Some advertising leaves you wondering what was that about but this hit the nail on the head. Everyone is different and trying to get on with their new norm post-COVID.”

“We know that older people and people with some conditions are more at risk from COVID-19 and we’ve worked together to protect them since the start of the pandemic. About 15% of our population falls into this at risk category but the reality is we’re not always going to know when we’re out and about who these people are. What puts them at risk might not be visible to you.

Jan Rynne, Leukaemia patient and co-founder of Chronic Lymphocytic Leukaemia Ireland (CLL Ireland), explained, “As an immune-compromised patient, COVID-19 might be devastating for my health. I remain restricted in how I live life right now. It would be really helpful if society would remember that COVID-19 is still a threat to some of us and it would help us to live our lives in a more normal way if others wore their masks in busy spaces and allowed for some personal space, for example, when queuing in shops or banks.”

‘You Never Know’ is an advertising campaign launched by the HSE to encourage people to keep up the public health behaviours that slow the spread of viruses, like COVID-19, and help protect people more at risk from serious illness.

New HSE reminds people of the importance of protecting each other from

“It is encouraging to note that in the most recent National Inpatient Experience Survey ﬁndings for 2021, 83% of our patients rated their overall hospital experience as “good” or “very good”. In May 2022, the HSE published our ‘Listening, Responding and Improving’ report, with information on the quality improvement plans underway in our hospitals to improve patient experience,” he said.

“We acknowledge there are many areas of services and care requiring improvements and the HSE is committed to ensuring that improving patient experience continues to be a key focus for us all throughout the healthcare system.”

A project in relation to acute services, was carried out by researchers at NUI Galway using the London School of Economics (LSE) Healthcare Complaints Audit Tool (HCAT), an innovative and internationally recognised method of classifying complaints.

Analysis of patient complaints about hospital care by researchers at NUI Galway found that more than one-in-four issues relate to while the patient is receiving care on the ward. Other common issues complained about were accessing appointments, treatment, safety, and cleanliness of hospital environments.

The report was published in June 2022 and the HSE welcomed the results of the joint project with NUIG, with Chris Rudland, Assistant National Director, National Complaints Governance and Learning Team, saying, “It is HSE policy to proactively encourage patient feedback through Your Service Your Say service and through other initiatives such as the National Inpatient Experience Survey.“Listening to our patients and providing the opportunity for them to share their experience is at the core of our commitment to improving patient care and the hospital experience for patients and their loved ones. Many of our hospitals now have patient liaison and patient advocacy services in place to support patients throughout their time in our care.”

By examining trends in complaints, researchers from NUI Galway have identiﬁed where in healthcare, quality improvement e orts should be focused. For hospital care, one of the key areas highlighted was, while patients receive care on the ward.

In addition, using HCAT to analyse complaints can identify hot spots (where problems occur most frequently or cause major impact) and blind spots (where problems occur but cannot be easily observed by

Learning hospitalcomplaintsfromaboutcare 2022

| 41HEALTH MATTERS AUTUMN 2022

Continuing work is also under way to deliver quality improvement priorities across acute hospitals. These include programmes to improve patient admissions, hospital food and nutrition, sta communication skills, discharge information for patients (including clearer medication instructions) and the roll out of activity programmes for older patients.

Collaborate and listen

The project demonstrated the value of applying HCAT to complaints. This helps to identify growing problems as well as opportunities for improvements in clinical safety and quality. We can also learn about the key issues that those who use healthcare services complain about.

healthcare sta ) that can help researchers and the health service to prioritise the issues to address in healthcare settings.

Using data such as complaints from patients and family members ensures their voices are represented in service improvements. This joint research initiative with NUIG can transform how the HSE analyses and learns from patient complaints and will guide the development of quality improvement initiatives in our hospitals to improve patient experience and provide tangible evidence about what matters to patients.

NUIG and HSE collaborate for innovative use of complaints data to focus healthcare quality improvement efforts

he National University of Ireland Galway and the HSE have partnered on a unique study to analyse patient and service user complaints to identify ‘hot spots’ and ‘blind spots’ in healthcare delivery to better target service improvements.

Service Standards

• Public good - we should put people ﬁrst, treat everyone equally and provide good value for money

Technology & Process

Developing consistent and clear systems, processes and operations to build trust with the public. A key element of this involves investment in technology to allow for smoother, more consistent patient experiences.

Over the course of the sta consultation sessions, a new set of 5 themes emerged.

Understanding Trust and the HSE through the lens of our Staff Communication

• Respect – we should communicate better, listen more and be inclusive and responsive in our relationships

ollowing extensive research to help us understand what trust means to the public, sta and patients and service users during 2021, we commissioned a series of workshops with sta that took place in early 2022.

• A short online survey

MAPPING OUR THEMES BACK TO OTHER RESEARCH ON TRUST AND OUR ACTION PLAN

• Engagement with our online research community

The key focus of this research was to learn from a sta perspective how to build trust in the HSE.

We identiﬁed key priority actions under each of these themes. We have taken these actions and mapped them to the four categories of things that inﬂuence public trust in the HSE, which emerged from previous research.

• 16 workshop sessions with sta from all areas of the organisation

Public Good

Each theme that emerged from the sta consultation sessions presented its own challenges and opportunities.

• Competence – we should provide high quality and safe patient care which is reliable and consistent and we should support our sta to fulﬁl this aim.

sta from all disciplines signed up to participate and we collected feedback from over 100 members of sta via:

The aim of the workshops were to share and explore our ﬁndings to date and listen to suggestions for actions that will improve trust in the HSE. In the health service, if people feel they can trust us, they are more likely to seek our help at the right time. This includes reporting symptoms, following treatment plans and attending screenings.Over400

STAFF CONSULTATION THEMES

Culture

Creating consistent quality service through interactions and training while managing expectations to increase trust.

There were so many suggestions that came through in the sta consultations. We have captured some examples of the suggestions under the di erent things that impact on public trust in the HSE.

• Integrity – we should be ethical, honest and more open; particularly in owning up to our mistakes

TRUST AND CONFIDE NCE

Initially, we sought to analyse our ﬁndings through the lens of four things that we know inﬂuence trust, which emerged from previous research:

Investing in fully listening to all stakeholders, including patients, sta and the wider public. Truly listening to and learning from feedback received, while identifying opportunities to implement learnings to develop a better service.

HEALTH MATTERS AUTUMN 202242 |

Building trust through positive and strong communications with the public, from the inside-out and top-down. Some suggestions on how to do this included keeping patients at the heart of all communications, keeping patients and sta updated on outcomes and humanising the HSE through e ective media relations that highlights the ongoing good work and transformation happening across our health service Learning and Listening

Creating an attitude and atmosphere of trust, and demonstrating through our behaviours. This is something to be developed over time, but we need to lay the foundations now.

Competence

We listened and learned so much from these sta consultations. When working on updating the Trust and Conﬁdence action plan, we will take on board the learnings from our discussions with sta . Some of these discussions conﬁrmed that our existing actions were right and supported from a sta point of view, particularly the importance of being open and honest when things go wrong, recognising the work of colleagues and engaging proactively with

Sta discussed that the development of the RHAs gives an opportunity to improve some of the ways that we work. Some suggestions included: Focus on consistency in interactions across the organisation and di erent regions, build patient-centric systems to avoid failures (for example, operating hours, booking systems etc.) and focus on ease for users, not on ease for the organisation. Other suggestions included updating the HSE website to make it more userfriendly and to include a central repository of information and services for patients and sta , investing in and implementing digital health records for all patients and service users and carrying out continuous performance appraisals to reﬂect and feedback on sta service quality with a focus on improvement.

Integrity

Some of the suggestions that emerged through our consultations included: Do not hide mistakes, do not try to avoid situations that might lead to a less than optimum outcome, learn from mistakes quickly and implement learnings across HSE, empathise, show compassion and listen to the patient before deciding on right actions and try to agree to realistic timelines, options and outcomes at all stages.

Sta suggested that we look develop relationships with media to encourage positive stories, invest in means to communicate positive stories and look to include more sta advocates to generate solutions at ground level.

Respect

NEXT STEPS

the media. We heard of the significance and value of digital developments to help us to serve the public better and we will work to include actions that address digital concerns and issues to help earn us public trust. There was also much discussion about how the new structures and RHAs could help to earn trust and a recognition that we need to learn from our previous reform programmes. We would like to thank all of those who volunteered their time, thoughts and expertise to this work. We were so impressed with the knowledge, experience and expertise that our HSE colleagues shared. Listening to our colleagues’ insights and opinions has added to the evidence that we have collected in how we should act in order to earn and protect the public’s trust and confidence in the services we provide. We know that this work will be challenging and will take time and we look forward to working with you in the coming months and years to pursue the goal of building trust and confidence in the HSE.

Sta suggested that we ensure all communications language is clear and patient-friendly, we get better use of sta and patient advocates attendance and involvement at key meetings, we develop an updated process for outcomes of feedback, we build empathy into patient interactions (for example, via training) and we develop a system of collecting learnings (for example, case studies) that can be communicated across the organisation.

| 43HEALTH MATTERS AUTUMN 2022

The programme is available every month in a di erent location via the local CNME/CLD and in 13 di erent locations in total. It is much more e cient and e ective in terms of time and money and is a great choice for nurses to attend di erent programmes being run in alternative locations.

The Meitheal Programme (Partnership in Palliative Care with the Older Person) is an inspiring collaborative nurseled initiative that aims to support nursing home sta to increase their conﬁdence and competence in the palliative care they deliver to residents and families and consequently avoid unnecessary transfers to the acute services.

Services Cavan Monaghan) and sta from private organisations with other regional and national key stakeholders with a shared interest in the delivery of quality palliative care to residents with life-limiting conditions in nursing homes.

PALLIATIVEANDINCREASESPROGRAMMESTAFFCONFIDENCECOMPETENCEINCARE

Some of those gathered at the launch of the evaluation of the Meitheal Programme.

Quality palliative care is best realised through strong integrated networks between generalist and specialist providers, and when all healthcare professionals work together to meet the palliative care needs of all.

he introduction of the National SACT (Systemic Anti-Cancer Therapy) Programme for Nurses Working in Cancer Care will ensure training is consistent throughout the country, standardising knowledge, competency and best practice, as well as providing specialisation in cancer care nursing. This, in turn, will enhance professional conﬁdence and job satisfaction.

and that by enabling sta through educational and ‘on the ground’ clinical support enhancedinterventions,knowledge and conﬁdence was evident with a need MonaghanLouth,Palliativebothcollaborativesustainabilityforapproaches.TheeventwasagatheringofHSEsta(SpecialistCareServicesMeath&Cavan/&OlderPerson

Following successful completion of this programme and their UKONS SACT Competency Passport, nurses are then free to move between employers without the need for retraining. They are registered as a SACT administrator on HSELand and will be prompted annually to be re-accredited.

The National Clinical Programme for Palliative Care strives to ensure that patients with life-limiting conditions can easily access a level of palliative care service that is appropriate to their needs regardless of their care setting or diagnosis.

“The authentically expressed shared compassion and beliefs by all present at the event showed that great heights can be reached in the delivery of palliative care for nursing home residents by collaborating together and supporting nursing home sta to do so,” said one of the organisers.

HEALTH MATTERS AUTUMN 202244 |

It means that cancer patients will beneﬁt from the same high-quality nursing care from nursing sta no matter where in the country they are being treated.TheNational Programme Design Team has 34 representatives from around the country, including representatives from the UK, and they have worked together to create a programme which will ensure that nursing sta are conﬁdent and competent in safely handling and administering SACT, but also in providing holistic care to cancer patients and theirThefamilies.pilotprogramme was launched through the CNME in Tullamore, c/o Maura Loftus, Director of RCNME, and the CLD in Tallaght University Hospital, c/o Sylvia Macken, Course Facilitator. Some 21 nurses from around the country attended the two-day programme either online, face-to-face, or blended. Local clinical experts in Cancer Services/ Pharmacology facilitated the programme.

The aim of the programme is to standardise the education and assessment of SACT administration and patient care nationally, to ensure consistently safe and high-quality SACT practice.

Anti-cancer therapy programme ensures consistent training throughout the country Cancer therapy

A launch of an evaluation of the Meitheal Programme was hosted by Specialist Palliative Care Services in the Kilmore Hotel Cavan, to collectively share the ﬁndings and recommendations of the evaluation. This included the achievements and challenges experienced by those who supported and facilitated the programme and those who undertook the programme in their nursing home setting.

The SACT Nursing competency training and assessment is now standardised nationally. Nurses from any publicly funded hospital where SACT is being delivered to adult patients (25 hospitals), can feed into any programme nationally. There is a great collaboration and learning from nurses in the di erent hospitals.

The ﬁndings of the evaluation highlighted varying degrees of knowledge, teamwork and communication with a real need for support

MEITHEAL

Two documents launched during midwife conference

Midwifery Updates

wo important documents were launched during the National Midwifery Conference which was co-hosted by the National Women’s and Infants Health Programme (NWIHP) and the O ce of the Nursing and Midwifery Services Director (ONMSD).

The HSE O ce of the Nursing and Midwifery Services Director brought together national and international experts for the Better Together for Digital Health Conference at The National Convention Centre, Dublin.

safe and e cient provision of care services. It's about helping healthcare professionals save time and save lives. It’s also enabling people who use our services to experience better care. eHealth is fundamental to providing new and integrated models of care.

Over 130 attendees of the Dublin conference were treated to a programme of renowned international, national and local speakers with topics spanning the past, present and future of midwifery. A key theme for discussion at the conference was progress made in relation to Ireland’s National Maternity Strategy (2016-2026).

CEO Paul Reid also addressed the conference and acknowledged the signiﬁcant contribution midwives made during the pandemic and continues to make as we go through the recovery. Insight was given into progress with Sláintecare and the developments in relation to the new Regional Health Areas (RHAs).

With over 40 national and international speakers taking the stage, the conference showcased many of the digital health

developments and improvements from across our health service. A range of digital health topics are covered at the event including telehealth, improving health outcomes, showcasing international collaborations, digital capability and digital literacy, driving innovation and the patient experience.

BETTER TOGETHER FOR DIGITAL HEALTH

Loretto Grogan, National Clinical Information O cer, ONMSD, HSE, said, “Nurses and midwives play a vital role in digital health and in planning for future implementation of connected digital health. Digital health is about the digitisation of health services and processes so that the data about the right patient is available in the right place and at the right time to ensure

| 45HEALTH MATTERS AUTUMN 2022

Speaking at the conference, Dr Geraldine Shaw, HSE O ce of Nursing and Midwifery Services Director (ONMSD), said, “We have all seen how digital health advances have progressed during the COVID-19 pandemic and we hope to continue to build on this momentum. Today we see how people, processes and technology have enabled healthcare transformation and change.”

Professor Fran McConville, Midwifery Adviser, World Health Organization, provided a keynote address at the conference and share global achievements in midwifery as well as opportunities and challenges. This year – 2022 – marks 100 years since the foundation of the International Confederation of Midwives (ICM), the international organisation which leads celebrations of the day in 120 countries.

Digital health topics covered at the event today include telehealth, improving health outcomes, showcasing international collaborations, digital capability and digital literacy, driving innovation and the patient experience. For more information on digital health visit HSE.ie

Angela Dunne, National Lead Midwife, NWIHP; Minister for Health Stephen Donnelly and Margaret Quigley, National Lead for Midwifery, ONMSD, at the National Midwifery Conference.

The range of topics on the programme also included; historical journey of midwifery in Ireland (Dr Philomena Gorey), the professional journey of midwifery (Dr Denise O’Brien), the future of midwifery (Angela Dunne), the NHS experience of continuity of carer (Professor Trixie McAree), postnatal maternal morbidity (Caroline Brophy), multidisciplinary approach to maintaining normality in complex pregnancies (Professor Michael O’Connell and Orla Cunningham), innovation and collaboration (Janet Murphy and Claire Bulﬁn), MIDSIGHT – inside the mind of a student midwife (Carol Desmond and Bernadette Toolan), Policy and Practice/ CNO O ce (Georgina Bassett), waterbirth (Paula Barry and Tracey Armstrong/service user), leadership in midwifery (Mary Brosnan), All Ireland Midwifery Network (Dr Maria Healy and Professor Patricia Leahy- Warren) and the Irish national maternity bereavement experience survey (Anna-Maria Verling). Close of the conference was made by Margaret Quigley.

Minister Stephen Donnelly attended and spent time after his speech ﬁelding Q&As from the audience on current midwifery related issues and concerns –all which went down very well.

“Getting our eHealth infrastructure right is core to supporting the implementation of the other strategic actions. It is a key enabler to facilitating integrated care.”

The National Standards for Infant Feeding in Maternity Services 2022, a HSE Baby Friendly Initiative, is a resource that will support the continued provision of a high quality service for women and babies in Ireland. The updated Practice Standards for Midwives 2022, launched by the National Midwifery Board of Ireland (NMBI), which will further support good professional practice and a womancentered approach to care.

A steering group was convened to oversee the project, with representatives from the ONMSD HSE, all Schools within the CoMH, UCC, healthcare clinicians across acute and community services, patient/service user and student representatives. The steering group sought guidance from the IPE subgroup of the Irish Network of Healthcare Education (INHED).

Internationally, IPE has been successfully introduced into a number of health professional programmes and has the

potential to positively change healthcare cultures by influencing practitioner’s interactions.InIreland

Interprofessional Education key to preparing students for a career in healthcare

The World Health Organization (WHO) have promoted IPE by publishing the Framework for Action on Interprofessional Education & Collaborative Practice.

• develop effective teamwork and communication skills that are transferrable to clinical practice.

opportunities for students to engage with other disciplines to:

• reflect on their own roles in the multidisciplinary team (MDT),

“The mix of disciplines was huge and very helpful when discussing whole person care…such a great preparatory opportunity for the real-life setting.”

s the health service moves towards new models of healthcare delivery, patient care delivered by effective multidisciplinary teams provides more integrated care and is considered more beneficial than care delivered by independent healthcare professionals.Interprofessional Education (IPE) is fundamental in preparing students to enter the healthcare workforce, where teamwork and collaboration are competencies that are increasingly essential for safe and effective patient care. IPE is recognised as a means of creating a practice-ready workforce who can work together to reduce medical error and improve healthcare outcomes.

• learn about the roles of others and

The Professional regulatory bodies within healthcare in Ireland, including the Nursing and Midwifery Board of Ireland (NMBI), the General Dental Council, CORU, the Pharmacy Regulator and the Medical Council Ireland are supportive of IPE.

In line with the goals of Sláintecare, the future of healthcare in Ireland includes a culture of integration and participation. IPE is regarded as an integral part of the redesign of healthcare systems to promote interprofessional teamwork, both pre and post qualification. This encouraged Carmel Buckley, Area Director, Office of Nursing & Midwifery Services Director (ONMSD), to contact the College of Medicine & Health (CoMH), UCC to discuss the possibility of implementing a pilot programme that could assess the perceived benefit of IPE to students. Effective IPE provides meaningful

IPE is advanced however it is not standardised in health and social care education across third level institutions. Making Every Contact Count is an example of where the Irish health service previously worked in partnership with their academic partners to promote IPE with undergraduate students.

HEALTH MATTERS AUTUMN 202246 |

OMSD HSE/UCC Interprofessional Education and Collaborative Practice in Healthcare

This pilot project delivered three Interprofessional Education workshops to undergraduate students and graduate entry students across CoMH, UCC (Physiotherapy, SaLT, OT, Audiology, Medicine, Pharmacy, Nursing (all divisions), Midwifery, Dentistry, Public Health, Radiography) during the 2021/2022 academic year.

All students agreed that the contribution of the patient representative contributed positively to their learning. “The patient story was eye-opening. Amazing insight. Involving service users was crucial.”

The facilitators also articulated the benefits of this pilot. Dr Mike O’Connor,

Older Adult (Frailty) - 31 participants

These workshops were delivered in February 2021 as follows:

A total of 93 healthcare students voluntarily participated in the in-person IPE workshops, with 10-15 multidisciplinary students participating in each sub-group. Workshops were facilitated by clinical and academic facilitators and patient/service user representatives participated in each workshop.Throughout the workshops the multidisciplinary students worked collaboratively, deliberated the cases, had discussions with service users and contributed to a multidisciplinary management plan discussion. The study utilised the Interprofessional Collaborative Competency Attainment Scale (ICCAS) to evaluate students views of IPE before and after the IPE workshops. Feedback questions on the session format, preparatory materials, communication and content were also collected.

“They loved the workshop and wished we could have more during my college experience.”

Many students reported that they found the workshop format, and opportunity to work in a multidisciplinary group beneficial. “A great way to learn outside of the text books.”

HSE National Clinical Advisor and Group Lead, Acute Operations, said, “The concept of exploring IPE working at undergraduate level and centred around a patient is just marvellous, and so logical…The shared understanding of role, perspective and mutual respect will certainly be enhanced in these students.”

| 47HEALTH MATTERS AUTUMN 2022

“The concept of exploring IPE working at undergraduate level and centred around a patient is just marvellous, and so logical…The shared understanding of role, perspective and mutual respect will certainly be enhanced in these students.”

between the disciplines emerged as positive themes. “The mix of disciplines was huge and very helpful when discussing whole person care…such a great preparatory opportunity for the real-life setting.”

The findings of this IPE pilot project found that IPE was perceived by students to be beneficial and resulted in increased confidence in all interprofessional competencies. Following participation in the workshop >80% students found their ability to collaboration interprofessionally increasedStudentssignificantly.articulated that exposure to new disciplines and professions, together with the sharing of knowledge and skills

Paediatrics (Diabetes) – 28 participants

Young Adult (Inflammatory Bowel Disease) - 34 participants

One of the main recommendations by the students was to have more IPE workshops in undergraduate programme and to involve more disciplines. They “loved the workshop and wished we could have more during my college experience.”

This initiative encourages students to develop teamwork and communication skills, appreciate their professional role and the roles of others within the MDT, which is key to the implementation of Sláintecare. Successful MDT partnerships contribute to a positive work environment which impacts the recruitment and retention of health workers. Consistent with the Sláintecare model a partnership between health service providers and educators will support the evolution of care models over time as well as multi-disciplinary and interprofessional learning to enhance team-based practice and integrated care.

Taoiseach Micheál Martin addressed the conference and emphasised the importance of ‘Leaving No One Behind’ as we move towards a Tobacco Free Ireland. This was the ﬁrst time since May 2018 that the Irish Tobacco Control Community had assembled for a national conversation.

Youth representatives also took to the conference stage to express concern around the increasing trends in e-cigarette use among young Take-homepeople.messages from the conference included:

A new integrated Stop Smoking service for pregnant women who smoke has been launched.

Almost 30 medical and midwifery sta at UMHL have been trained to identify the smokers among women attending antenatal appointments, and to o er advice as well as a carbon monoxide test and a referral to HSE Quit Mid West services in their communities.

Maria Bridgeman, Chief O cer of HSE Mid West Community Healthcare, said that this collaboration with UMHL would ensure that pregnant women who smoke can easily access the HSE Quit Mid West service.

• Smoking still causes over 4,500 deaths each year.

“The HSE standard treatment support programme includes an initial assessment of all aspects of smoking behaviour, with follow up on the quit date and then weekly support during the ﬁrst four weeks of quitting. Our Stop Smoking Advisors o er individualised support for pregnant women to quit, covering

Eileen Ronan, Director of Midwifery, UMHL, said, “Early interventions around tobacco use with pregnant women who smoke can result in reduced risks of complications in pregnancy and birth.

Nicotine Replacement Therapy (NRT), carbon monoxide monitoring and practical support on changing routines, managing cravings and dealing with challenging moments,” she said.

• 75% of the public support the goal of ending the harm caused by smoking in Ireland completely (support varies for di erent Tobacco Endgame tactics).

48 | HEALTH MATTERS AUTUMN 2022

"Babies are less likely to be born prematurely or to face the additional breathing, feeding and health problems that are often associated with premature birth. In addition, the risk of sudden infant death syndrome is reduced,” she said.

Conference speakers included Dr Paul Kavanagh, Specialist in Public Health Medicine, HSE; Dr Ciara Reynolds, Institute of Public Health; and Dr Milly Neuman, Trimbos Institute, The Netherlands.

The new dedicated service is based at University Maternity Hospital Limerick (UMHL), where almost 5,000 women access antenatal services per annum, and will be a ‘gateway’ for pregnant women to the HSE Quit Mid West service, which is free and available across Limerick, Clare and North Tipperary.

It is estimated that the initiative has the potential to support 400-500 pregnant women to quit smoking every year.

HELP PREGNANT WOMEN STOP

Smoking Smoking still causing 4,500 deaths each year UL HOSPITALS GROUP

Over 170 delegates from across the HSE, local authorities, community and voluntary groups and private industry gathered at the Aviva stadium to learn about how tobacco control continues to evolve in Ireland.

Dr Frank Doyle, Senior Lecturer in Psychology at the RCSI, described the conference as “a fantastic mix of inputs from patients who have managed to quit smoking themselves, to clinicians who are helping them, to policy makers who are trying to assist the environment for clinicians but also learning from international colleagues who had many lessons for us all”. AND HSE MID WEST HEALTHCARE JOIN FORCES TO SMOKING

COMMUNITY

Pictured at the launch of the new dedicated HSE Quit Mid West service at UMHL are, from left: Niamh Wallace, Head of Service, Health and Wellbeing, HSE Mid West Community Healthcare; Dr Naro Imcha, Associate Clinical Director, Maternal & Child Health, UL Hospitals Group; Bedelia Collins, Health Promotion & Improvement / Health & Wellbeing Manager, HSE Mid West Community Healthcare; Miriam Nolan, CMM2, Antenatal Clinic, University Maternity Hospital Limerick; and Eileen Ronan, Director of Midwifery, University Maternity Hospital Limerick.

The Tobacco Free Ireland Programme used this conference platform to publish a new Programme Plan (2022-2025) setting out actions across the health service to tackle the harm caused by smoking at a conference on how to end tobacco related harm. An accompanying State of Tobacco Control Report (2022) examines recent trends in smoking in Ireland, tracks progress and highlights emerging challenges. Also launched at the conference is the ﬁrst Tobacco Endgame study of public views on potential proposals which could help deliver the goal of a Tobacco Free Ireland. You can view all of the conference presentations on YouTube here.

• There is a widening gap in smoking prevalence across socioeconomic groups, which means that the burden of smokingrelated harms falls heaviest on the most vulnerable in society.

Photo: Brian Arthur Photography

• Recent trends underscore the need for continuing e orts to build a Tobacco Free Ireland.

he Tobacco Free Ireland Programme, HSE Health and Wellbeing, hosted a conference to mark World No Tobacco Day. This conference, Tobacco Endgame: Nobody Left Behind explored the key elements and strategies for a Tobacco Free Ireland.

| 49HEALTH MATTERS AUTUMN 2022

Sampling is carriedout on food products such as spices from Pakistan. Rice from Pakistan and India is an example of a product that’s on a controlled list and requires additional checks. Where necessary, food samples are sent to the HSE Public Analyst Laboratories.

Both EHS staff and hauliers are obviously keen to keep goods moving and to avoid congestion and delays arising. Perishable goods are checked and moved on quickly.

The facilities in the new building allows the EHS team to deal with a greater volumes of goods. There are huge improvements with EHS staff having access to improved sampling rooms, more bays, better cold storage and other facilities and improved office space.

The area where the HSE staff work is a hive of activity. Lorries back into HSE inspection bays in Yard Four at a busy Dublin port where goods are unloaded and checked. Operationally on an average week the team will carry out 1,100 food inspections and document checks.

HSE Environmental Health Service Assistant National Director Ann Marie Part explained, “The work being done by the EHS team at Dublin port is really essential work. The HSE Environmental Health Service has a statutory responsibility to ensure that foods of non-animal origin, tobacco, alcohol, vaping products and cosmetics are all assessed to make sure they are safe for the public in the first instance and that they are compliant with EU legislation.

Sarah Middleton in Dublin Port

The teams work closely with Revenue, DAFM and the Food Safety Authority of Ireland. For certain food products, EHS carry out dual inspections with DAFM. Document checks are carried out on every product of non-animal origin and food contact material products coming into our Border Control Post in Dublin Port.

Legislation governs all of the document and other checks which are carried out on the range of imported items including foods of non-animal origin, food contact materials from China and Hong Kong, cosmetics and tobacco.

Environmental Health Service staff members Deirdre Devine and Emma Connolly at the Dublin Port facility. Environmental Health Service staff members Leanne Franzoni and Niamh Curran.

ENVIRONMENTALSERVICE AT DUBLIN EXPANDEDPORT

"EHS staff are undertaking more physical exams of the food products and food contact materials entering Ireland and the wider EU from third countries thus ensuring safe food entering the food chain.

n May 2022, HSE Environmental Health Service (EHS) staff moved into a purpose-built new building in Yard 4 in Dublin Port. In 2019 the EHS team carried out 2201 consignment inspections. Post-Brexit, by the end of 2021, this figure had increased to 55,350. By May 2022, EHS staff were on target to overtake the figure achieved in 2021.

EHS staff Nicole Feeney and Daragh O’Connor. Damian Smyth carrying out a check at the Port.

Data fed back to the European Commission as a result of sampling carried out in Dublin Port has resulted in improved EU food control legislation.

The huge improvements include access to sampling rooms, more bays, better cold storage and better office space

EHS staff members work a 12-hour shift at Dublin Port and the team operates over seven days a week, 24 hours a day. Eighteen ferries arrive daily in roughly four peaks.

"These are tangible benefits for the Irish public. This is all about making sure goods are safe for human consumption. Ultimately this is about protecting public health.’’

“Our move to the new premises means we now have five EHS inspection bays in Dublin Port compared with the two we had previously.

Almost all of the goods moving in and out of Dublin Port are transported by haulage companies, large and small. For hauliers, it is really important that they are able to move their goods in and out of Dublin Port quickly and efficiently, and for the HSE Environmental Health Service, it is imperative that public health and consumer safety are protected at this major access point to the EU and Irish markets.

• MenB vaccine protects against Meningococcal B which can cause meningitis or septicemia or both.

Thankfully we have these wonderful e ective vaccines which prevent babies from getting these severe vaccine-preventable diseases, some of which can have a life altering impact.

You’ll be given an immunisation passport. This is where the nurse will record what vaccines your baby has received. Keep this in a safe space. Your child will need this for their next round of vaccines, the booster MMR and 4-in-1 vaccines in primary school.

• The 6-in-1 vaccine prevents Diphtheria, Hepatitis B, Haemophilius inﬂuenza type b, Whooping Cough, Polio and Tetanus.

• PCV13 vaccine protects your baby against invasive pneumococcal disease which can cause invasive disease such as pneumonia, meningitis and septicemia.

• MR vaccine protects your baby against Measles Mumps and Rubella.

• You can breastfeed your baby or give your baby milk to drink a few minutes before their vaccination. This can help to reduce pain at the injection site.

There are a number of things happening here in Ireland and around the world which make it all the more important to keep up to date with your baby’s ﬁrst vaccines. We know from recent Health Protection Surveillance Centre (HPSC) reports that in Ireland, the number of children up to date with their childhood vaccines isn’t as high as we would like. We need 95% of babies vaccinated so that diseases like measles don’t spread. We’ve also seen reports of polio and measles outbreaks in some countries. Traces of polio have been discovered in sewage in both London and in Poland. Polio is just one of the diseases the 6-in-1 vaccine protects your baby against while the MMR vaccine protects against measles. Also the WHO and United Nations International Children’s Emergency Fund (UNICEF) have just published a report which shows the global uptake for baby vaccines has dropped which is a worry. The world has reopened after the pandemic, people are travelling again, which leaves the potential for diseases to spread more easily.

Q: WHAT ARE THE VACCINES NEEDED AND WHAT DISEASES DO THEY PROTECT AGAINST?

The primary childhood vaccination schedule – or your baby’s ﬁrst vaccines - are given to your baby when they are 2, 4, 6, 12 and 13 months of age. That’s just ﬁve visits to your local GP General Practice. It’s usually your General Practice Nurse who gives the vaccines to your baby. Your GP or General Practice Nurse are always happy to talk to you about the vaccines.

Q: WHAT’S HAPPENING IN THE NEWS AT THE MOMENT THAT CASTS A SPOTLIGHT ON BABY VACCINES?

Once your baby has completed their ﬁve GP visits, they will be protected from a number of vaccine preventable diseases:

he HSE National Immunisation O ce launched the #KeepUpToDate campaign this summer. #KeepUpToDate is a reminder to parents and guardians to have their baby vaccinated on time.

Q: DO YOU HAVE ANY PRACTICAL TIPS FOR BRINGING BABY TO THEIR VACCINE APPOINTMENT AT GENERAL PRACTICE?

• Contact your GP General Practice to make an appointment, they are always happy to hear from you and help with your baby’s vaccines.

• It’s busy when you have a new baby: Put a reminder in your phone for their next appointment. Or put the timetable for your baby’s vaccines on the fridge door as a reminder.

HEALTH MATTERS AUTUMN 202250 |

• Rotavirus vaccine protects your baby against Rotavirus disease which causes vomiting and diarrhoea, which can cause dehydration that may need admission to hospital for treatment.

• The GP practice nurse will explain how the vaccines are given at your appointment. And of course remember you will be there to comfort your baby if they get upset at all. They are in the best of hands.

• MenC vaccine protects your baby against Meningococcal C disease which can cause meningitis or septicemia, or both.

• Bring liquid paracetamol to the 2 and 4 months visit.

• If you ever have any questions about vaccines for your baby, see trusted sources like the www.immunisation.ie and talk to your GP or practice nurse.

You can download Your Child’s Immunisation. A Guide for

http://bit.ly/PCIPBookParents: #KEEPUPTODATEWITHBABY’SVACCINES

Dr Chantal Migone is a Specialist in Public Health Medicine at the NIO. Dr Migone has worked in public health for more than seven years, and as a GP for more than 10 years.

Q: WHEN DOES YOUR BABY NEED TO GET THEIR FIRST VACCINES?

“If you are 65 or over, or if you are in an at-risk group, the pneumococcal vaccine is free. However, you may have to pay your GP or practice nurse a consultation fee. If you have a medical card or GP visit card you will not have to pay a consultation fee.”

Are your patients protected against#SayNoToPneumopneumo?

VACCINATION PROTECTS THOSE MOST AT RISK FROM PNEUMO

“Anyone can get pneumo and you can get it at any time of the year. But we tend to see most cases in the winter months. The elderly, the very young and those with a weakened immune system are most at risk of severe illness and IPD.”All those aged 65 and older are at risk of pneumo and invasive infection. Other risk factors include having diabetes; a weakened immune system due to disease or treatment; Down syndrome; or certain chronic conditions.

OTHER VACCINES RECOMMENDED FOR SCHOOL CHILDREN

“People can carry the pneumo-causing bacteria in their nose and throat without being sick and can easily spread the bacteria to others. This means pneumo disease can cause complications that range from mild to very severe.”

When pneumococcal bacteria spreads from the nose and throat to the ears or sinuses, it typically causes mild infections such as ear and sinus infections. When the bacteria spreads to other parts of the body, it can cause lifethreatening illnesses like pneumonia, sepsis and meningitis.

COVID-19 vaccine is recommended by the National Immunisation Advisory Committee for children from 5 years of age. Visit the HSE website to understand why vaccination is important and to book an appointment.

“When pneumo leads to more serious problems like pneumonia, or meningitis, we call it invasive pneumococcal disease, or IPD,” she said.

“Pneumococcal disease is a serious but vaccine-preventable disease. It is caused by the common bacteria, Streptococcus pneumonia,” explained Dr Keegan.Pneumococcal bacteria can spread by from person to person by coughing, sneezing, or close contact.

Pneumococcal disease, or pneumo, is a major cause of illness and death in Ireland. While everybody is at risk of getting the disease, the elderly, the very young and those with a weakened immune system, are most at risk.

Each school year, HSE school vaccination teams across the country o er two separate vaccines: 4 in 1 and MMR vaccine to children in Junior Infants; and the HPV, Tdap and MenACWY vaccine to students in ﬁrst year.

– get the pneumococcal vaccine

For more information on HSE national immunisation programmes visit immunisation.ie

Dr Aparna Keegan, Specialist in Public Health Medicine, National Immunisation O ce shares the facts.

CHILDREN STARTING SCHOOL – TIME TO GET VACCINATED

“Over the years, the pneumococcal bacteria has become resistant to many medications. This makes treating pneumococcal disease much more di cult. But it also means that prevention of pneumo by vaccination is more important than ever.”

• Measles is a highly contagious virus that is spread by close contact with an infected person and causes fever, a cough and a rash.

“Those at risk of pneumo disease, including those aged 65 and older and those with certain long-term medical conditions, should get the pneumococcal vaccine, PPV23,” she sadi.

Learn more about pneumococcal disease and PPV23 by completing the new PPV23 HSeLanD training programme developed by the HSE National Immunisation O ce.

| 51HEALTH MATTERS AUTUMN 2022

In October, nasal ﬂu vaccine will be available free of charge from participating GP practices and pharmacies across the country for children aged 2 years and older and I would encourage parents to take up the opportunity to protect their children. Visit www.immunisation.ie for information.

In Ireland the pneumococcal vaccine, PPV23, is available to all those aged 65 and older, and those aged 2 years and older with certain long term medical conditions at their participating GP. A full list of those eligible to get PPV23 is available at immunisation.ie.

“The latest vaccine uptake reports show we have high uptake for our school vaccination programmes and I hope the same will be true for this school year too,” she said.

“I would encourage parents to visit our website for information about why it’s important to protect their child and if you have any questions speak to a trusted health professional,” said Dr Jessop

• ertussis (Whooping Cough) is a contagious bacteria that spread by close contact with an infected person and cause a "Whooping" cough and vomiting. The diseases can last up to three months.

The pneumococcal vaccine works by helping the immune system produce antibodies to ﬁght pneumococcal infection. Administering PPV23 to those we care for who are most at-risk is the best way to protect them from pneumococcal disease.

School teams deliver consent packs for parents to primary and second level schools across the country. It’s important for everyone to complete the form for their child and return it to ensure they can be vaccinated when the team visits your child’s school.

WHAT IS PNEUMO?

“If your patient is 65 or older, they only need to get the vaccine once to be protected,” said Dr Keegan.

As our children return to school it is as important as ever that students avail of the vaccines o ered, said Dr Lucy Jessop, National Immunisations Lead in the HSE National Immunisation O ce.

The COVID-19 pandemic has caused disruption for the last 2 years in the venue the vaccination programme was delivered in but we hope most students will be able to get vaccinated in their school this year. A number of children may need to be vaccinated in HSE clinics, but if this is true for your child, the school team will let parents know the details.

• Meningococcal disease can cause meningitis which can leave people with serious after-e ects. It’s important to know the signs of meningitis and get help immediately if you are worried about your child.

WHO IS AT RISK OF PNEUMO?

system of decision support arrangements for people who need help with making decisions, with legally recognised decision-makers to support a person to maximise their decision-making powers.

However, the 2015 Act is also crucially important to healthcare workers. The 2015 Act provides a framework and guiding principles to guide best practice in supporting people who use their services in decision-making and ensuring the person is at the centre of the decision.

Notwithstanding these delays there is much that can be done now to prepare for commencement of the 2015 Act. The HSE National O ce of Human Rights and Equality Policy has developed extensive information and learning resources for sta , which can be accessed on HSELand and through www.assisteddecisionmaking.ie.

MAJOR IMPLICATIONS OF THE 2015 ACT

he Assisted Decision-Making (Capacity) Act (the 2015 Act) is about supporting decisionmaking and maximising a person’s capacity to make decisions. This Act applies to everyone and is relevant to all health and social care services. The 2015 Act will have major implications for the people who use our services and also for us, as healthcare workers.

WHY THE 2015 ACT MATTERS Commencement of the 2015 Act is so important primarily to a person whose capacity to make one or more decisions is, or may shortly, be called into question or a person who wishes to plan ahead for their future healthcare for a time when they may lack capacity. Helen Rochford Brennan, Global Dementia Ambassador, stated, “It essentially delegates power and control back to me, the individual, to decide what I want to do with my life and what I believe is best for me, and not what others think is in my best interests.”

WHAT WE ARE DOING TO PREPARE

Decision-MakingAssisted

The 2015 Act introduces new guiding principles about interacting with a person who has di culties with their decision-making capacity. It also moves to a ﬂexible functional approach to the assessment of capacity – moving away from “all or nothing” status approach to capacity. The 2015 Act also provides legal clarity as to who can make legally compliant decisions for a person who lacks capacity which is critical where matters of consent to treatment are at issue.

While the Act was signed into law in 2015, it hasn’t commenced yet. Progress on the Bill will resume in the Houses of the Oireachtas as early as possible following the beginning of the autumn session, and it remains the intention and ﬁrm commitment of Government to commence the 2015 Act in full as soon as possible. ‘Commencing the act’ means that the law is now in e ect and people and organisations will have to follow it.

Assisted Decision Making (Capacity) Act will have ‘major implications’ for healthcare workers

HEALTH MATTERS AUTUMN 202252 |

The 2015 Act brings about important changes for people who require support to make decisions and for anyone interacting with them, including healthcare workers. At its core, it provides a human rights compliant legal framework for decision making where a person lacks capacity. It puts the person at the centre of their healthcare treatment and provides for the individual’s right of autonomy and self-determination to be respected.

The 2015 Act establishes the Decision Support Service who will provide oversight of the new decision support arrangements, along with providing improved oversight of Enduring Powers of Attorney process. It also provides a legal basis for advance healthcare directives.

The road to commencement of the 2015 Act is not over yet. Challenging times ahead remain as we await further debates on the amending legislation. However, it is critical that we remain on track with commencement to realise and protect many fundamental rights for people who have di culties with decision-making.Asconcludedby Gráinne Cunningham O’Brien, Principal Social Worker and Joan O’Toole, Principal Medical Social Worker, Midlands Regional Hospital, Tullamore, “Commencement of the Assisted Decision-Making Act matters to demonstrate in law the importance of respecting each individual’s right to independently assert their own will and preference over the notion of best interest.”

The most recent webinar series on preparing for commencement is available through www.assisteddecisionmaking.ie.

WHAT IS NEXT

Minister for Children, Equality, Disability, Integration and Youth Roderic O’Gorman emphasises that, “The Assisted Decision-Making Act will bring about fundamental change in the way that we view capacity in the State, having much more regard for the will and preference of persons rather than simply doing what we think is best for them.”

It abolishes the current wardship system and requires all wards of court to be discharged from wardship within three years of commencement of the 2015 Act. In its place the 2015 Act establishes a tiered

WHERE WE ARE NOW

The o ce launched e-learning modules on supported decision making in health and social care in April 2022 which are available on HSELand.

There are many other resources– video, audio and in written format, available to access through the website. The o ce regularly updates the website to ensure that the most up to date information on what the Act will mean for front-line practitioners is available. The o ce also produces a quarterly newsletter. You can sign up to the o ce’s mailing list by emailing adm@hse.ie.

prescribing’.thepartnershipworkingshevoluntarywithdeliveredprescribingAllacrossinCommunitiesHealthysitesbasedareasofdisadvantagethecountry.HSE-fundedsocialservicesareinpartnershipcommunityandorganisations,”said,addingthattogetherinisthe‘keytodevelopmentofsocialTheAll-IrelandSocialPrescribingConference

| 53HEALTH MATTERS AUTUMN 2022

The All-Ireland Social Prescribing Conference is organised by the All-Ireland Social Prescribing Network, an island-wide steering group that drives this innovative healthcare approach. Tony Doherty, co-chair of the Network believes the conference has highlighted the important work carried out across the island:

is organised by the All-Ireland Social Prescribing Network, an island-wide steering group established with the purpose of championing Social Prescribing so that it is valued, understood and sustained across the island of Ireland.

The All-Island Social Prescribing Conference was an opportunity for social prescribers, project managers, strategists and beneficiaries to gather and consider how this important health and wellbeing intervention could be further developed and broadened to benefit more who need it.

“The power of seeing everyone coming together at this conference with the goal of continuing to move forward and making a difference was fantastic. If we continue to work together to highlight the importance of social connections and relationships to health and wellbeing, there is no reason why social prescribing cannot become fully mainstreamed in our health service, north and south of the island in the future.”

“HSE Health and Wellbeing through the Slaintecare Healthy Communities Programme have been supporting the increased growth of Social Prescribing

Celebrating and Sustaining Throughout the Island

The conference ‘Social Prescribing: Celebrating and Sustaining Throughout the Island’ underlined the critical role of social prescribing projects and services based in community centres, healthy living centres, and primary care centres, and highlighted the growth and development of social prescribing north and south, providing a forum for shared learning throughout the island of MinisterIreland.Feighan said he believes the conference showcased how social prescribing successfully links people with sources of community support and social interaction.“Following the impact of the Covid-19 pandemic, support for mental health has never been as important. Social prescribing counteracts social isolation and improves social connectedness for people,” he said.

The conference was also addressed by NI Mental Health Champion Siobhán O’Neill; Health Service Executive Helen Deely; Glynne Roberts from the Welsh Health Department; Martin Hayes from the NI Department of Health and a number of social prescribers and beneficiaries.

All-Island Social Prescribing Conference Delegates: Back (l-r) Lisa Sieger-Jamison, Gary Glennon, Tony Doherty, David Robinson, Steven Lindsay, Róisín Ryder, Emer McDaid, Ciarán Lockhart; Front (l-r) Karen Galway, Susan Scully, Jill Mulholland, Claire Cashman, Deirdre Connolly, Jennifer Neff, Orla Walsh.

services, and are providing more support for social prescribing through the HSE Social Prescribing Framework, Sláintecare Integration Fund services, and through the Sláintecare Healthy Communities Programme.“Thehealth services in Northern Ireland and in the Republic are supporting a different approach to healthcare, one that has grown throughout the island and one that is backed through policy and funding by government departments.”

PRESCRIBINGSOCIAL

he third All-Island Social Prescribing Conference took place in Derry’s City Hotel with over 200 delegates from across the island of Ireland attending. The two-day event was addressed by Frank Feighan and Minister for State with the responsibility for Public Health, Wellbeing and National Drug Strategy and was brought to a close by MLA and Health Minister Robin Swann.

A vast number of speakers from both the Republic and Northern Ireland were addressed by NI Mental Health Champion Siobhán O’Neill; Health Service Executive Helen Deely; Glynne Roberts from the Welsh Health Department; Martin Hayes from the NI Department of Health and a number of social prescribers and beneficiaries. Together they showcased the social prescribing landscape. The conference brought project managers, strategists, social prescribers and people who have received social prescriptions together for the two-day event to discuss and discover how this innovative approach to health could be expanded.

Helen Deeley, Assistant National Director for Health and Wellbeing Programmes, was speaking at the conference.

At the All-Island Social Prescribing Conference were MP for Foyle Colum Eastwood; Derry City and Strabane District Council Mayor Sandra Duffy; Jennifer Neff, Managing Director Elemental; Frank Feighan, Minister for State with the responsibility for Public Health, Wellbeing and National Drug Strategy.

“There are more than 30 HSEfunded social prescribing services across the country. 19 of these sites are Sláintecare

For more information on Social Prescribing and the All-Ireland Social Prescribing Network visit allirelandsocialprescribing.iewww.

Commenting on the new eLearning Programme, Dr Una Kennedy, GP Advisor to the NCCP said, “If cancer is found early, before it has grown bigger or spread to other parts of the body, it’s easier to treat and there is a better chance of curative treatment and long term survival. Stage at diagnosis is the most important determinant of survival for most major tumour types.”

• Early Diagnosis of Cancer – Part 2 (covering colorectal, uterine, ovarian and cervical cancer)

New Early Diagnosis of Cancer eLearning Programme for Primary Care Staff

The Early Diagnosis of Cancer eLearning programme takes approximately 60 minutes to complete (30 minutes per module). Each module includes ‘extend my learning’ content for those who wish to undertake further learning or who want practical activities to help transfer their learning into their area of work.

“If cancer is found early, before it has grown bigger or spread to other parts of the body, it’s easier to treat and there is a better chance of curative treatment and long term survival. "

Available now on HSeLanD, the new eLearning programme ‘Early Diagnosis of Cancer’ will advise healthcare sta on how to recognise signs and symptoms of cancer and refer patients, when necessary, to the appropriate next step in their journey to a possible cancer diagnosis.

She added, “These modules are excellent resources to help health care professionals recognise the signs and symptoms of cancer and refer a patient promptly, so that their cancer can be diagnosed at an early stage. Increasing the proportion of cancers diagnosed at an early stage (Stage I or II) is a key step in improving cancer survival in Ireland.”

The Programme may be especially relevant to GPs, who are typically the source of referrals to secondary care for people with suspected cancer. However, the programme is also highly relevant to other primary and allied healthcare professionals, such as practice nurses, public health nurses, and community pharmacists, who can all play an important role in recognising people with possible signs/symptoms of cancer and advising them on appropriate action to take.

Learners can dip in and out of the programme at any time and can ﬁnd it by searching for ‘Early Diagnosis of Cancer’ in the search box on HSeLanD or by accessing it through the Clinical Skills course catalogue.

The programme also includes a brief assessment to enable the learner to assess whether their learning requirements have been met. From June –September, learners will be asked to complete a brief post-completion evaluation survey. Feedback from this survey will be used to help us improve the online course.

he National Cancer Control Programme (NCCP) has launched a new Early Diagnosis of Cancer eLearning programme to provide primary care and allied healthcare professionals with the knowledge and resources required to help improve the early diagnosis of cancer in Ireland.

The new eLearning programme contains 2 modules:

The new eLearning programme is aligned to the National Cancer Strategy and the NCCP Early Diagnosis of Symptomatic Cancer Plan 2022 – 2025. Development of the Programme was led by the NCCP, with support from additional clinical subject matter experts, and was designed and developed in collaboration with the HSeLanD team.

The Irish College of General Practitioners (ICGP) has awarded 1 external CPD point upon completion of this programme.

Early Diagnosis of Cancer

• Early Diagnosis of Cancer – Part 1 (covering lung, breast, prostate and melanoma skin cancer)

HEALTH MATTERS AUTUMN 202254 |

he HSE’s National Cancer Control Programme (NCCP) has recently published a framework to improve the care and treatment for adolescents and young adults with cancer, which includes three new specialist units at St. James’s Hospital in Dublin, University Hospital Galway and Cork University Hospital.

These units will bring together all the relevant experts and allow this collective knowledge, experience and interest to work towards better experiences, better outcomes and better long-term quality of life for this group of patients.

Arising from the National Cancer Strategy [2017 -2026], where the unique and distinct needs of the adolescent and young adult cancer patients in Ireland were recognised and recommendations were made, the framework looks to implement robust care pathways for young people with cancer in Ireland and covers the period up to 2026.

Around 200 children are diagnosed every year with cancer up to the age of 16, with 180-190 adolescents between 16 and 25 years diagnosed everyStudiesyear.over the past three decades have shown that while paediatric and older adult cancers have seen a large increase in survival rates, the same however cannot be said for some speciﬁc adolescent and young adult cancers.Professor Owen Smith, National Clinical Lead for Children, Adolescent and Young Adult Cancers at National Cancer Control Programme, HSE

said: “Adolescent and young adult patients constitute a unique group that deserves special attention. Although there is marked variability between the deﬁnitions of adolescents and young adults, ranging from 15-20 to 15-39 years, cancer continues to be the leading disease-related cause of death in this population.

“Adolescents and young adults with cancer are a diverse group as deﬁned not simply by their age and distinct biology of their cancer, but in terms of the challenges they face with regards to adequate access to age-appropriate oncological care, representation on clinical trials, short- and long-term health and psychosocial issues, that include fertility considerations, transition to survivorship care, psychosocial support, adherence to treatment di culties and other dilemmas and problems exclusive to this group of patients.

To read the full report search 'Framework for the Care and Support of Adolescent and Young Adults (AYA) with cancer in Ireland 2021 to 2026’ on hse.ie.

“The framework succinctly outlines strategies to coordinate state-of-the-art integrated AYA care to be delivered locally when possible but centralised when necessary, by providing separate facilities and specialist care teams for these patients. Once this has been achieved the challenge will then be to secure the future through education, research/innovation and future service developments. The ultimate aim of the framework is to improve the standards and quality of cancer care provided to AYAs, and at the same time deﬁne outcome measures of high-quality care for AYA patients across the proposed AYA cancer network as outlined in the National Cancer Strategy.”

Three new cancer units for adolescents and young adults

Minister for Health Stephen Donnelly; Dr Karen O’Neill, Specialist Registrar in Paediatrics; Prof Owen Smith, National Clinical Lead for Children, Adolescent and Young Adult Cancers, HSE NCCP; and Prof Risteárd O’Laoide, National Director, HSE NCCP.

New ‘Framework for the Care and Support of Adolescent and Young Adults (AYA) with cancer in Ireland 2021 to 2026’ launched.

| 55HEALTH MATTERS AUTUMN 2022

Spark Team - Neilan

sessions from Insight with Microsoft and the Royal College of Surgeons of Ireland showcased the cutting edge of medical technology and immersive software.

HEALTH MATTERS AUTUMN 202256 |

Chief Clinical O cer Colm Henry spoke to the ever increasing need to innovate in healthcare, and the challenges felt throughout the COVID-19 pandemic to date.

The day culminated in the Spark Ignite Competition’s National Final – which saw teams from all over the country compete for the title, funding and support from Spark to bring their idea to reality. Ideas ranged from an application to revolutionise the delivery of ADHD care, to a Critical Care Nursing Information resource and a Kidney Health App.

Govender, Gormly,HeBurke,McNamara,RachelDermotCaitrionaernan,JaredAmyCarroll

The winners – who were awarded funding towards the development of their idea – were Bernadette Higgins and Anne Murray, with their innovative solution ‘Wee Catch It!’ Hailing from the Mid-West Public Health Department, their solution, which overcomes the challenges of collecting a clean catch urine sample in those with incontinence, is set to be a strong asset in striving towards responsible antibiotic use for the Urinefuture.sample collection is important for a variety of reasons, including identifying infection and other conditions. Collecting a clean, accurate midstream urine sample in babies, children and adults with incontinence in an e cient and hygienic way is challenging. This can lead to contamination of samples and often results in unnecessary antibiotic prescribing and costly unplanned hospital admissions. ‘Wee Catch It’ is currently in prototype development phase, and the Health Protection nurses will now work towards developing the unique product and software for national and international use.

ealthcare innovators rose to the challenges of COVID-19 and drove positive change in their departments. Over 200 delegates attended the HSE Spark Programme’s ‘Spark Summit’ in June, many to receive awards in recognition of their achievements in health service improvement and delivery.

Frontline health innovators descend on Dublin for Spark Summit ‘22

Norma Caples, Advanced Nurse Practitioner in Heart Failure from University Hospital Waterford, who developed a mobile phone application to revolutionise the management of heart failure.

Martin Ryan, Director of Undergraduate Studies in Design Innovation at Maynooth University, spoke powerfully with patient representative and advocate Elaine Chillingworth of their work to improve the patient journey through design-thinking for those with facial amputations at St James’ Hospital.

Exhibitors displayed their innovative solutions in the main foyer, while delegates networked and shared their solutions to healthcare challenges, with the aim of scaling them from one site to many. Breakout

The summit played host to inspiring keynotes, including: Trevor Vaugh, Assistant Professor in Design at Maynooth University, gave an emotional account of helping to develop the AI-driven voice simulation software currently in use by veteran broadcaster Charlie Bird.

Spark Summit

“We are an example of how passionate, creative nurses are in an ideal position to invent and develop ideas as we spend more time with patients. Nurses have a wealth of knowledge of how products work and can make patients’ and healthcare workers’ lives better.

“The ability for a nurse to innovate is deﬁned by a desire to improve some of the most vital solutions in healthcare. While it’s easy to recognise pain points in our working environment, ﬁguring out what to do next can feel overwhelming. However, having completed a MSc module ‘Idea and Representation’ from the MSc in Design for Health and Wellbeing, at University of Limerick, combined with the Spark Ignite programme, these opportunities o er the support needed to all frontline sta to develop their ideas from a spark to their fruition. Innovation in healthcare is essential to continuously improving HSE service provision,” said Bernadette.

“As a parent, I know the distress of trying to get a urine sample from a baby. As nurses, our patients are the centre of all we do. We want to be able to deliver the best patient experience we can in an e ective, e cient, simple, comfortable, safe and cost e ective way. ‘Wee Catch It’ does all this. The idea is that it will improve the process for the healthcare worker, provide education, promote appropriate and timely treatment and reduce the risk of harm to the patient and the wider population.”TheSparkProgramme and Summit is run through the HSE, with the O ce of the Nursing and Midwifery Services Director (ONMSD), the National Health and Social Care Professions O ce (HSCP), and National Doctor Training and Planning (NDTP).

| 57HEALTH MATTERS AUTUMN 2022

From top to bottom: Chief Clinical O cer Dr Colm Henry, Trevor Vaugh (Assistant Professor in Design at Maynooth University) and Charlie Bird (Veteran TV Broadcaster - RTE), Martin Ryan, Director of Undergraduate Studies in Design Innovation at Maynooth University with patient representative and advocate Elaine Chillingworth, St James Hospital, General Crowd at Spark Summit, Gar MacCriosta: Chairperson Public Health Advisory Committee at Linux Foundation + Digital Advisor, eHealth, HSE, Afternoon Application of Design in Healthcare Panel: Dr Chris Soraghan (SJH), Rebecca Walsh (Design DIrector @ Big Motive) Maire Kane (Designer in Residence @ SJH) , Gar MacCriosta (as above), Tech Innovators, Spark Ignite Winners: Bernadette Higgins (see below) and Anne Murray

Bernadette Higgins, ADON, who hails from Longford and lives in Clare, said that she is delighted with the validation and looks forward to taking the idea to the next stage.

“Being shortlisted and winning the Spark Ignite Award is an honour considering the exceptional standards of all of the other entrants. Winning this prestigious award in such a high calibre competition has given the validation to believe in the innovative med tech device ‘Wee Catch it’ and drive it forward.

O’ReillyHuPhotos:

The Spark Programme enables and empowers those right at the frontline to develop solutions to the problems that they see every day. All members of the HSE can get involved with the programme which is growing an innovation network and cultivating an innovation culture throughout the HSE through initiatives, events and research. For more visit hse.ie/spark

Anne Murray, CNM2, from Cork and living in Kilcornan, Co Limerick, said, “Nurses have always been unintentional innovators. Improvising, moulding and tweaking what was available to us. They bring true meaning to the phrase ‘necessity is the mother of invention’ in their e orts to optimise the care they give. In recent years, healthcare recognises the enormous value of fostering creativity and innovation in health care workers. We are so incredibly honoured and humbled to have been chosen from such an incredible group of passionate SPARK ﬁnalists, all of whom had amazing innovations. Without the HSE’s SPARK programme, our innovation would still be just an idea.

INDIVIDUAL HEALTH IDENTIFIERS

linking digital data points for improved healthcare delivery

HEALTH MATTERS AUTUMN 202258 | How the Individual Health Identifier project is re-shaping health, from decision-making to delivery

oogle says that the world has undergone a decade of digital transformation in just 12 months. This statement is true within the HSE’s Health Identiﬁer Service (HIDS). A young but agile team, they are living proof that digital transformation is reshaping healthcare as we know it, and for the better.

In the future the IHI number will enable the linking of correct patient health records from di erent systems to give a complete medical history.

was the scale of this project that the IHI was used to uniquely identify 4.2 million citizens with a 97% accurate match rate. Having a ‘clean data lake’ is digital transformation in itself. It is the holy grail of public service delivery for many if not all public sector agencies.

In e ect they are two central computer systems which manage the IHI in Ireland as guided by legislation.

The story centres on the Individual Health Identiﬁer (IHI).

What is the IHI?

The Health Identifier Act 2014 allows the Minister for Health to delegate specific functions under the act to the Health Service Executive. After five years of scoping, planning and governance, the first live pilot IHI group was set up. It would be 2020 before the formalisation of the Health Identifier Services (HIDS) business unit within the HSE was established to manage health identifier records, which consists of an IHI and other personal data, such as email address, phone number or mother’s maiden name.

| 59HEALTH MATTERS AUTUMN 2022

Emergencyservices.legislation was brought in to expedite the rollout of the COVID-19 vaccination programme and in 2021 a review of the HIDS legislation was undertaken given the expanded requirement for IHI use in the pandemic.

The Individual Health Identiﬁer (IHI) is a number that safely identiﬁes a person who has used, is using or may use a health or social care service in Ireland.

In 2020 the HIDS team found themselves part of a national public health emergency response, supporting multiple healthcare delivery

While their aptitude for transformation was tested during the pandemic, there is a bigger story to be told about how a team of three grew to a team of 30 in just over two years and how they have been central to how the health service reorients itself from data for reporting purposes to data for decision-making purposes.

helps to ensure that health and social care can be delivered to the right person, in the right place and at the right time.

During, and to this day, to varying degrees, the HSE is responsible for PCR testing, contact tracing, vaccinating the population and providing booster doses to vulnerable citizens. It was probably the single biggest mobilisation of public health in modern history aided by technological advancement.Whilethere were a number of digital systems used to deliver the HSE’s public healthcare regime during the pandemic, the IHI played a pivotal role. The COVAX project needed the IHI to safely identify patients but its e ectiveness goes beyond the pandemic response in terms of optimising healthcare delivery.

Governance-ﬁrst approach

It’s important to take readers back to the beginning of the IHI story. While COVID-19 illustrates how it is used in practice, IHI was born on the back of the Health Identifiers Act This2014.piece of legislation allowed for two new national data collections to be set up, •namely:theNational Register of Individual Health Identifiers; and • the National Register of the Health Services Provider Identifiers.

IHI and COVID-19

Maria McCann and Lisa Farrelly beside the large IHI infographic at the Nursing Midwifery Conference.

We speak to Joe Ryan, National Director, Operational Performance and Integration and Maria McCann, an organisational psychologist and Director of Health Identiﬁers service on how the pandemic has helped them scale digital opportunity within the health service with a view to replicating this lived experience into other areas of healthcare provision.

The ability to correctly identify an individual is essential for patient safety. It

The HIDS team of three rapidly grew to over 30. They did not anticipate how their working lives would be changed nor how their work would be so central to digital

Accelerating innovation with purpose Joe Ryan says the pandemic was an innovation accelerator and his team pivoted very quickly. Agility was the key to grasping the opportunity for the IHI to link a lot of the new technology innovations that were brought in, in order to be able to manage the pandemic, and in particular the vaccination and contact tracing capacity and capability.

“There was a necessity to have an engagement with practically every individual in the country on a very personal level. In other words, we needed to either swab and test or put a needle in your arm and the safety around this was paramount,” heSuchsays.

“We are moving from archaic paper-based systems to more secure systems that add value to the patient and the health service. IHI enables us to stitch all of that safely together.“We're investing around about 0.8 of 1% of our budget in e-Health, whereas other countries are in between 3 and 5%. That's where we need to be. Government knows that's where we need to be. As we go there, we can go there much more conﬁdently and much more e ciently now with the work that's been done.” out more about the IHI here: contact a member of the HIDS team to receive a presentation on the IHI integration project within the HSE email HIDS.info@hse.ie.

What is the real win for the patient in all of this?

“The IHI enables connections to systems and sites for a full patient journey. Now that the IHI is in place, we will be able to strive forward to implement it into new systems. The next step of our transformation journey is to accelerate our working with clinicians and health care providers across our health service.”There are up to 60 HSE teams or areas waiting to go through a supportive eight-step consumer engagement process of IHI integration. A prioritisation exercise is underway to strategically deliver the IHI to Acute and GP services. Maria McCann says, “Governance is a support structure, not a deterrent and our engagement is a partnership. We have developed the roadmap of IHI integration, and we are excited to go on that journey with our colleagues.”

WHAT IS THE DIRECTORY?HEALTH

From a technical perspective the Health Directory allows ICT systems to integrate on a technical level by using standard unique identifiers for health care practitioners, health care sites and health services and share information across numerous systems that may need to use the Ultimatelyinformation.the Health Directory will provide a repository of current, up-to-date, quality assured and verified key contact and communication information, codes, health identifiers and other data.

Better decisions for better healthcare Joe says, “We know we want to scale the e ectiveness of data for actionable insights across the HSE and the IHI is a key player in this. We have an IHI that is highly accurate, highly populated, and completely enabled by the legislation. So, we are in a much stronger position than we've ever been to drive the IHI into every system we can. Not only the new systems, but the systems that have millions of records and are just crying out to be cleansed.”

“While we have technology experts on our team and across our ehealth partners, we like to think of ourselves as enablers for our colleagues who are delivering better healthcare. It’s not all about the technology. In fact, the IHI is also about people and process engagement, communication, governance and data management under-pinning our work. This core partnership delivers on the above and the technology wraps around, supporting us all to scale the objectives of the HSE’s work.”

Paperless systems

Joe says a long overdue move from paper to the cloud is happening.

https://www.hse.ie/eng/about/who/national-services/individual-health-identiﬁer/ To

Data for better decision-making

The Health Directory Database has two main functions: From a business perspective it provides the most up-to-date information in relation to health sites/locations, health care providers (practitioners & organisations) and services provided by the HSE.

Joe says you have to earn trust. “IHI supports us to be strong custodians of data. We are bound by legislation to maintain these public records in the interest of public healthcare delivery and in doing so we will be able to support di erent parts of the HSE to improve their data quality by implementing the IHI.

“We were swept into a public health emergency response, providing 24/7 back-up support to frontline healthcare teams using systems that needed IHI and data quality support for identity management. We had no choice but to learn fast and pivot based on understanding what worked and what did not work. Agility is a key characteristic of organisational transformation, but we were thrust into this environment, like our other HSE colleagues, with a willingness to do

HEALTH MATTERS AUTUMN 202260 |

transformation within the HSE. But more than that, safely delivering over four million unique identiﬁer records within the vaccination system.

The HSE Health Directory is a technical infrastructure which stores, maintains and publishes standard codes and identiﬁers for health-related sites/locations and practitioners, services and Itorganisations.hasbeencompiled by the Health Identiﬁers Team using a range of internal HSE sources.

whatever it took to support our colleagues who were saving lives and preventing serious illness,” says Maria.

“Where we're moving to, and where we have been moving particularly during the pandemic as we developed IT tools, is designing processes right, and then we design the systems to deliver those processes, and that way you deliver a safe way in which our clinicians can handle personal, precious data. And that makes their job easier and helps them to make better decisions.”

Public trust and data

Maria McCann, Director of the Health Identiﬁers Service says that her team was immersed in the ‘learn-fast’ model of organisational change, working side by side with the HSE tech partners A2I.

Joe Ryan is National Director for Operational Performance and Integration in the HSE. While his tenure in the organisation spans 16 years, his previous career was in software and IT. Familiar with the importance of data for reporting purposes, he says, the legitimacy of data for actionable insights is where the real breakthroughs are made.

The main beneﬁt of the IHI is patient safety. Healthcare systems will be able to safely identify the patient and the IHI improves the accuracy in associating medical records held in di erent healthcare organisations so they are correctly attributed.

Find

The ‘learn fast’ model

The development of Patient Safety: learning, sharing and improving together was sponsored by Dr Orla Healy, National Clinical Director, NQPSD and coordinated by Lorraine Schwanberg, Assistant National Director, QPSIM. From the outset, the project team, led by Catherine Hogan, has worked collaboratively with; patient representatives, colleagues within the HSE and across Irish healthcare (Fig 1) and international partners. The collaboration has supported a co-design approach to build a valuable and sustainable learning resource. HSE Digital Communications have been instrumental in translating our vision for shared learning and bringing the platform to life.

• Further Learning will highlight upcoming conferences, QPS surveillance data and new publications.

• A multiagency National Patient Safety Alert Working Group co-chaired by Dr Darren McLoughlin and Lorraine Schwanberg will standardise their identiﬁcation, development and dissemination.

THE KEY ELEMENTS OF THE PLATFORM ARE:

• PSAs will be issued through the existing HSE e-Alert system to nominated designated persons in each service and will be freely available through a searchable repository on Patient Safety: learning, sharing and improving together.

‘Patient Safety: learning, sharing and improving together’ will continuously evolve to identify and provide relevant and vital content, and will grow to include other learning sources. The platform, located within the NQPSD website, will be an excellent addition to our ever growing patient safety toolkit.

• Safety Stories will give a voice to both patients / service users and sta who have been involved in, or impacted by patient safety issues (including positive and less favourable experiences) and want to share learning.

• Additionally, a new Safety Community for QPS professionals will be facilitated through the Q Community.

e are thrilled to introduce Patient Safety: learning, sharing and improving together, a new online resource for Irish healthcare launching in autumn 2022. It will enable users to freely access and download up-to-date quality and patient safety (QPS) information with particular emphasis on sharing learning on patient safety. Patient Safety: learning, sharing and improving together will be accessible to sta , patients, service users and the public. It will be a vehicle to share learning, motivate everyone to get involved in patient safety and support the application of relevant learning for QPS improvements at all levels of the organisation.

Hogan,Catherine ProjectQPSIMLead Dr McLoughlin,Darren Consultant in ED Co-chairMercyCorkMedicine,UniversityHospitalandUniversityHospital,CorkNationalPatientSafetyAlertWokingGroup Schwanberg,Lorraine NQPSDNationalAssistantDirector,–IncidentManagement(QPSIM)Co-chairNationalPatientSafetyAlertWokingGroup Dr Orla Healy, National Clinical Director,PatientQualityNational&SafetyDirectorate(NQPSD)

Patient Safety: learning, sharing and improving together

• Patient Safety Supplements (PSSs) will provide a summary article whereby we share timely and relevant QPS information for learning purposes. The content of PSSs will be based on several sources of patient safety intelligence and input from subject matter experts.

A Vehicle to Share Learning

| 61HEALTH MATTERS AUTUMN 2022

• National Patient Safety Alerts (PSAs) will be issued on authority of the Chief Clinical O cer. PSAs are a high priority communication, issued by the HSE in conjunction with relevant stakeholders, which require HSE services and HSE funded agencies to take speciﬁc action(s) within an identiﬁed timeframe and are designed to reduce the risk of occurrence or recurrence of incidents that have the potential to cause harm’.

“We know from our own and international evidence that as many as one in eight patients may su er harm while using health services, and that a substantial proportion of that harm is avoidable. Notably, at least half of medication-related harm is potentially preventable. Medication-related adverse events are highly common and have both immediate and long-term e ects to patients and healthcare systems worldwide.

Established in 2019, World Patient Safety Day is one of the WHO’s o cial global public health days. By celebrating World Patient Safety Day, countries can help to increase public awareness and engagement to promote patient safety. Each year, a new theme is selected on a priority patient safety topic to highlight its importance and call for urgent action to address the issue. Medication Safety was selected as the theme for this year’s World Patient Safety Day 2022, with the slogan ‘Medication Without Harm’.

“A 2020 report by the State Claims Agency found that Irish hospitals are improving at reporting medication incidents - this is encouraging as better reporting can help to signpost areas for improvement, focusing on where we can have the greatest impact in improving the safety of medication systems for the beneﬁt of patients and sta . It also signposts us to the medications and medication groups which are more commonly associated with medication incidents. We still have far to go, however; reducing patient harm associated with medicines or their omission will require our continued and concerted e orts locally and nationally over many years.”

The Programme team acts as a central hub for the implementation of the Patient Safety Strategy, sharing learning and resources; fostering a culture of learning and education to build capacity and capability for quality and patient safety across the HSE; and providing communication around the Strategy that informs, connects and supports. For more information on the HSE Patient Safety Programme, please visit: www.hse.ie/eng/about/who/nqpsd/patient-safetyprogramme/

Resistance & Infection Control programme (AMRIC); the National Safeguarding O ce; and the National Medication Safety Programme, to name but a few.

• Promoting the “Know Check Ask” campaign. This campaign supports people who take medicines and their families/carers to ‘Know’ their medicines and keep a list, ‘Check’ they are using their medicine in the right way and ‘Ask’ their healthcare professional if they have concerns. The team is working with Patients for Patient Safety Ireland to further promote the campaign message and use of a medicines list.

• Supporting safe medication use in the COVID era, including coordinating HSE clinical guidance, public information, and working with groups including community pharmacy, GPs, addiction services, and eHealth developments.

WHAT IS WORLD PATIENT SAFETY DAY?

THE HSE NATIONAL MEDICATION SAFETY PROGRAMME ‘SAFERMEDS’ The National Quality & Patient Safety Directorate is also home to ‘Safermeds’, the HSE National Medication Safety Programme. The Safermeds team provide clinical and quality improvement expertise and support for health services in addressing medication safety challenges. The programme is aligned with the WHO ‘Medication Without Harm’ Challenge priorities, collaborating to reduce medicationrelated harm associated with transitions of care, polypharmacy and high-risk situations. Current projects include:

THE HSE PATIENT SAFETY PROGRAMME

The HSE Patient Safety Programme is leading and coordinating a number of events to celebrate World Patient Safety Day in the HSE. The Patient Safety Programme is a key programme of work managed and led by the National Quality & Patient Safety Directorate, and was developed as a key driver of the HSE Patient Safety Strategy to support services in delivering safety and quality improvements to address the most common causes of patient harm. The programme works with national clinical programmes such as the Deteriorating Patient Improvement Programme (DPIP); the Antimicrobial

n 17th September, Ireland joined other countries across the globe in celebrating World Patient Safety Day. The HSE supports this international observance, led by the World Health Organisation (WHO), which focuses on raising awareness and ensuring that patient safety is recognised as an international health priority.

• Leading the HSE’s delivery of the EU-funded iSIMPATHY project in border counties. The project delivers medication reviews with patients of GP practices to address the challenges of polypharmacy (the use of multiple medicines)

• Developing an elearning programme in collaboration with the Irish Institute of Pharmacy focussed on ‘Medication without Harm’, which was recently launched on HSELand and is accessible for all healthcare professionals.

World Patient Safety Day highlights patients as the priority

HEALTH MATTERS AUTUMN 202262 |

• Collaborating in multiple research, guidance development and project groups related to medication safety and reducing medication related harm.

Dr Orla Healy, National Clinical Director for Quality and Patient Safety in the HSE, explained, “Keeping patients and everyone in our services safe is the priority for all of us who work in healthcare. Our goal in the HSE National Quality and Patient Safety Directorate is to ensure that all of our services deliver patient centred high quality healthcare.

• Coordinating the HSE’s response to preventing venous thromboembolism (blood clots), including coordinating the development of HSE clinical guidance for VTE prevention in hospitals and community settings. Patient alert cards, developed with the patient advocacy group Thrombosis Ireland, are now available in 17 di erent languages.

Member of the National Quality & Patient Safety Directorate at the RCSI, where they co-hosted the inaugural conference ‘A Systems Approach to the Clinically Deteriorating Patient’ in June 2022. From Left to Right: Dr John Fitzsimons, Maria Lordan Dunphy, Dr Dervla Hogan, Sheema Lughmani, and Dr Maureen Flynn.

• Co-hosting a joint online event with the State Claims Agency. The event will present recent analysis of medication related incidents, and share work from the HSE Safermeds Programme. For more information see https://www.safermeds.ie

For more information on how the HSE Patient Safety Programme and events to celebrate World Patient Safety Day, please visit: https://www.hse.ie/eng/about/who/nqpsd/patient-safety-programme/

HOW IS THE HSE CELEBRATING WORLD PATIENT SAFETY DAY?

• Delivering a special episode of the popular QPS Talktime series focused on World Patient Safety Day. For more information on QPS Talktime, see connect/qps-talktime/https://www.hse.ie/eng/about/who/nqpsd/qps-

• Launching the ﬁrst four podcast episodes in the new All-Ireland QPS podcast series “Walk and Talk Improvement”. The series focuses on the real stories of patients and sta across the island of Ireland, as told by themselves in a candid and reﬂective way, and how they created improvements in healthcare to enhance both patient safety and the quality of services.

The National Quality and Patient Safety Directorate facilitated a number of events to celebrate and promote this year’s World Patient Safety Day, including the development of awareness campaigns, capacitybuilding initiatives and, as in previous years, lighting up landmarks in orange (the signature mark of the campaign).

Dr Orla Healy added, “In recent years, the HSE has made signiﬁcant e orts to improve medication safety in our health services. We have outstanding people working in pharmacy services, working in collaboration with multidisciplinary teams across community and hospital settings, with dedicated and capable sta providing excellent services all year round. The importance of this work was highlighted during the COVID-19 pandemic, particularly when there was a high demand on healthcare services, ensuring the continuity of supply of medicines and advice to support their safe use.”

Events included:

| 63HEALTH MATTERS AUTUMN 2022

• Producing a video on the importance of medication safety, recorded with the support and contribution of our patient partners from Patients for Patient Safety Ireland.

Dr Orla Healy, HSE, opened the conference outlining how the existing HSE systems-approach to quality and patient safety influences the work of DPIP and staff involved in managing deteriorating patients, with the aim to improve the quality and safety of care delivered.

cardiopulmonary arrests and patient outcomes.

Chris Hancock, Lead Acute Deterioration Programme (2010 – 2020) Wales, provided an insight into how over the last decade the Acute Deterioration Programme in Wales has addressed patient deterioration and sepsis management in the acute and the community sectors.

Anticipation – Dr Dorothy Breen, CUH, presented on the benefits of multidisciplinary Safety Huddles to improve patient outcomes through situational awareness. Formal training of multidisciplinary frontline teams in team skills, quality improvement training and patient safety skills helps to build a safety culture, improves communication and empowers every member of the team to identify patients at potential risk of deterioration.

Escalation & Response – Derek Cribben, Nurse Lead, National Critical Care Programme, and Eithne Hartley, cANP TUH, presented on the development and roles of the Advanced Nurse Practitioner, ANP, Critical Care Outreach response system. The ANP response system provides a supportive educational resource, which assists staff to care for and manage deteriorating patients to avoid ICU admission. In addition, ANPs help to facilitate timely ICU admissions and safe ICU discharges. Established ANP Response Systems have demonstrated reductions in in-hospital cardiopulmonary arrests and re-admissions to ICU. There will be 47 ANP/ cANPs in acute hospitals by the end of 2022.

Governance – Catherine Wall (TUH) gave an excellent presentation, again using a powerful patient story, on the role of governance in managing the deteriorating patient. She emphasised the importance of senior clinical leadership, senior management support, multidisciplinary input and the collection of data to inform quality improvement and patient outcomes.

DPIP’s goal is to eliminate preventable deaths from unanticipated inhospital cardiopulmonary arrests and reduce admissions to ICU through a systems approach to promote early recognition, intervention and reevaluation. HSE/NQAIS Data reports approximately 900 unanticipated in-hospital cardiopulmonary arrests in acute hospitals annually however, the true incidence of in-hospital cardiopulmonary arrest is unknown.

DPIP

The RCPI Situational Awareness For Everyone (SAFE) Collaborative course aims to develop quality improvement (QI) and patient safety skills through situational awareness methodology (programme information can be found at Recognitionhttps://courses.rcpi.ie–GerryDuignan, Clinical Engineer, and Natasha Reilly, CNM1, from Cavan General Hospital presented on the hospital-wide implementation of Vital Signs Automation (Digital INEWS system). Their lived experience demonstrated the benefits for staff and patients with greater accuracy in documentation, scoring and assurance in the digital track and trigger tool. In 2022, Phase 1 of the VSA-Digital INEWS project will install the system across 20 acute hospitals in 1 ward per hospital (500 acute beds in total).

HEALTH MATTERS AUTUMN 202264 |

Patricia Hughes, HIQA, presented on the revised approach to the monitoring of compliance with national standards particularly in relation to the deteriorating patient. Future inspections will focus on observing clinical care and communication with staff and patients to ensure that care is patient-centred, safe and effective with appropriate governance systems in place.

Save the Date: DPIP Conference 25th April 2023, Dublin Castle. The programme would welcome any suggestions for the next conference. Further information on the DPIP can be found at: htmlimprovement-programme-partnership-dpipp-.safety-programme/deteriorating-patient-www.hse.ie/eng/about/who/nqpsd/patient-https://oremailDPIP.1@hse.ie

Patient preventableProgrammeImprovementaimstoeliminatedeaths

The keynote speaker Dr Gregor McNeill, Consultant in Intensive Care Medicine & National Clinical Lead, Scottish Patient Safety Programme, presented a powerful story of patient deterioration coupled with an overview of the Scottish response to deteriorating patient including; the benefit of audits having led to improvements in the rate of in-hospital

Dr Nigel Salter, SVUH, spoke about the need for a National In-hospital Cardiac Arrest Audit to attain reliable data to inform patient safety outcomes and reductions in avoidable deaths. Dr Conor White, SVUH, ReSPECT Project Lead, presented the ReSPECT advanced care-planning model, which empowers patients to agree and document realistic clinical recommendations relating to clinical care in future emergencies. The ReSPECT model project is a pilot project in SVUH which aims to prevent inappropriate ICU admissions and/or resuscitation attempts by focusing on patient-centred decision-making and collaboration.

The DPIP was established in May 2017 to ensure the implementation of quality health care for the recognition and response to deteriorating patients through the development and adoption of Early Warning Systems (EWS).Over 35,000 nurses and doctors use an EWS daily on over 1.7 million in-patients per year to anticipate, recognise, escalate and respond to clinical deterioration in acutely ill patients.

A key priority of the HSE Patient Safety Strategy 2019-2024 is to focus on reducing the common causes of harm to patients including failures in early recognition and response to clinically deteriorating patients. The Strategy aims to provide a standardised, consistent approach to patient safety including incorporating safety improvement methodologies to achieve measurable reduction in patient harm.

he National Deteriorating Patient Improvement Programme (DPIP), in partnership with the National Quality & Patient Safety Directorate, held its inaugural conference entitled ‘A Systems Approach to the Clinically Deteriorating Patient’ at the RCSI in Dublin recently. This hybrid event was attended in-person by 180 people and over 280 people participated via live stream.

The conference speakers focused on the four key areas of the System’s Approach to managing clinical deterioration:

Speaking about the new framework, Rachel Kenna, Chief Nursing O cer, Department of Health said, “I am delighted to support the launch of this new Competency Framework for Infection Prevention and Control Practitioners in Ireland. This is the ﬁrst such framework on IPC for Ireland and it is an important step forward in advancing IPC practice. It will also assist with maintaining and improving expertise in IPC among health sta and promoting a high-quality and consistent approach to IPC practices. This framework is signiﬁcant for the delivery of Ireland’s second One Health National Action Plan on antimicrobial resistance 2021-2025, iNAP2, by helping to prevent and control the spread of infection and demonstrates Ireland’s commitment to best practice in this area.”

• assist in curriculum design of post graduate training courses for IPC in Ireland

The framework was launched at an implementation seminar where IPC leads from around the country came together to look at ways of implementing the framework in their services.

Dr Eimear Brannigan, HSE Clinical lead for AMRIC, said, “E ective infection prevention and control (IPC) is central to providing clean, safe and high quality health and social care for people who use those services. It also protects those who deliver the services and the wider community. All healthcare services must have basic IPC capacity within their core sta complement, and must also have access to higher-level expertise to support decision-making when necessary.

“This new document has been developed by the AMRIC nursing team, led by Josephine Galway, Director of IPC Nursing, to support health care professionals pursuing specialist careers in IPC. It helps identify the speciﬁc knowledge and skills they will require as IPC practitioners. I would like to congratulate the AMRIC nursing team for their leadership in developing and making available this valuable resource for healthcare professionals and service providers.”

• support organisationshealthcareingrowing and developing skilled and educated IPC workforce

he HSE Antimicrobial Resistance and Infection Control team (AMRIC) launched the Competency Framework for Infection Prevention and Control Practitioners in Ireland in May 2022. This important new framework was developed to support health care professionals taking up specialist careers in infection prevention and control (IPC). The new framework helps sta in identifying and gaining the speciﬁc competencies they will require as an IPC practitioner.

The framework aims to support managers, in growing and developing a skilled infection prevention and control workforce by:

Infection Control

For further information on AMRIC and IPC guidance please check www.hse.ie/hcai

• support self-assessment of competence by the IPC practitioner

This document will continue to support the growth and development of a skilled infection prevention and control workforce in Ireland.

• providing standardised core competencies required for IPC practitioners in Ireland

AMRIC launches Competency Framework for Infection Prevention and Control Practitioners in Ireland

| 65HEALTH MATTERS AUTUMN 2022

Josephine Galway highlighted that “Importantly, the framework builds on the learning and experience from the COVID-19 pandemic response, a time when IPC was so important for safe environments for patients receiving care and the sta that delivered such care. We hope that this framework document will give sta clear guidance on the skills and knowledge required to be an IPC nurse. I hope it will encourage healthcare workers to look at this vitally important service as a career choice. I would like to thank Eimear O’Donovan and Barbara Slevin, AMRIC team ADONs for all of their work on the framework and the very successful seminar.”

• assist and complement sta appraisal and professional development plan processes

It includes an assessment and extend my learning pieces for those who wish to undertake further learning or who want practical activities to help transfer the learning into their local area of work.

In addition, an independent evaluation of the implementation programme will be commissioned to assess its reach and impact.

A key focus of the project at present is the development of a HSeLanD module for all staff who provide care to people with dementia. This module will provide information and guidance on non-cognitive symptoms of dementia and methods to support people with dementia experiencing these symptoms, including appropriate prescribing of psychotropic medication. It’s envisaged that this programme will be available on HSeLanD later this year.

The Implementation Programme aims to:

The main driver for the development of the guideline was the Irish National Dementia Strategy (Department of Health, 2014) which stated that psychotropic drugs, in particular antipsychotics, should only be used when all other nonpharmacological interventions have first been tried and exhausted as per the NICE Guidelines. While the use of some psychotropic medications can be effective at controlling non-cognitive symptoms of dementia, they are not without risk and if prescribed should be reviewed at regular intervals and discontinued when clinically indicated.

Comprehensive implementation plan for new clinical guidelines

2. Develop a multi-component education package to support practice change and roll this out to relevant staff.

3. Develop, pilot and disseminate an audit tool and audit manual to assess compliance to the guideline.

Implementation of National Clinical Guideline No 21: Appropriate Prescribing of Psychotropic Medication for Non-cognitive Symptoms in People with Dementia

To keep up to date with progress of the wellfullimplementation-of-dementiapathways.programme,implementationseehttps://ie/resources-for-practice/national-clinical-guideline-no-21YoucanreadtheNationalClinicalGuidelinehereasastheguidancedocumentonnon-pharmacologicalinterventions.

Available on HSeLanD the Termination of Pregnancy e-learning programme contains 2 parts and takes approximately 90 minutes to complete.

he National Clinical Guideline on ‘Appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia’ was published by the Department of Health in December 2019 to guide the appropriate use of psychotropic medication for non-cognitive symptoms being experienced by people living with dementia.

All psychotropic medications have potential adverse effects, including stroke and death (1% of users likely to have a stroke or die). It is important that all healthcare professionals are aware of these risks and have knowledge about the national guideline on appropriate prescribing.

PROGRESS TO DATE

HEALTH MATTERS AUTUMN 202266 |

the National Women and Infants Health Programme and developed and designed by the Office of the Nursing and Midwifery Services Director (ONMSD).

The principle of the Act and the service NWIHP provides is to enable women to access care in a timely manner and to ensure that healthcare staff have the skills and knowledge to care for women during this time.

E-LEARNING PROGRAMME FOR ALL STAFF PROVIDING CARE TO WOMEN OPTING FOR A TERMINATION OF PREGNANCY

1. Raise awareness of the risks of psychotropic medications for people with dementia, and to raise awareness of the guideline as a key resource to guide clinical decision making.

The programme was requested by the Directors of the Centres for Nursing and Midwifery Education (CNME), funded by

A new e-learning programme is now available to provide midwives, nurses, doctors and other healthcare professionals with the knowledge and skills to provide high quality, safe, empathetic care to women opting for a termination of pregnancy within the confines of the Health (Regulation of Termination of Pregnancy) Act 2018. The programme was developed in association with the national implementation of the TOP Model of Care under the auspices of National Women and Infants Health Programme (NWIHP). An expert panel of clinicians and educationalists developed the content and design of the programme.

The NWIHP, under the governance of the HSE Chief Clinical Officer, provides strategic direction and leadership for termination of pregnancy services.

The online programme compliments the face-to- face ONMSD National Termination of Pregnancy Programme developed in 2020 which has been delivered by the Centre for Midwifery Education Dublin and which is available to all CNMEs nationally.

Project Trainers are being recruited to roll out the education programme across a range of settings. In addition to the HSeLanD module and train the trainer education programme, information resources are in development for service users and healthcare staff.

A train the trainer education programme is currently being developed and, with the guidance of local implementation teams, will be rolled out across acute, mental health, residential and community settings in 2023.

A national multi-disciplinary Steering Committee has been convened. Committee members have already played a key role in shaping the implementation approach and there has been great support and engagement to date. An Education Working Group has also been established to contribute to the planning and development of the education and training programme. There has been very positive engagement from this group and a suite of education and training resources is currently in development.

NEXT STEPS

In response, the National Dementia Office, HSE is now rolling out the clinical guideline through a comprehensive implementation plan. The national implementation of the guideline will improve health outcomes for people with dementia, reduce variation in practice and improve the quality of clinical decisions made by healthcare professionals.

| 67HEALTH MATTERS AUTUMN 2022

• Support quality assurance processes

Prefer red drugs

In 2021, total expenditure on the Community Drug Schemes on medicines within these therapeutic drug categories totalled approximately €300m with preferred drugs accounting for 42% of this expenditure.

The four goals are to:

While significant progress has been made to date in the prescribing of preferred drugs, the 10-year anniversary of the MMP provides the optimal opportunity to reiterate the advantages of the initiative and highlight the resources available to support prescribers.

• Deliver person-centred care

As part of the ongoing work in this area, the MMP has recently reviewed and updated the Preferred Drugs initiative and in some instances changes have been made to the drug of choice. Professor Barry continued by highlighting the significance of these small changes. “For example, if we as prescribers were to change all of our patients from esomeprazole to pantoprazole, we would have the ability to save € 6.7m per annum. All in all, up to €13m per annum could be saved by switching patients to the preferred drug of choice from the ten therapeutic areas covered by this initiative.”

The MMP has developed a number of initiatives aimed at enhancing evidence-based and cost-effective prescribing, one of which includes the Preferred Drugs initiative. This initiative which was the first to be implemented by the MMP, identifies a single preferred drug in ten therapeutic drug categories and offers prescribers useful guidance on selecting, prescribing and monitoring that drug for a particular condition. Prescribers are encouraged to make the preferred drug their drug of choice when prescribing from the relevant therapeutic drug class.

10 years of the HSE-Medicines Management Programme’s Preferred Drug initiative

• Grow our staff and strengthen our quality organisation

The strategy outlines how, through quality improvement, staff will be supported in their dual roles of performing the job they were trained to do as well as improving the system within a culture that supports research and innovation that focuses on adding Commentingvalue.on the launch of the strategy, Professor Catherine Wall, Director of QSRM and Consultant Nephrologist, said, “The hospital is committed to the delivery of effective, safe, person-centred care by highly trained and motivated staff as enshrined in our CARE values of Collaboration, Achievement, Respect and Equity. It is recognised that Quality is a shared accountability through the Hospital with everyone having a role to play. This QSRM strategy outlines how we will grow our people and strengthen our quality in order to deliver the best care to our patients.”

TUH PUBLISH QUALITY, SAFETY & RISK MANAGEMENT STRATEGY

Tallaght University Hospital have published their first hospital wide Quality, Safety & Risk Management (QSRM) Strategy setting out a plan to drive improvements in quality and safety over the course of the next three years.

he HSE Medicines Management Programme (MMP), established in January 2013 and successfully led to date by Clinical Lead Professor Michael Barry, is fast approaching its 10-year anniversary. The MMP works closely and collaboratively with the National Medicines Information Centre (NMIC), the National Centre for Pharmacoeconomics (NCPE) and the HSE-Primary Care Reimbursement Service (PCRS) to provide sustained national leadership in relation to the overall expenditure on medicines with a particular focus on their safe, effective and costeffective use.

According to Professor Michael Barry, “Small changes in prescribing behaviour can lead to significant cost-savings for both the HSE and also for patients who pay for their medicines. Given the high volume of prescribing, efficiencies achieved in the use of the preferred drugs can assist the HSE to fund new, innovative technologies as they become available.”

The hospital has actively driven innovation and research in quality and patient safety. The strategy published builds on the strong foundations of quality improvement such as Lean Six Sigma and is linked to important aspects of the Hospital’s strategy plan 2019-2024. It focuses on specific quality goals that are central to achieve excellence in healthcare.

Find us on:Email:www.hse.ie/yourmedicinesmmp@hse.ie@MedMgmtProg ACE Inhibitor Ramipril Angiotensin Receptor Blocker Candesartan Beta Blocker Bisoprolol Calcium Channel Blocker Amlodipine Oral DirectAnticoagulantOralAnticoagulant ApixabanWarfarin Proton Pump Inhibitor Pantoprazole Serotonin Noradrenaline Reuptake Inhibitor Venlafaxine Selective Serotonin Reuptake Inhibitor Sertraline Statin Atorvastatin Urology Tolterodine PR Medicines Management Programme Preferred Drugs Version 1.0 July 2022 For each preferred drug, a availableevidenceevaluationdetailedreportoftheavailablealongwithprescribingtipsareontheMMPwebsite(www.hse.ie/yourmedicines).FurtherinformationonthePreferredDrugsinitiativecanalsobesoughtfromtheMMPteam(mmp@hse.ie).

TUHExecutiveNugent,withNephrologistConsultantofWall,CatherineProfessorDirectorQSRM&Ms.LucyChiefof

• Strive for excellence in Quality, Safety & Risk

Report a known or suspected data breach to your line manager and local deputy data protection o cer (DDPO). You’ll ﬁnd contact details for your local DDPO sta on hse.ie

• Become aware of your responsibilities as a HSE sta member under GDPR

HEALTH MATTERS AUTUMN 202268 |

If you have already completed the programme, you can revisit it to refresh your skills and help improve the way you process data and keep it secure. Following completion of the Fundamentals of GDPR eLearning programme you will:

• emails sent to the wrong person when the incorrect email address recipient was selected and the email was sent in error.

Email related data breaches are among the most common reported breaches in the HSE and are mainly due to human error. Although these are often simple mistakes and can be easily avoided, they pose a great risk to both the privacy and protection of personal data.

To assess and refresh your knowledge of the correct use of HSE email, please complete both the Good Information Practices and The Fundamentals of GDPR training on HSeLanD. The updated sta webpage contains:

Data Protection

GDPR TRAINING MEMO FOR STAFF HSE STAFF ARE ENCOURAGED TO COMPLETE THE FUNDAMENTALS OF GDPR ON HSELAND

A personal data breach is the accidental or unlawful destruction, loss, alteration, unauthorised disclosure or access to personal data.

The DDPO will conﬁrm if the incident is a data breach. Data breaches are logged and the DDPO will advise on the necessary remedial actions toIndividualstake. impacted by the breach may need to be notiﬁed, if it is likely to result in a high risk to their rights and freedoms.

• Know how to direct a service user to get a copy of their personal data when requested

• Learn how to recognise and respond to an incident when personal data is not processed correctly

To date, over 110,000 HSeLanD users have accessed and completed the Fundamentals of GDPR eLearning programme on HSeLanD. To access and complete the programme, search for ‘GDPR’ on the HSeLanD dashboard or access it through the HR catalogue.

EMAIL ERRORS – TIPS TO REDUCE YOUR DATA BREACH RISK

• data quality and accuracy issues, where service user contact information is not maintained

The majority of personal data breaches in 2021 were due to reoccurring issues as follows:

• The HSE Electronic Communications Policy More Information On Reducing Your Data Breach in the HSE, Data Protection is Everyone's Responsibility”

REPORTING A DATA BREACH

WHAT IS A PERSONAL DATA BREACH?

The term ‘personal data’ means any information relating to an identiﬁed or identiﬁable living individual.

“RememberRisk

s a HSE sta member if you are required to report a breach, you should report it immediately. The HSE must report breaches to the Data Protection Commission within 72 hours of a notiﬁable personal data breach. This is done through the DDPO o ces, following consultation with the local service where the breach occurred.

The Fundamentals of GDPR eLearning programme will take approximately 35 minutes to complete and includes a short assessment. It also includes ‘extend my learning’ pieces for those who wish to undertake further learning or who want practical activities to help transfer the learning into their local area of work.

• Tips on how to avoid email errors

Your line manager will help you identify if the incident is a potential data protection breach. You should work together to complete the Data Breach Incident Report form which is on hse.ie and you’ll

What to do if you are dealing with a data breach

need to send the form to your local deputy data protection o cer (DDPO).Foraninformation systems security breach, call the National Service Desk on 0818 300 300.

• issues with paper ﬁles, where appointment letters were wrongly issued to incorrect address

COMMON EXAMPLES OF PERSONAL DATA BREACHES ACROSS HSE IN 2021

• Information on the di erent types of email errors

CONTINUING TO IMPROVE OUR RECRUITMENT AND RESOURCING CAPABILITY

OUR JOURNEY TO DATE

Over the next number of weeks, we will be formally establishing the Recruitment Reform & Resourcing programmes governance structure, and engaging again with our colleagues in Acute, Community and National Services to commence this vital programme of work. Using the framework of our Strategic Pillars, we will work together to deﬁne and agree a resourcing strategy for the HSE, across each profession, for the short, medium and long term. This will involve taking meaningful actions to address our services challenges in attraction, development, engagement and retention of our dedicated sta , for the beneﬁt of our colleagues and our service users.

and resourcing in the public services and previously in the private sector.

This crucial new programme of work is led by Eithne Fox who was previously Head of HR Shared Services for the HSE and has extensive experience in both recruitment

he spring edition of Health Matters highlighted the engagement across Acute, Community and National services to develop and implement a new Recruitment Operating Model to provide additional capacity and capability to recruitment across the HSE.

The transition to this new model is underway, and we are looking forward to realising the beneﬁts of these new ways of working as the model is implemented.

| 69HEALTH MATTERS AUTUMN 2022

This programme represents a new, holistic approach to resourcing and is an important step in developing our ability to meet current and future service demand. It is an exciting opportunity for us all to develop and futureproof the resourcing of our health service, while also taking action to develop how we develop, engage and retain our dedicated workforce who deliver vital health and social care services across the country.

We recognise that while developing our approach to recruitment is essential, we must now take strategic action in partnership with our services, to address the broader challenges of the development and retention of our dedicated health and social care workforce.

WHY ARE WE DOING THIS?

In March of this year, a small programme team commenced research into international healthcare and public sector resourcing programmes, identifying best practices and insights for our programmes structure. We began to work closely with colleagues within National HR, Acute, Community and National services to agree the principles and framework that would guide the Recruitment Reform & Resourcing programmes actions and outputs.

A series of workshops took place with numerous colleagues from across the Health Service to share our programmes vision, and to deﬁne and agree the Strategic Pillars that will guide the roadmap for delivery of the Programmes objectives. Our colleagues provided rich insights to the current resourcing challenges facing their services, and their contribution to those sessions was invaluable in guiding the establishment of this new programme. The Strategic Pillars demonstrate the breadth of the programme and will be used to guide the programmes actions and the delivery of its objectives.

OUR NEXT STEPS

National HR introduces a new Recruitment Reform and Resourcing Programme

As we look toward the future, to the transition to Sláintecare, growing demands on our services and in a very competitive global talent marketplace we recognise that we must also take a new, holistic approach to the resourcing challenges facing our services. A new strategic programme of work, the Recruitment Reform & Resourcing Programme has been established to consider not only how we recruit, but how we attract, develop, engage and retain the dedicated workforce that deliver vital health and social care services, both now and into the future.

These pillars have also been approved by the Strategic Workforce Planning & Resourcing Governance Group and have also been shared with the People and Culture Sub Committee of the HSE Board.

As we continue this journey, we look forward to working closely with you and in sharing the progress of this new programme.

ABOUT NEIS

Construction is deemed as a sector that has great opportunity to enhance service delivery through digital transformation. The HSE is one of the main public bodies currently progressing this digital journey through the National Estates Information System (NEIS). NEIS is very much aligned to public sector strategy and the digital roadmap for the construction sector.

Aconex (Project CDE, Contract and Cost Management)

Phase 2: Tririga “Real Estate” i.e. Property Management, October 2022

request to report anything from a faulty air handling unit to a service requirement on a heating system, NEIS will be the single point of connection to do business. HSE Capital & Estates will have better information, enhanced integration of project teams, better collaboration, communication and co-ordination. From an external perspective, the system will be accessible for third party service providers to work live in partnership with the HSE in the delivery of construction projects and managing the Estate.

IHEEM is an International Professional Engineering Institute, specialising in the Healthcare Estates Sector. NEIS’s Anna Boch, Business Change Manager, presented at the CIF Digital Construction Summit in Croke Park during June. Anna shared a case study on how the HSE is currently rolling out the NEIS project, as well as insights into how the HSE is implementing a change culture to successfully build and manage Ireland’s biggest public sector asset.

PHASE 1B: Tririga “Operations” i.e. Maintenance incl. Medical Equipment, April 2022

PHASE 3: Tririga “Facilities” incl. Space Management, April 2023 October 2023

BETTER WITH NEIS

SHARING THE JOURNEY News has spread of this innovative project and members of the NEIS team have been sharing insights at a number of conferences. Bernard Pierce, NEIS project lead, was a guest speaker at the two-day IHEEM conference in Croke Park during May. Bernard presented on the theme of Developing A Sustainable Workforce identifying “Our sta are our greatest asset.”

WITHBETTERNEIS

The Digital Journey of National Estates Information System

THE NEIS PROJECT IS BEING DELIVERED IN PHASES, ROLLED OUT OVER A THREE-YEAR PERIOD -

NEIS is under way, and the world is taking notice.

PHASE 2: Tririga “Environmental” i.e. Environment & Sustainability, April 2023

he HSE is the largest property owner in the State and has an extensive portfolio which includes in excess of 4,000 buildings across the country. The property portfolio spans across acute hospitals, primary care, community nursing homes, o ce accommodation, and laboratories including COVID-19 testing centres and vaccination clinics.

Tririga “Projects” i.e. Capital Programme Management

HSE Capital and Estates ensure throughout the full life cycle of all facilities, from purchase, design, build, operation, maintenance and disposal, that all facilities are professionally managed to ensure the smooth functioning of the entire health system.

Despite the challenges presented by the COVID-19 pandemic and the cyber-attack on HSE systems, NEIS is moving at pace and remains very much on target. This is largely attributed to the NEIS team who are committed to supporting all end users on the new system and will provide all training before, during and after implementation. As regards progressing the programme of work, NEIS is now in Phase 2 of its forecasted timeline for real estate and property management which is scheduled to be accessible during October 2022.

HEALTH MATTERS AUTUMN 202270 |

NEIS is one of the largest digital change projects on-boarded by the HSE. Within the organisation, NEIS will deliver better data, better decisions and better outcomes. The system will be recognised as a system for everyone. It will see HSE service users across the organisation log on to the new system to submit their maintenance requests online. This means that instead of making a phone call or submitting a manual

With the on-going change towards a more digital world, NEIS was introduced to design and launch a modern consolidated system in line with international best practice. The purpose of this approach was to replace the multiple manual, legacy and fragmented systems in place across the organisation. 18 months into its implementation programme, the National Estates Information System is changing the way HSE Capital and Estates - and the HSE at large - operates.

NEIS is delivering an Integrated Workplace Management System (IWMS) and Common Data Environment (CDE), which will support all HSE Capital & Estates and Maintenance functions across the HSE. It will communicate and share data, providing one central source of information, “a single version of the truth”. The integration incorporates functional models across real estate, capital projects, facilities, workplace operations, portfolio data, and environmental and energy management within a single technology platform. There will be integrations with the new Integrated Financial Management System (IFMS) which means that ﬁnance and real estate management will be able to view the information required to make decisions based on real time data.

PHASE 1A: Capital Projects and Construction Management, October 2021

| 71HEALTH MATTERS AUTUMN 2022 SCREENING Phase 1A: Capital Projects and Construction Management, October 2021 Aconex Project Common Data Environment (CDE), Contract and Cost Management Tririga “Projects” i e Capital Programme Management Phase 1B: Tririga “Operations” i.e. Maintenance incl Medical Equipment, April 2022 Phase 2: Tririga "Real Estate" i.e. Property Management, October 2022 Phase 3: Tririga "Environmental" i e Environment & Substitutability,April 2023 Phase 4: Tririga “Facilities” incl Space Management, October 2023 WE ARE HERE!

“The ambulance service staff are now able to do it on their mobile device while they're returning from calls. They're able to do it while they're sitting outside ED (Emergency Departments) waiting to hand over patients and they’re most happy that they're getting it paid within their fortnightly pay. And they know it’s been approved within a matter of hours.”

WHAT WOULD YOU SAY ARE THE BENEFITS OF MY HSE SELF SERVICE?

3. When you receive your login details go to https:// myhseselfservice.ie and enter the login details provided.

Let’s hear from the users

Tammy Horan, Homecare Support Assistant in HSE South East, had the following to say.

“No, I’d never go back to the paper way again, absolutely not. This way is easier and faster, your record is all there online for you to see and you can access it whenever you like. If you're doing it the paper way it's time consuming, and if you don't photocopy it you don't have a record of what you have sent in so at least this way the record is all there in front of you.”

Clive O’Regan, Paramedic Supervisor in the South East, had the following to say when asked about his experience of using My HSE Self Service

“Self Service has worked out fine for us and I'm happy to use it. I know we had people nervous about using it because they didn't like using mobile devices and weren't familiar with IT setups. But once we started using it here, none of the staff at this stage would go back to using the old method of writing it on paper and submitting it in for approval.”

WOULD YOU EVER GO BACK TO THE PAPER CLAIMS FOR TRAVEL?

HEALTH MATTERS AUTUMN 202272 |

4. Need Help? Contact NiSRP Helpdesk: support.nisrp@hse.ie or 0818 300 296

WHAT DO YOU LIKE ABOUT MY HSE SELF SERVICE?

“I like the fact that it’s easier to access, it's quicker, all your information is there for you to see online. Once you get the hang of it its fine, I’m definitely happy with it.”

THE BENEFITS OF MY HSE SELF SERVICE

“No, I'm quite happy to use it on the phone, PC or tablet as are all the staff here and we've educated a good few of them in how to use it. Most people are happy now not to use paper, to save paper and the environment, the ease of access, they can do it online and they have it approved straight away, and even looking for the paper form sometimes was a nightmare at some ambulance stations. I genuinely know with a lot of the staff who wouldn't have been familiar with or happy using a PC that they're just delighted now to be able to take out their phone and or the work PC and put it in. Even the older generation who wouldn’t be comfortable with it are now using self-service.”

WOULD YOU EVER GO BACK TO PAPER CLAIMS FOR TRAVEL?

2. You will receive a reply which includes a form for you to enter your set up details. Complete all fields on the form (if a field is not applicable to you then use “N/A” in that field) return the completed form to support.nisrp@hse.ie

Programme Director Ivan McConkey said, “The team have already had positive engagement with staff and management in HSE South. I am confident that with further close collaboration with our colleagues in HSE South NiSRP will be successfully implemented in spring 2023.”

1. Send a blank email to support.nisrp@hse.ie with “user set up request form” in the subject line.

“Submitting the travel is great because there's less paperwork, it is not as time consuming, It's faster and you can go back and edit if you make a mistake or contact your line manager to check it at their end so in that way I find it great. You get paid your mileage a lot quicker which wasn’t the case before. Once you get the hang of it its fine, I’m definitely happy with it.”

UPDATE ON IMPLEMENTATION IN HSE SOUTH FROM THE PROGRAMME DIRECTOR

WHAT DO YOU LIKE ABOUT MY SELF SERVICE?

WHAT WOULD YOU SAY ARE THE BENEFITS OF MY HSE SELF SERVICE?

The NiSRP team are working closely with colleagues in HSE South and have conducted engagement sessions with management and staff. Local NiSRP Project Leads are in place and play a crucial role in both collecting local information and processes along with communicating any change impact on staff. A key stage in this implementation is to carry out parallel testing which includes two phases of testing the current live system against this new integrated system. This testing took place recently over the summer months.

NiSRP is now available in HSE East, South East, Mid West, North West and Midlands. NiSRP spoke recently to some My HSE Self Service users to give them an opportunity to share their experience of using the system

Sustainability in Limerick

BENEFITS FOR UL HOSPITALS GROUP AND THE ENVIRONMENT

The retrofitting effort has resulted in energy savings of 3.6-million kWh across the sites of UL Hospitals Group. For perspective, a single watthour is the amount of energy expended by a one-watt load, such as a light bulb, drawing power for one hour.

While it is too early to provide data for the efficiencies and cost savings that will accrue through the retrofitting and energy efficient design of new builds, the works undertaken by the Group to date have played a role in helping to stabilise the national grid during periods of high demand.

The HSE Capital & Estates and UL Hospitals Group via the HSE Sustainability Committee is now turning its attention to development of a ‘behavioural change’ campaign on all sites. The aim is to maximise the impact of the infrastructural developments and upgrades by getting staff workforces to become more engaged with day-to-day energy savings through turning off lights and heating that is unneeded, closing windows while heating is on.

Pictured at the bank of PV cells on the roof of the 60Bed Block at UHL are (front): Kevin Mahoney, Electrical Maintenance Manager, UL Hospitals Group; with (middle, from left): Rachel Keating, Energy Officer, HSE Capital & Estates; and Clodagh Hanratty, Estates Manager, HSE Capital & Estates; and (rear) Niall Joyce, Group Building and Maintenance Manager, UL Hospitals Group.

To bring UL Hospitals Group into line with national efforts to make the country more sustainable has required an equal focus on future-proofing of new developments, and on bringing older systems and buildings into line with contemporary standards.

These initiatives have created savings of approximately €184,000, helping to offset the emission of 991 tonnes of CO2, which is equivalent to the CO2 absorbed by 45,000 trees, or the emissions from driving 2.5-million kilometres in an average car.

UL HOSPITALS Group's efforts in recent years to future-proof new developments and upgrade its existing building stock is repositioning the organisation to the fore of a national HSE campaign aimed at providing quality healthcare that minimises impact on the environment.

The renewable energy sources included in some of the recent constructions at UHL include PV Panels in the 60-bed block; in the diagnostics laboratory; and in the staff Health and WellbeingAir-sourceBuilding.heatpumps, which transfer heat absorbed from the outside air to provide heat for radiators and hot water, have been used in the diagnostics lab, the 24-bed and 14-bed blocks and in the Health & Wellbeing building.

The retrofitting efforts have proceeded alongside the development of new projects, particularly in UHL, which are all compliant with NZEB (Near Zero Energy Buildings) standards and have high degrees of insulation and efficient building services.

RETROFITTING OF EXISTING BUILDINGS

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Rachel Keating, Energy Officer, HSE Capital and Estates, said, “Energy usage across HSE facilities is being reduced by implementing energy improvement works, promoting Energy Efficient Design and establishing energy and sustainability teams. ULHG and HSE Capital & Estates are continuing to identify new energy upgrade projects and encourage cognisance of energy awareness for all staff in their day to day work.”

NEW CONSTRUCTION PROJECTS

CROOM ORTHOPAEDIC HOSPITAL

Clodagh Hanratty, Estates Manager, HSE Capital & Estates) said the partnership between HSE Capital & Estates Climate Action and Sustainability Office and the Sustainable Energy Authority of Ireland was crucial to the successful completion of energy improvement works across the sites.

FUTURE FOCUS

Work undertaken to date through collaborative initiatives between HSE Capital & Estates and UL Hospitals Group is already having a significant impact, resulting in six-figure cost savings, reducing CO2 emissions, and also enabling the Group to power itself independently on occasions when demand has the potential to destabilise the national grid.

The most recent retrofitting initiatives across Group have included the insulation of pipework in plant rooms and roofs, and replacing older pumps with modern, energy-efficient pumps. LED lighting upgrades have been undertaken, and advanced efficient control systems installed for boilers. These initiatives have complemented previous works, including PV Panels (solar panels) and rainwater harvesting in Ennis Hospital, in addition to a combined heat and power (CHP) system in UHL, which generates energy on-site. The latter has since been upgraded.

UL Hospitals Group ushers in a new era of energy sustainability

“In recent years, UL Hospitals Group has benefited from decreased carbon emissions and highly energy efficient new extensions initiating the pathway to achieving our Climate Action Plan target of reducing emissions by 51% by 2030,” she said.

The HSE Capital & Estates Climate Action & Sustainability Office has identified the HSE’s 14 largest energy users in the Mid-West region, of which University Hospital Limerick is the largest, and over the past number of years has been working to make the sites more sustainable. Nationally, the HSE has committed to become a leading sustainable organisation, delivering healthcare in a way that preserves natural resources, reduces carbon emissions, and mitigates the effects of climate change, while also safeguarding high quality care and treatment for patients.

Croom Orthopaedic Hospital has benefited significantly in recent times from the development of a brand new 24-bed inpatient block and a state-of-the-art operating theatre suite and sterile services department.

There has also been a focus on tackling the hospital’s status as the HSE’s largest user of oil in the Mid-West during 2021.

Consequently, Croom Orthopaedic Hospital has become the first acute HSE facility in the country to be upgraded from oil or gas burners to air source heat pumps. The project was completed in January 2022, and it is anticipated that significant energy, costs and CO2 savings will result.

New eLearning Modules

attend an appointment and lifestyle factors are not addressed, people can interpret that to mean that their lifestyle (smoking, high stress, low physical activity levels) is not a cause for “Risingconcern.levelsof chronic disease may also create signiﬁcant di culties for health services, as it will be increasing di cult to provide a high quality service to increasing numbers of patients. All health services managers have to consider what they can do to encourage healthier lifestyles among sta and patients. The Making Every Contact Count programme is a positive ﬁrst step towards integrating conversations about health and wellbeing into routine care”.

What is the MECC training programme? The MECC eLearning programme includes 8 eLearning modules, all 30 minutes in length and an optional follow-on workshop that provides an opportunity to practice brief intervention skills. It can be provided

Helen Deely, Assistant National Director, said, “Chronic disease is set to increase exponentially in the next two decades, based on the current rates of smoking, alcohol and drug intake and overweight and obesity. Some people will die 10 years earlier than their peers, as a result of a chronic disease such as cancer, heart disease and stroke. The majority of these diseases can be prevented by quitting smoking, reducing alcohol/drug intake, getting enough physical activity, eating a healthy diet and managing weight and stress. Research has found that when health professionals talk to people about these lifestyle factors, they are more likely to be serious about making changes to their lifestyle. Equally, if patients

Talking about the launch of the two new modules, Dr Philip Crowley said, “The aim of Making Every Contact Count (MECC) is to develop a culture within the health service where we use every opportunity we have to talk to patients about quitting smoking, reducing alcohol intake, improving their diet, increasing physical

HEALTH MATTERS AUTUMN 202274 |

Two new eLearning modules published on HSeLanD as part of Making Every Contact Count

activity, managing their weight and minding their mental health and wellbeing. Like many doctors/health professionals, I know it can be challenging to have these conversations but I also know that it can make a big di erence to a patient’s health and life when they make improvements.”

wo new eLearning modules have been published on HSeLanD as part of Making Every Contact Count. The two new 30 minute modules; Promoting Mental Health and Wellbeing and Talking about Overweight and Obesity, are designed to support health professionals to talk to patients about these complex topics is a supportive and non-judgemental way, as part of routine care. Existing modules address behaviour change, physical activity, healthy eating, smoking, alcohol and drug use and brief intervention skills. All modules are available on HSeLanD.

While individuals can do the MECC eLearning programme and workshop, it is more e ective if it is implemented by the manager of a team, service, ward, department or discipline, so that most sta within the service start to implement brief interventions as part of routine care at the same time. Managers within CHO services and hospitals can get support in implementing MECC in their service from the Health and Wellbeing team within their CHO. You can email contactcount@hse.iemakingevery.togetthename and contact details of someone in your area that can provide implementation support.

Conversations about overweight and obesity are challenging due to the weight bias (negative attitudes and beliefs about others due to their weight or body size) and weight stigma (when people are treated unfairly because of their weight or body size). This new module aims to explain the complex factors at play which can result in a person developing overweight and obesity. It also provides guidance on how a healthcare professional can discuss these during supportive, non-judgemental brief

interventions with their patients as part of routine care.

A patient resource ‘Talking about weight: a guide to healthy behaviours’ is available free of charge from www.healthpromotion. ie to support patients who are interested in making changes for health and wellbeing.

functioning well in our day to day lives. This does not mean that we won't face challenges or have periods when our mental health is low, but it does mean that we believe we have the resources to cope with and recover from them. Minding our mental health and wellbeing is about actively checking in with ourselves and taking care of ourselves, not just during stressful times, but as part of daily life.

This module also shows that for most healthcare professionals their role in having a brief intervention with a patient is not about providing weight loss advice. It is to engage in a supportive, non-stigmatising conversation on health and wellbeing that doesn’t make assumptions about weight.

Mental wellbeing underpins our capability to make and sustain health behaviour change, for example, through our level of motivation, self-e cacy, resilience, and exposure to stress. Conversely, we also know that positive mental health contributes to healthier behaviours, such as reduced alcohol, tobacco, and substance use.

Good mental health and wellbeing is about generally feeling good and

HEALTH MATTERS AUTUMN 2022

How is MECC implemented in health services?

face-to-face in 3.5 hours or virtually in 2.5 hours. The eLearning modules and workshop enrolments are available on HSeLanD. If you have already completed the 6 eLearning modules, you can continue your MECC journey by completing the two new modules and receive your new certiﬁcate of learning.

Promoting Mental Health and Wellbeing

Talking about Overweight and Obesity

Emphasising the collaborative approach, which involves the HSE, Local Authority and local community services, Minister for Public Health, Wellbeing and National Drugs Strategy, Frank Feighan, who o cially launched the ﬁrst Sláintecare Healthy Community in Bray, said:

HEALTHY Communities

láintecare CommunitiesHealthycontinues to be rolled out across the 19 communities with the ﬁrst local launch taking place in Bray, Co Wicklow in May. This national initiative focuses on bringing about real, measurable change, based on an understanding of the determinants of health and evidence-based health and wellbeing programmes.

ernan, Head of Service for HSE Health and Wellbeing for Community Healthcare East speaking at the launch stated:

Healthy Communities aims to help improve and promote healthier lifestyle behaviours

The launch was well attended by a cross section of the community and it featured a number of the delivery services showcasing their services on the day. Sláintecare Healthy Communities aims to provide support to people in the identiﬁed communities to make real and tangible changes in their lives to improve theirAislinghealth.He

“Health inequality impacts on life expectancy, the risk of chronic disease and the general health of a person. HSE Community Healthcare East welcomes the signiﬁcant investment in Bray under the Sláintecare Healthy Communities programme to allow us to work in partnership with Wicklow County Council and local community groups to further enhance supports for tobacco cessation, healthy eating, parenting and social prescribing in the area.

“These locally commissioned community partners who have an existing reach and engagement into the Bray community will be a key asset to the programme as they are already imbedded into your community. Taking an evidence-based approach, this work will build on existing health and wellbeing programmes in the Bray community and mobilise available resources to address local needs.”

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Micheal Nicholson, Wicklow County Council, Jennifer Darcy, Social Inclusion Coordinator, Bray Area Partnership, Aisling He ernan, Head of Service for HSE, Health and Wellbeing for Community Healthcare East, Frank Feighan, Minister for Public Health, Wellbeing and National Drugs Strategy, District Cllr Aoife Flynn Kennedy, Cathaoirleach of Bray Municipal and Brian Gleeson, Wicklow County Council Chief Executive.

Healthy Eating Active Living programme ran a learning and sharing webinar ‘Shaping a Healthier Food Environment in healthcare settings’ in May. The webinar attended by over 120 sta involved in food provision across the health services. Speakers on the day gave a strategic overview and our vision for a healthier food environment, real world examples of the Happy Heart Healthy Eating Awards reducing Food Waste in the health services and implementing the current food, nutrition and hydration policy for adult patients in acute hospitals. Special guest Chef Joyce Timmons shared experience and knowledge on pushing boundaries in healthcare cuisine covering:

Why focus on a healthier food environment in the health service?

• The HSE is the largest public employer in the state with over 11,500 sta across 2,500 locations. The WHO has identiﬁed workplace health promotion programmes targeting healthy eating and physical activity as one of the best buys for sta and visitors.

What does improving the food environment in healthcare look like?

For further information on the Healthier food Environment visitpriority-programmes/heal/who/healthwellbeing/our-www.hse.ie/eng/about/healthy-eating-at-work/

Sláintecare Healthy Communities is led by Healthy Ireland in the Department of Health.

“We have seen the installation of three community kitchens, which will enable the delivery of healthy eating and cookery courses; alongside the installation of outdoor gym equipment and playground bouldering rocks and the refurbishment of the sports pavilion and playing pitches in Ballywaltrim. This programme aims to support the health and wellbeing of the people in Bray by providing better access to the range of services needed to help improve and promote healthier lifestyle behaviours.”

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Brian Gleeson, Chief Executive of Wicklow County Council, said the local authority “looks forward to working with our partners in the Department of Health and the HSE and the wider community in Bray, to enhance the health and wellbeing agenda”.

• Sustainability: The HSE spend over €40million annually on food. In 2018 food waste was costing the health service up to €11.6million per anumn.

A one-o total fund of €250,000 has been made available. The focus of this fund, the Sláintecare Healthy Communities Community Enhancement Scheme, is to support projects through Wicklow County Council that will positively impact on the health and wellbeing of those who live within the Bray area.

The HSE now have a suite of nationally agreed policies, developed with input from clinicians and catering professionals within health services. These set the standard for what food provision and food environment should look like for patients, service users and sta . We also have tools and supports for sta working to improve the food environment across healthcare including a series of training modules on HSELand and learning and sharing events. Work is continuing with HBS to ensure that catering services have the capacity to purchase products and ingredients to o er healthier food choices.

SHAPING A HEALTHIER FOOD ENVIRONMENT ACROSS THE HEALTH SERVICES

The webinar can be viewed on watch?v=UbTPntgQm5Uwww.youtube.com/https://

“Health welcomestheofexpectancy,impactsinequalityonlifetheriskchronicdiseaseandgeneralhealthofaperson.HSECommunityHealthcareEastthesigniﬁcantinvestmentinBrayundertheSláintecareHealthyCommunitiesprogramme..."

Over the years the quality of food in healthcare has featured in the national Patient Experience Surveys and there has been negative media coverage of food provision across health services. There is a strong rationale for focusing on improving the food environment across healthcare settings.

Health Minister Stephen Donnelly was unable to attend the event, but sent a video message to express his delight that Bray was the ﬁrst of the Sláintecare Health Communities local launches to take place nationwide.

Minister Donnelly said the beneﬁts of the €250,000 grant from the programme are already visible in Bray.

• For patients and services users healthcare related malnutrition is associated with adverse clinical outcomes including increased morbidity and mortality. 1 in 4 patients admitted Irish hospitals are at risk of malnutrition. Even those identiﬁed as nutritionally well on admission tend to eat and drink less when actually unwell or injured

Below: Students from Moyne College at the launch along with Charlie Meehan, Jarlath Munnelly and the MMHA team.

MMHA co-ordinates the School’s Education Programme – MindOut – throughout Mayo by providing implementation support to schools facilitating the programme. The main aim of MindOut is to support the mental health and wellbeing of students and equip them with skills and coping strategies to manage current challenges in their lives. There are an estimated 17 secondary schools that will be facilitating the MindOut Programme come September 2022.

ayo Mental Health Association (MMHA) were delighted to announce the launch of their new Information Centre in Ballina in March of this year. This brand-new Information Centre will provide a conﬁdential signposting service for people in the community who are experiencing mental health di culties or require options for members of their family. This is done through the Association’s directory of services. MMHA also o er an outreach counselling service to the community with a 24-48-hour turn around.

A highly e ective MMHA rehousing project has been in operation for the past 40 years. Currently in partnership with the HSE, St Vincent de

The Association also facilitates a School’s Education Programme called Breathe. This programme was set up in 2013 by MMHA as an evidencebased educational talk to promote, participate, and facilitate mental health awareness and well-being for students in an interactive format. The Breathe Programme currently involves 24 secondary schools and engages with up to 10,500 pupils across Mayo.

HEALTH MATTERS AUTUMN 202278 |

The World Health Organization’s (WHO) Comprehensive Mental Health Action Plan 2013-2030 recommends the development of communitybased mental health services and mental health care and treatment into primary care. This plan also recommends the e ective collaboration between formal and informal care providers. In line with WHO’s plan, Mayo Mental Health Association plans to meet these recommendations by providing their service and supporting the existing mental health services in Ballina.

New information centre will offer confidential signposting to mental health services

Another area of work carried out by MMHA is Health Promotion. We facilitate and co-ordinate various community health promotion initiatives throughout the year including Woodlands for Health, Moving Your Mind, and the Mayo Mental Health Fair. MMHA work in partnership with the HSE, Mental Health Ireland, Mindspace, Mayo Sports Partnership, and Mayo GAA.

Paul and Mayo County Council, the Association provides good quality accommodation for over 40 residents throughout Mayo who are experiencing mental health di culties.

MAYO MENTAL HEALTH ASSOCIATION

The launch of the new MMHA Information Centre in Ballina.

One of the main goals set out in the Healthy Ireland Implementation Plan (2018-2022), is to increase the number of services and resources for the adult counselling service and increase accessibility to mental health services. MMHA aims to support the Healthy Ireland Implementation Plan by providing an information centre with a conﬁdential sign-posting service and an outreach counselling service, along with the progression of our existing health promotion and school’s education programme.

The ambitious document outlines CHI’s commitment to the implementation of the plan and aligns with the goals contained in the Health Services People Strategy. By creating a supportive, wellbeing focused working environment, sta will be empowered to take personal responsibility for their own health and wellbeing. This in turn will support patients and families with the quality of care they are provided.

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For

CHI PLAN WILL PRIORITISE THE HEALTH AND WELLBEING OF STAFF IN THEIR WORKPLACE

en’s Health Week (MHW) has become a permanent ﬁxture on the HSE Health & Wellbeing calendar and once again in 2022 it was delivered in collaboration with many partners led by the Men’s Health Forum in Ireland.

Speaking during the webinar, Paul Ferris, Men’s Health Week 2022 Ambassador, ex-professional footballer with Newcastle United, and award-winning author, said, “From my personal experience of living with health and wellbeing issues, I appreciate that men and boys need both opportunities to improve their health, as well as support to do so. Men’s Health Week o ers an ideal time to focus our attention upon the needs of males, and to make a positive and meaningful di erence to their lives. We all need to commit to realistic missions which will improve both our own health and the health of males generally. Everyone has a part to play in achieving this.”

www.mhﬁ.org/mhw/mhw-2022.html

• Local men continue to die, on average, younger than women do.

The Healthy Ireland plan for CHI includes initiatives like the Flu Campaign, Schwartz Rounds, Garden Spaces and Tobacco Cessation schemes.

years particularly, often to the detriment of their own health. We need to look after our wellbeing, both physical and mental, and this should be facilitated in the workplace where we spend so much of our time. This is our commitment to look after our sta into the future, and to ensure CHI is a fantastic place to work.”

• Men’s mental health needs are often under the radar and remain unmet.

• Males have higher death rates than women for almost all of the leading causes of death, and at all ages.

Many of the key statistics, crystallised in the ‘Men’s Health in Numbers’ publications www.mhﬁ.org/ MensHealthInNumbers1.pdf show that:

One of the highlights of the week was the HSE hosted the Masculinities and Men's Health Webinar, which had over 200 attendees.

• Poor lifestyles (including smoking, drinking, diet and lack of exercise) are responsible for a large proportion of chronic diseases.

With over 60 partners helping to create an awareness about Men’s Health by organising various virtual and live events and demonstrations, it was a truly inspiring week. One such initiative involved, the HSE Health & Wellbeing funder partner, parkrun working with HSE Health Promotion O cers to encourage all men and boys of all ages to join their local free weekly parkrun. Over 14 events happened nationwide, along with many other parkrun’s joining in to encourage everyone to attend their free local 5k run.

MEN’SWEEKHEALTH2022 MISSION IS POSSIBLE further information about the week visit:

The idea of the week is to encourage men to take positive action when it comes to their health.The theme for MHW 2022 in Ireland was ‘Mission is Possible’, with a call to action ‘The Action Starts With You’. It focused upon asking everyone (men themselves, service providers and policy makers) to take on realistic and achievable ‘missions’ (tasks, actions, goals and objectives) to improve men’s health.

Other highlights from the week include when colleagues Dr Noel Richardson was interviewed on Ireland AM , Dr Bobby Smyth working with Alcohol Action Ireland got great coverage in many media outlets including the Sunday World and Finian Murray did the day in the life piece with the Irish Irish Examiner

Minister for Health Stephen Donnelly joined sta from Children’s Health Ireland (CHI) to launch its Healthy Ireland Implementation Plan 2022-2025, which will encourage and support their sta , patients and families to lead healthy lives.

Chief Executive, CHI, Eilísh Hardiman said, “While our operational priority in Children’s Health Ireland is to provide timely access to quality care, we must support both the people delivering these services and the people we serve to look after their own health and wellbeing while with us. It’s especially important that children be given the tools to make healthy choices so they lead healthier lives.

“Our sta have shown unrivalled dedication to our patients in the last two

• Late presentation to health services can lead to a number of problems becoming untreatable.

The short ﬁlm will form part of a Traveller Youth Mental Health Resource Pack, while it has been released via limerickyouthservice.comwww.and across LYS’s respective social media channels. Five

smaller versions of the short ﬁlm focusing the CHIME themes have also been released. Welcoming guest at LYS’ Northside Youth Space, Maurice Walsh, Youth Work Manager, said, “We are delighted to see you all here today. This short ﬁlm is part of a Traveller Mental Health Resource that will be of use to young people in schools, as well as youth and community organisations.

Written by and featuring teenagers and young adults with the Travelling Community, the short ﬁlm highlights the challenges young Travellers face in terms of mental health support-from outside and indeed, within their community.

At the launch of a new ﬁlm focusing on youth mental health amongst Travellers were: Karen Healy-Earls, Cailyn Healy, Crystal Ward and Margaret Ward. (higher res coming)

HEALTH MATTERS AUTUMN 202280 |

From those consultations, seven young people took part in the CHIME mental health recovery programme and from it decided to create Our Story, a short ﬁlm to capture their experiences.

Throughout the piece the young adults speak openly about their own mental health and the discrimination they have faced in the education system and in society in general.

“Who we are and what our heritage means to us, makes us proud of being Travellers, but that shouldn’t stop us or anyone like us from reaching out for help, which is what this ﬁlm is about. With mental health

A member of Youth Work Ireland and the Irish Association of Community Training Centres, Limerick Youth Service remains committed to connecting with young people and supporting them to reach their full potential.

imerick Youth Service (LYS), in partnership with the HSE’s Midwest Community Healthcare, has launched Our Story, a hard hitting and evocative short ﬁlm that addresses the prejudice faced by young people from the Travelling Community, its e ects on their mental health, and how they are trying to overcome it.

“We hope this short ﬁlm and what we speak about, will provide hope and encouragement for those who are struggling with their mental health. Travellers’ unique cultural identity should be celebrated, promoted and respected, not something that should be hidden, in fear of discrimination.

“It is also about young Travellers being visible and vocal in the area of mental health and being a resource to their peers, friends, families and their community. While this project started in 2019, it was heavily interrupted by COVID-19 and the young people involved showed huge commitment and resilience over a di cult period.”

sometimes our heritage makes people feel like they can characterise us, without knowing us. We are more than a label makes us out to be. We are all human and we deserve a chance at life without being pre-judged.”FionaO’Grady, Limerick Youth Service CEO, explained, “What prompted Limerick Youth Service’s involvement in this project was the strong focus on youth voice and supporting young travellers to raise the issues that matter to them and for us to show that we are willing to listen to those issues.

“The film is very moving and we would like to thank the young people for been so honest and open in speaking about their mental health and the discrimination they haveCrystalfaced.”Ward, LYS’ Traveller Youth Mental Health Project, who took part in the short film, said, “After a long journey, it’s hard to believe the day has finally arrived and we are launching this much needed resource for young members of the Travelling Community. Today is a day that will set a foundation for a brighter and more positive future for those of us who struggle with their mental health.

As part of the project, almost 100 young members of the Travelling Community took part in consultations across Limerick, Clare and North Tipperary, sharing their experiences of their mental health, from speaking among their peer group and family to assessing support and barriers they face.

Short film highlights strength and resilience of young Travellers

The Traveller Youth Mental Health Advisory Panel were: Katie Harty, Noreen Harty-Ryan, Annemarie O’Reilly, Nora Tuohy, Crystal Ward, Margaret Ward and Martin Ward, supported by Limerick Youth Service, the HSE Midwest Community Healthcare, the HSE’s Connecting for Life initiative, the Traveller Mental Health Unit and the Dormant Account Funds.

Log out and shut down your computer or laptop at the end of the day

Don’t select the ‘keep me signed in’ option on websites, Apps or social media

DODON’T

When you let hackers in, who knows what you are letting out.

Never download and use free software or online games

Be cyber safe and aware when you’re online at work.

Use a unique password for each website and social media account

Report suspicious emails to your IT helpdesk

Don’t use a personal USB stick. Order a password-protected USB stick from your IT helpdesk

Don’t click on a link in an email or text message if you don’t know the sender

Find out how to be cyber safe at healthservice.ie/cyber

Lock your screen when you leave your computer or laptop

Don’t open an email if you don’t know the sender

HEALTH MATTERS WINTER 2021

Your patients rely on you to protect them

People with weakened immune systems or who have underlying health conditions rely on you to be vaccinated to protect them against flu.

Flu Vaccine for Healthcare Workers

Getting the flu vaccine also protects your family, your colleagues and the patients you care for.

Order Code: HN100467

Flu causes pneumonia and bronchitis and can make chronic health conditions worse.

You can protect your family and those around you

hse.ie/flu

It takes just a few minutes to protect yourself and the people around you.

It’s been given to millions of people for more than 60 years.

Flu vaccine is safe

You can spread flu without knowing it

Some people have no symptoms.

Up to 500 people die from flu every year in Ireland.

1 in 5 healthcare workers develop flu every year.

You are 10 times more likely to get flu

Flu is serious

HEALTH MATTERS WINTER 202154 | Public Health Advice