Health Matters Summer 2022

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STA FF MAG AZINE OF TH E I R I S H HEALTH SERVICE

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STAFF SHARE IN HOLI FESTIVITIES

Celebrating Diversity Plus Revolutionary cancer treatment

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CONTENTS 2 5 6 8

A MESSAG E F RO M O UR ED I TO R

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Welcome to the latest edition of Health Matters. I don’t think there is any community in the country that hasn’t welcomed some of the thousands of displaced Ukrainian families that have made Ireland their temporary home. However, as well as a warm welcome, there is a huge amount of practical help that our visitors need – from accommodation and schooling, to employment and health services. It was fascinating to find out the sheer volume of the logistical operations being put in place by HSE staff to ensure that the Ukrainian refugees receive all the help they need. Seven Ukrainian women who have joined the HSELive helpline team to provide assistance to their compatriots in their native language shared their experiences so far with us. Each woman has a story to tell about their journey to the far west of Europe, thousands of kilometres from their homes and the challenges they face. But all have said that they are delighted to have been able to get back to work and feel like they are making a difference. We spoke to Dublin GP Dr Kateryna Kachurets, originally from the Ukrainian capital, who moved to Ireland six years ago. She is currently working with the HSE and the Irish College of General Practitioners (ICGP) on the Ukrainian crisis response. She outlined all the things that are being done to assist the refugees while they are in Ireland - access to a medical card with health screening services available as needed upon arrival, for example, COVID advice and relevant vaccinations. Medical emergency guides offering English-Ukrainian and English-Russian phrasebooks are available, as well as health information in Ukrainian and Russian on the HSE website. It has been a mammoth task by all the HSE teams involved and it has further highlighted the resilience and kindness shown by health service staff over the past two difficult years. A sincere thanks to all those who have sent in contributions to this edition and I hope you find plenty of interesting reading in it.

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Joanne Weston

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Editor

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Health service responds to Ukraine crisis Remembrance and Recognition exhibition Doctor recalls her teen cancer journey Ambitious plans to improve cancer outcomes in younger people My bowel cancer experience Taoiseach visits cross-border centre NEIS milestones Memory clinic secures long-term funding Coombe recruitment drive Launch of clinical simulation facility Refurbished birth suite opens Learning Talks podcast NMH joins Global Chain of Light Electronic Patient Record system goes lives at TUH Renewed hope over wait lists Care centre holds Ukrainian fundraiser Values in Action at contact tracing centres NAS staff share their experiences Our quit stories COVID time capsule Defence Forces leave lasting impression Soothing Sounds live music programme Poetry Day marked Revolutionary cancer treatment Inclusion Health social workers Injury units in action Enhancing care in the community Innovative project helping service users with intellectual disabilities Health Passport unveiled in Wexford New homes bring delight Dementia books available in libraries Dementia care and support programme MICAS has busiest year to date Alternative Pre-Hospital Pathway Steps to Health Charlie Bird climb for testers Traveller mental health project Let the fun begin again Letterkenny staff put best feet forward Your Opinion Counts A Day in the Life of Splinter Nurse

44 H.E.A.R.T. Awards for midwives and nurses 45 ICARE leadership programme 45 Podiatry collaboration 46 Specialised Rehabilitation Units in focus 48 Sharing the Vision 49 Hello, How are You? 50 Early Diagnosis of Symptomatic Cancer Plan unveiled 51 Breast screening research 52 Bedside care innovation on display 53 Careers Showcase for TY students 54 Sláintecare fund 56 Robotic-assisted surgery improving outcomes for women 57 200 years of vaccines 58 Infection control 59 New Regional Health Areas 60 Public Health Directors appointed 62 HSE recognised as Best Organisation Transformation Initiative 63 Breastfeeding initiative is change in action 64 Virtual rehab making a real difference 66 Nursing Policy Portal 67 CPD achievements by Irish NRC SNOMED CT 67 NiRSP update 68 Revised HSE National Consent Policy 69 New Research governance framework 69 Internal Controls Programme starts second year 70 Pathfinder Climate Action programme gets under way 72 Patient Safety is everyone’s business 72 Book of Abstracts published 73 Welcome for new National Centre for Clinical Audit 74 Open Disclosure training programme 75 Occupational Health 76 Woodland Park to be created on HSE land 76 Angling group set up at mental health facility 77 Love Run for Heart Foundation 77 Poets and Players Society at St James 78 Three Green Flags for CUH 79 Gardeners win 80 Be Sun Smart this summer

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M E ET T H E TEA M

H SE Head of Internal Communications Emma Finn Internal Communications Team Yvonne Costello Ann McLoone Amy O'Neill Frances Plunkett Shane Larkin Paddy Crosse Keeva Carpenter

As hvi l l e Med i a Grou p Editor Joanne Weston Art Director Áine Duffy Creative Director Jane Matthews

Published by Ashville Media, Unit 55 Park West Road, Park West Industrial Estate, Dublin 12, D12 X9F9. Tel: (01) 432 2200 ISSN: 0332-4400 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.

A M E SSAG E F R O M O U R C EO PAU L R E I D In the last two years, our health service staff have shown resilience time and time again as they faced down the continuous waves from the COVID-19 pandemic, in addition to the cyberattack on our IT systems. Now, they have shown kindness and solidarity as they welcome thousands of displaced Ukrainian refugees fleeing the ongoing war in their country. Our staff have ensured that our Ukrainian visitors are met with a smile and a helping hand. We can only imagine what each one has been through to make it to these shores. I am very proud to be at the helm of an organisation that is making them feel so welcome and safe. There was important progress for the future of our health services with the Government decision to proceed with setting up six Regional Health Areas (RHAs) within the HSE, on the basis of the geographical boundaries. There will be a phased introduction of the new bodies in 2023 and they will be fully operational from 2024. Each RHA will have full autonony to plan, resource, and deliver health and social care services for the needs of its unique population. It will empower frontline staff and bring decision-making closer to services and, most importantly, service users. I must take this opportunity to pay tribute to our outgoing Chief Operations Officer Anne O’Connor, who has made an extraordinary contribution to the health service during her time with us. She has not only led the operations of the health service through a period of great challenge and pressure, but she has done so while retaining an unwavering commitment to high quality and continuous improvement. She has been a great colleague, and is highly respected and admired throughout the health service. Anne will be continuing to contribute to healthcare services in Ireland in a very senior role and on behalf of the HSE I want to wish her very well in her new position.

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“Our staff have truly represented the best of the HSE, responding admirably to this challenge” Mid West pulls together to provide unprecedented support for Ukrainians

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ithin days of the beginning of the Russian invasion of Ukraine, the International Protection Accommodation Service (IPAS) took on the considerable task of finding and providing places to stay for the thousands of people arriving here. The availability of hotel accommodation, allied with the arrival of flights from Poland into Shannon Airport, meant large numbers of Ukrainian nationals were accommodated in Clare from early March. From the outset, some of the county’s coastal communities, popular with tourists each summer, welcomed hundreds of Ukrainian nationals. The town of Lisdoonvarna, famous for its annual matchmaking festival, saw its population double with 800 new arrivals. Kilkee and Ballyvaughan also welcomed considerable numbers of people from early- and mid-March. It’s now estimated that there are some 2,700 Ukrainian nationals living in Clare - about 10% of all those who fled to this country. A further 1,000 Ukrainians are in Limerick and North Tipperary. Put simply, this arrival of so many people into the Mid West region in a matter of weeks was unprecedented, and it placed a significant demand on a range of local services. An integrated inter-agency approach has been key in responding to this crisis. The HSE liaised closely with local authorities and local Gardaí to devise a coordinated approach, particularly during the early weeks of the crisis. This close working relationship had already proven invaluable during COVID-19 in particular, and was again helpful now. A Ukraine-specific subgroup of the local HSE Mid West Area Crisis Management Team was also established to co-ordinate the provision of healthcare services, while the HSE is also being represented on county-specific Co-Ordination Groups and Community Forums across the region. The provision of GP care has been the biggest challenge. GPs throughout the Mid West have stepped up to the mark and taken on new patients, with some even coming out of retirement to offer their expertise.The ShannonDoc Out of Hours service has also provided invaluable support. However, it has also been necessary to open a GP response clinic in areas that have welcomed the largest numbers of people to date. This pop-up service includes a nurse, interpreter and admin support and is being attended by around 100 patients per week.

Separately, health screenings have been conducted in a range of settings, with supports for those with more complex needs being put in place. Dealing with COVID-19 posed a challenge, but now vaccinations are being offered in accommodation throughout the region. Importantly, to support those who have endured such a difficult experience over the past few months, a range of psychosocial supports have also been put in place. Chief Officer, HSE Mid West Community Healthcare, Maria Bridgeman, has paid tribute to all of those who have participated into the response. “While the arrival of so many people into our region in such a short space of time naturally placed considerable pressure on our services, our chief aim has always been to try to ease the trauma of the victims of this dreadful war,” she said. “Our staff have truly represented the best of the HSE, responding admirably to this challenge. In particular, I want to thank our Social Inclusion team, who have spearheaded our response, and all those staff who have taken on additional work, or in some cases returned from retirement, to play their part. “I also want to thank the other agencies, both in- and outside the HSE. Local councils, Gardaí and the Red Cross have also worked tirelessly to support those arriving from Ukraine. Our close working relationship has proven invaluable. “I also want to sincerely congratulate those in local communities throughout the Mid West who have gone above and beyond in giving a truly warm welcome to our new arrivals. During what must be the most incredibly difficult time for people from Ukraine, as they find themselves so far from their homes, I hope that our efforts have offered some comfort.”

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Ukrainians recruited to help assist fellow refugees.

HSE LIVE Displaced refugees will find a reassuring voice at the end of the HSE helpline as a number of Ukrainians have been recruited to help provide information and assistance to their fellow Ukrainians in their native tongue. Anna Kachalaba, Tetiana Fesak, Zoia Andriichenko, Karina Sheludko, Iana Dakhno, Mariia Hrebeniuk and Anna Simson are just some of the Ukrainian refugees to have joined the HSELive team and they have shared some unique insights on life for them thousands of kilometres from home. Zoia explained how it took her three days to get here. “Me and my 10-years old son travelled by train, then by bus, and then by plane. So, it was a long trip. We were met by a friend of my husband, with whom he worked more than 13 years ago.” Tetiana left Ukraine with her 13-year-old daughter on the twelfth day of the war. “First, we went to Slovakia and then moved to Ireland. Thanks goodness I met a very nice Irish family on Facebook and now we are staying with them. The host family and all the neighbours are very welcoming,” she explained. Karina arrived in the country on March 21st. “I knew almost nothing about Ireland, but I just knew that I will go to English-speakers' country. When the war began, Ireland opened its borders to Ukrainians without visas. It was that fact that made my decision where to go,” she said. They were all full of praise for the welcome they have received. “All I can think about is the super helpful and kind Irish people who were so eager to help in every way through every step of the way! Everything was well organised at the airport and in the hotel where we stayed, and we (with my mom) are very grateful for that,” said Anna Kachalaba.

Iana explained, “I arrived in Ireland in March, it’s a wonderful country with beautiful landscapes and open-hearted people, who are very helpful to Ukrainians, and we really do appreciate that and shortly the day will come and we will welcome Irish people at our home, Ukraine.” Despite the wonderful Irish hospitality, refugees face a number of challenges when settling here in Ireland, with Anna Kachalaba citing accommodation as a major headache. Iana added that not having transport is another issue. “One of the biggest challenges is mobility, as Ireland is countryside country,” she said. Zoia agreed. “My friends from here met me and try to help me as possible. So, I hadn't problem from start. But now transport is a problem. To get somewhere, I need to ask my friends, because we live in suburbs, and there is no bus,” she said. “I also asked about help with accommodation from different organisations, like Citizen information, Intreo, IPas, HAP, but they all ignore me and I can't find necessary information. So, I think that people who said from start in airport that they need a help are in a more comfortable situation than I am. That's why for now a little bit hard to be here in Ireland. But all people that I met here - they are so incredible and so great.” Tetiana said, “The biggest challenge was to leave Ukraine and move to the unknown direction. My parents and husband are in Ukraine now and I am really worried about them. It hurts a lot. We had to pack everything in one small bag and go. Thanks to all Irish people, we are much better now. I love Ireland - its people, nature, cities. It’s a fantastic country.” Mariia has been a regular visitor to Ireland and said that has helped her to settle.

“Actually, because I know a lot about Ireland as I have been visiting it for a long time, and my family is here. I’m feeling comfortable, and I haven't stressed about being in a new place. But the most complicated thing for me is that I'm very far from home, of course I miss it. But I think I can be useful here now. It’s an important thing.” Anna Simson added, “The family of great people gave a place in their home for my family, they help us in all cases and make our life very easy from the first days. So I had no challenges while settling in.” Al the women said it was important to them to find a way of making themselves useful and helping their compatriots. Mariia said she was thrilled to join the HSELive team, with some seeing the positions advertised in Ukrainian groups on social media. “I was looking for a job in Ireland, and I was very happy to find out that I can help Ukrainians not only in Ukraine, even here! I think it's very important for Ukrainians in Ireland, especially for those, who don’t know the English language, to understand that they are not alone here, and everyone in HSE are happy to help them.” Karina Sheludko “ I searched for work, because it is really difficult for me to be unemployed. I saw a post in the Telegram group ‘Ukrainians in Ireland’ about this opportunity and I sent my CV the same day. I had previous experience in Ukraine air company helpline, so this job is not something new, strange or difficult, rather known, easy and a pleasure.” “I saw a post in Facebook group and decided to myself it will be great opportunity to help Ukrainians in Ireland to settle in,” said Anna Simson. Tetiana said, “Some weeks after coming I started looking for a job. I have always wanted to be a doctor so when I saw this position in HSE I decided that it was a great possibility to learn something new. So I applied for it and now I am here.” Iana added, “I am happy to be a part of the team for Ukrainian line, who came here as refugees.” The group said the most commons queries from their fellow Ukrainians on the HSE helpline was about COVID-19 vaccinations and booster doses, in addition to finding out how to get a PPSN and Medical Card. “The most common queries are to help with registration for COVID-19 vaccine, because when people moved here, they interrupted course, or time to get booster became. Also, they asking for help about booking of vaccination appointments, because in Ukraine we have pretty different process of it, and everything here is new for our people,” said Mariia.

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UKRAINIAN-BORN GP HELPS CO-ORDINATE HSE RESPONSE TO REFUGEE CRISIS Accessing healthcare will form an integral part of their experience in Ireland, says Dr Kateryna A Kyiv-born GP is at the heart of the health service’s response to the arrival of thousands of Ukrainian refugees following the Russia invasion back in February. Dr Kateryna Kachurets, originally from the Ukrainian capital, moved to Ireland six years ago and is a GP in Dublin and currently working with the HSE and the Irish College of General Practitioners (ICGP) on the Ukrainian crisis response. She did her medical training in Poland, and her intern year in Dublin, while completing her GP training in the Midlands scheme in Naas and Tullamore. “Ireland has welcomed over 30,000 Ukrainian people since the start of the Russian invasion on February 24th. It is anticipated that people will continue to arrive as the situation develops. We are well aware that many will have encountered very physically and emotionally challenging journeys to get to Ireland,” she explained. She said the highest priority for people arriving in the country will be finding accommodation and addressing any immediate medical issues. The facilitation of Ukrainians in accessing healthcare will form an integral part of their experience in Ireland and will play a big role during this traumatic time, said Kateryna. “For most Ukrainian nationals, adjusting to life in Ireland will take time. Many will face language difficulties, navigation of a different healthcare system, enrolling children in schools within the community, accessing childcare and applying for employment. Not to mention, having to gradually accept the uncertainty of their future and immediate life upheaval. The approach to daily living in western Europe compared to Ukraine differs in a myriad of ways, notably in the provision of healthcare and the transport system. For example, a lot of areas are much more regulated in Ireland, compared to Ukraine, such a private businesses, healthcare, and education.” She explained that Ukrainian people can access the same health and social care services as people already living here. This has been expedited by the HSE and the Department of social protection with fast-tracking of PPS number assignment to those who register on entering Ireland. This facilitates access to a medical card with health screening services available as needed upon arrival, for example, COVID advice and relevant vaccinations. Medical emergency guides offering English-Ukrainian and EnglishRussian phrasebooks are available, as well as health information in Ukrainian and Russian on the HSE website. “Significant differences exist between the healthcare systems in Ireland and Ukraine. The first major difference would be that medical care is largely focused within secondary care in Ukraine. With relatively easy access to specialist care, patients normally attend a specialist first-line without any initial contact with a GP,” said Kateryna.

“On-demand lab tests and imaging are also available in Ukraine – with no referral needed for any laboratory, whereby patients can decide which diagnostic tests they think they need, and bring it to a doctor later for interpretation. “A further disparity is that free medical care in Ukraine, is not, in actuality free in Ukraine. By law, Ukrainian health care is supposed to be free. However, in reality, patients end up paying for almost everything: medications, procedures, doctors’ time, hospital stays. Therefore, we must anticipate many patients in advanced stages of disease many of whom are afraid of going to the hospital because they cannot afford the cost of examination and treatment.” The HSE is currently developing a new model of health screening at Citywest, which will aim to provide accommodation support, initial health screening and signposting of resources available to Ukrainians in Ireland. The current plan is to pilot it by the end of May. Also, the new GP Framework has been updated in conjunction with the MO to include guidance on the Primary Childhood Immunisation Programme (PCIP) and the delivery of Maternity and Infant Care Services. “I wish to thank everyone in Ireland for the outpouring of support and love for my home country in recent months. We will continue to respond to the evolving situation and do our upmost to support newly arrived Ukrainians here in Ireland,” she added.

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REMEMBRANCE AND RECOGNITION Staff exhibition remembers and recognises efforts during pandemic Fiona Naughton, Physio Assistant with Joan Moynihan, Physiotherapist who were involved in the Remembrance and Recognition Exhibition in the Arts Corridor of Merlin Park University Hospital.

Staff involved in the Remembrance and Recognition Exhibition in the Arts Corridor of University Hospital Galway, from left: Johnny Tierney, Mortuary Dept; Miriam Conry, Social Work Dept; Colette Fallon, FOI Co-ordinator; and Father John O’Halloran, Chaplain.

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he announcement in January of a National Day of Remembrance and Recognition prompted a group of staff working in Galway to plan an event as a hospital community which would acknowledge both the personal and professional experience of the pandemic. Staff working in University Hospital Galway and Merlin Park University Hospital came together to contribute to an evocative exhibition by sharing their thoughts and reflections on the COVID-19 pandemic. The month-long exhibition was on display in the Arts Corridors in UHG and in Merlin Park from mid-March. Margaret Flannery, Saolta Arts Director, was one of the staff involved in arranging the exhibition. “A call went out to colleagues to come forward with prose, poetry, photographs or whatever medium they would like to use to tell their story, of their experience of the pandemic. What we received was eclectic, representing the genuine fear, fatigue and pride of hospital staff. It is good to know that despite the trauma of the past two years there is also a little humour.” Anne McKeown, End of Life Care Co-ordinator at the hospital, said, “We asked staff to share some of their experiences from the early days of fear of the unknown to the relief of vaccination, the highs and lows and the effect it had on themselves, their family and work colleagues. It is fair to say that there are some staff who are not yet able to talk about their experience of the pandemic. However, all the exhibits are displayed anonymously so that those viewing them are able to identify with the sentiment, rather than the person.” People attending the hospital for appointments during the exhibition

were invited to stop for a few minutes and read a few of the thoughts staff shared. Here are some examples: “What is Covid-19, are we going to get it and die? Are we going to bring this home with us? ……. The fear at first, everyone was in the same boat, nobody knew what was coming. Day by day, each day, there was new policy drawn up, PPE training, donning and doffing, what masks to use, the extra cleaning which had to be done on everything that we touched - lifts, door handles, light switches, release buttons on doors and lifts. Every point we touched making sure we were clean moving on to our next jobs. The fear was the biggest part at the start for us and our families. But also for the patients, who we met from day one to the day they left to go home or those patients who unfortunately died due to COVID-19, may they rest in peace.” “The quote ‘If you enlist you must march’ was very relevant in those early days. While it was not necessary for me at any time to be knowingly in close contact with a COVID-19 patient, I will always appreciate those that knowingly did so unseen without hesitation day in day out in those early pre vaccination days. They are real heroes - we salute them.” The project was an initiative under the Healthy Ireland Plan, HSE Staff Health and Wellbeing with support from the Saolta University Health Care Group. HEALTH MATTERS SUMMER 2022 | 5

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M YSTO RY Doctor recalls her own teenage cancer journey

F Dr Karen O’Neill, Specialist Registrar in Paediatrics Far right: Karen with Prof Owen Smith during her own stay in Crumlin

rom teenage cancer patient to paediatrician, it’s a journey that has brought Karen O’Neill full circle – right back to working with the doctors and nurses who originally treated her. Diagnosed with Acute Myeloid Leukaemia at 16, Karen describes herself as lucky to have been treated in Crumlin Children’s Hospital. As a 29-year-old Specialist Registrar in Paediatrics now looking back, Karen recalls, “It came at the end of the summer after my third year in secondary school. I had completed my Junior Cert – I had a couple of weeks where I was increasingly tired and dizzy walking around. People were commenting that I had lost a lot of weight but I hadn’t really noticed that myself. Then I went to a hockey camp and when I came home I was covered in bruises.” Prompted by the bruises and the tiredness blood tests were arranged by her uncle who was her GP. “And that was how I got diagnosed. It was really unexpected as I hadn’t been very unwell.” Her luck as she describes it was being treated

in Crumlin: “I was transferred there following a discussion between the Connolly Hospital Adult Consultant Haematologist and Prof Owen Smith a Consultant Paediatric Haematologist at Crumlin. At 16, I fell into the very unlucky cohort of patients, diagnosed as an adolescent, who fall in between the cracks of paediatric and adult services. Nowadays, if I was diagnosed like that I would have to remain in an adult unit but they were a little more lenient back then. “I pretty much lived there on their wards for about five months while I underwent chemotherapy. The facilities in Crumlin were very different to what they are now. I was sharing a room with one other person which invariably was a small infant or toddler. The age difference was often so vast because I was at the very eldest end of the spectrum. But I always look back and say that I am very lucky to have been able to access paediatric services. They look after the family unit, not just the adults on their own. My parents and brother were able to be involved and was able to keep up with school in the hospital.

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“I had four rounds of intense chemotherapy in total. I might get home for a night or two after that finished but was readmitted with infections pretty quickly after each course. I spent less than two weeks out of the five months at home during that time. I was a fixture on their ward. In fairness they said if I had gone to an adult unit, they probably wouldn’t have let me go home at all. The treatment is very intense and involves a very high risk of sepsis.” Karen says she inevitably bonded with some fellow teenagers who were also undergoing treatment at the time, adding that she is still in contact with some of them today. “At the end of the five months I was very lucky as I was declared in remission. It was then a case of building your life back up again. I didn’t have to have any further treatment. I had lost maybe 25kg in weight and muscle mass, and I was very weak, so it was about building strength back.” Although home, Karen recounts how she was still not free to live a normal teenage life. “My friends in Transition Year were experiencing that first sense of independence. But I had regressed – being helped to the toilet and being showered by my parents. From a psychological perspective its very tough because in your mind you are able to do it but then reality sets in and you realise the toll this has taken on your body is enormous. “When I returned to school to go into fifth year, I had a weakened immune system and so I lost a lot of days because of infections.” Reflecting on her subsequent decision to become a doctor, Karen says, “When I arrived on the ward in Crumlin in August 2008, I never thought I’d become a doctor. I got my Junior Cert results when I was there and Prof Smith (who is now the National Clinical Lead for Children, Adolescent/Young Adult Cancers at the National Cancer Control Programme) got very excited and told me he knew I was

going to be a doctor. By the time I had finished my treatment, I turned around to him and said I was looking forward to taking over his job some day!” Remarkably, Karen and Prof Smith today count one another as both colleagues and friends. “What I loved then and still love about hospitals is that community atmosphere, that camaraderie. And having lived in the hospital for five months, I became part of that community. I knew everyone and they all knew me. That was something then that really inspired me to work in the hospital. I’ve always been interested in science and so the more I learned about my illness, the more I wanted to learn about the treatment and everything else involved.” Survivorship is a particular area that Karen wants to focus on longer term. “Children who finish treatment for their cancer hopefully have decades of their lives ahead of them. I am in a privileged position to have not only been cured but to be left with very few long-term side effects of my treatment. But not all children are so lucky. Those who survive, after often left with life-changing disabilities, long term impact on organ systems and psychological trauma. That’s a huge area of interest for me within oncology – the late effects and the survivorship. The treatment may be over but how does it affect your life. Everybody has to build up back to a “new normal” life. It is important to support children, adolescents and young adults (CAYAs) to achieve their full potential after their treatment. Cure is no longer enough, we need to support these children and adolescents throughout their life after receiving treatment for cancer. The number of survivors of CAYA cancer continues multiply each year. Following treatment these patients have unique clinical and psychological needs. “These unique set of needs are beginning

to be addressed now following the publication of the current Cancer Strategy {2017-2026]. Thirty years ago we wouldn’t have been having this conversation because if I had been diagnosed in the 1980s there’s every possibility I wouldn’t be alive now. The same need wasn’t there because we had much fewer survivors. So, it is so wonderful to be able to have this conversation and look at the huge numbers of children and AYAs who survive their cancer. However, late effects can become apparent years after treatment and we need to be cognisant of minding these needs. “I am still being followed up myself from a cardiac perspective. It’s only in the last year or two through MRI that they are able to see the damage on my cardiac muscle. And for those diagnosed at a young age, you need to think about the impact of treatment over many decades.” Reverting back to her stay in Crumlin, Karen says even then she was having conversations with Prof Smith about the specific unmet needs of AYAs and how ageappropriate care was so important and the difference it can make. “He was telling me all about the services in the UK where they had Teenage Cancer Trusts funded units within paediatric and adult hospitals where AYA cancer patients were treated in an age appropriate environment which not just for medical needs but also the psychosocial requirements of an adolescent and young adult,” says Karen. Currently working in Portiuncula Hospital, Co Galway as a Specialist Registrar in Paediatrics, Karen says her long term ambition is to “be that person driving the survivorship service late effects and looking after all those children who have been left with life changing impact from their treatment and supporting them to be their best person and fulfil their maximum potential throughout their lives.” HEALTH MATTERS SUMMER 2022 | 7

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AMBITIOUS PLANS TO IMPROVE OUTCOMES IN CANCERS IN YOUNGER PEOPLE

Ambitious plans that will see cancer treatment designed around the specific needs of 16 to 25 year olds will improve outcomes and support quality of life for patients, according to Prof Owen Smith, National Cancer Control Programme (NCCP) Clinical Lead for Child, Adolescent and Young Adult Cancer. While initially lagging behind improvements in children and adult cancer survival rates, adolescent and young adult cancers have largely caught up over the past five to 10 years. Aiming to further improve those rates and implement this ambitious plan, Prof Smith, Consultant Paediatric Haematologist at Children’s Health Ireland at Crumlin and Professor of Paediatric and Adolescent Medicine at UCD, reflected on the achievements and looks forward to the new standardised service that will be available across the country. “If we went back 40 years and looked at the survival rates for children and young adolescents with acute lymphoblastic leukaemia – the most common cancer in children and adolescents up to the age of 20 - the survival rate was hovering around 45 – 50%. It’s now up to 90 – 95%. That’s staggering,” he said. “It’s such a positive development that gives great hope. However, when you look at the same leukaemia in older adolescents and young adults, survival rates are not as good. Two main reasons account for this difference – until recently these patients have been treated on adult chemotherapy protocols which are not as effective but also the biology of the leukaemia in this age group is more aggressive. “We’ve got to change that – we can’t change the biology, but we can change the treatment and that’s what’s happening. We are now using a more paediatric approach and are seeing big wins in terms of survival. We have opened a new clinical trial in Ireland for patients aged 1 – 45 years with this leukaemia. We will be part of a Pan European Consortium ‘ALLTogether’ involving 14 countries contributing patients to the trial.” Around 200 children are diagnosed every year with cancer up to the age of 16, with 180-190 adolescents between 16 and 25 diagnosed every year. Prof Smith notes that the 2017 – 2026 National Cancer Strategy recognised Children’s Health Ireland at Crumlin as the ninth designated cancer centre in the country but more importantly that AYAs with cancer are a unique cancer community and made specific recommendations to address their needs. This new programme will see a state-of-the-art AYA cancer care network delivered locally where possible but centralised when necessary by providing separate facilities and specialist care teams in the new Children’s Hospital and in three of the eight adult designated cancer centres across the country. It will bring together all the relevant experts and allow this

Prof Owen Smith National Clinical Lead NCCP Child, Adolescent and Young Adult Cancer

collective knowledge, experience and interest to work towards better experiences, better outcomes and better long term quality of life.” Working with colleagues in UCD and Trinity, Prof Smith explained that they are “trying to re-define the concept of cure. Cure to many people is being cancer-free in three to five years. But to me it’s having your fertility preserved, not having these long-term chronicities; it’s living a normal life. “We can do that by changing the drug approach by introducing immunotherapeutics and getting rid of some of the chemotherapy but also by looking at the host genomes of the patient – what genes they have variants in that make them more pre-disposed to toxicities.” Stressing the need for ongoing vigilance around symptoms, Prof Smith said, “When you are an adolescent or a young adult, you are infallible. Because these things are rare, you are not mixing with friends who have had cancer. At my age a lot of my friends have cancer. So the teens and young adults tend to hide it.” Recently appointed as the Chair of the European Society of Paediatric Oncology Adolescent and Young Adult Programme, Prof Smith concludes with his own aspirations of wanting to “spearhead a standard plan for the treatment and management of childhood, adolescent and young adult cancers across the European Union. Hopefully it will go in parallel with what we are going to do with the NCCP across the island of Ireland.”

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MY STORY

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icky White contacted BowelScreen to share his cancersurvival after an off-the-cuff remark from his surgeon. “At the appointment following my surgery, Consultant Surgeon Professor Fiachra Cooke, from Waterford General Hospital, said I should become an ambassador. He said I’d be an ideal person to spread the word,” Nicky said. “I was only too happy to get involved, so I emailed BowelScreen to see if I could help.” Nicky’s email led to him become the face of BowelScreen during Bowel Cancer Awareness Month in April. He told his powerful story in the Irish Daily Mail and Irish Times, appeared on Ireland AM and his local radio station South East Radio. Nicky and his wife Catherine were even invited to meet Stephen Donnelly, the Minister for Health, during his visit to Wexford General Hospital on Friday April 22nd. Nicky, a retired postal worker from Cleariestown, Co. Wexford, was 64 when he had bowel cancer detected via screening in 2020. He had taken the at-home FIT kit test and when the results indicated a level of blood in his stool, he was offered a follow-up colonoscopy. It revealed a large cancerous tumour. Nicky had surgery followed by chemotherapy which he has completed and thankfully he is now cancer free. “During my treatment, my doctor told me that if I had been diagnosed six months later I wouldn’t be talking about treatment. Taking the screening test saved my life. I want to make sure other people like me know how important the screening test is,” said Nicky. “The day I was retiring from An Post, there was a presentation with 50 people there, mostly men, and at the end I said, ‘When you get to the age of 60 make sure you have the stick test – if I hadn’t done it I wouldn’t be here. When you get the letter through the post don’t be afraid to do it and don’t throw it in the bin. “I’d hate to think that I’d have left my test in the cupboard and forgotten about it altogether. Luck was on my side. “I had some experience with the media through my involvement with an inter-county ladies GAA football and refereeing for 14 years. I even had the honour of refereeing the 1996 All-Ireland final draw and replay at Croke Park. I was still nervous enough before going on Ireland AM, but once I was on the sofa I was grand, and felt calm. The presenters really put me at ease and I was well prepared. I think I got my message across “A few friends sent me messages asking me about being on the telly and wondering why I hadn’t told them. When I met Minister for Health

M Y E X P E R I E NCE O F B E I NG A N H SE PAT I ENT ADVO CAT E – ‘J U ST T ELL IT LIK E IT IS ’ Stephen Donnelly who said how powerful the story was and that he’d read it in the Irish Times. “I’m proud of being a voice for screening, despite it being about a sensitive subject, and my family are proud of me too. I was happy with everything that was printed about me in the newspapers. My cousin, who is a retired nurse, even contacted me to say that I was a powerful advocate for the cause of screening in men. Men are the world’s worst at looking after their health so I’d encourage them to get the test done. “We kept it from my grandkids when I was sick, so when the little lad, who is eight, heard me on the radio he asked my wife Catherine if I was going to die and she said, ‘No, no, no.’ They were too busy jumping around excited about granddad being on the telly to hear what I said on Ireland AM. When they see it in years to come they will understand much better. “I’d say to anyone interested in telling their story that they should just let themselves be guided by the HSE communications staff. There’s no need to dramatise the story, just tell it like it is and people will listen.” National Screening Service communications team worked on the campaign with the new National Press Office proactive media team. The team pitched Nicky’s story to different members of the media, arranged interviews and liaised directly with him on the arrangements. The BowelScreen Programme, NSS communications and the HSE Press Office are sincerely grateful for Nicky’s help with the campaign. After a hugely successful Bowel Cancer Awareness Month, Nicky is now considering joining BowelScreen’s Public Patient Representative panel so he can keep working towards a greater uptake of BowelScreen. Visit BowelScreen.ie for more information.

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TAOISEACH VISITS CROSS-BORDER HEALTH SERVICES IN THE NORTH WEST Attendees at the NEIS Tririga Training Session at HSE Scott Building, Tullamore. Sitting from left to right: Jack Cunningham, Electrical/Mechanical Foreman; Grace Kenny, Staff Officer; Colm Masterson; Maintenance Officer; Patrick LynamMaintenance Manager, Paul Cuskelly, Building Foreman; and Brendan Cuskelly, Engineer Officer L/O.

SIGNIFICATION MILESTONE ACHIEVED BY HSE NATIONAL ESTATES INFORMATION SYSTEM (NEIS)

Minister Charlie McConalogue; Bill Forbes, Co-operation and Working Together (CAWT) Chief Officer; Neil Guckian, Chief Executive, Western Health & Social Care Trust; Taoiseach Micheál Martin; Paula Keon, HSE Assistant National Director, EU & North South Unit; and Damien McCallion, CAWT Director General.

The cross-border North West Cancer Centre (NWCC) was among the stops on Taoiseach Micheál Martin’s two-day visit to Derry. The centre is a joint North South capital build, serving patients from Donegal, Derry and beyond. The centre, based in Altnagelvin in Derry, is now in its sixth year of operation. Cancer patients from Donegal have been able to avail of radiotherapy services here since November 2016. Over 4,200 patients from the north west of Ireland have had their radiotherapy treatment locally, with over 1,000 patients treated each year in 2020 and 2021. The centre provides a range of radical and palliative treatments including access to emergency radiotherapy. NWCC has brought huge benefits by offering innovative and lifesaving treatments and reducing waiting times for patients from the Western Trust and Letterkenny University Hospital areas. Over 850 patients from the Republic of Ireland have accessed radiotherapy locally at the NWCC across a range of tumour sites since the centre opened. The Taoiseach also visited Altnagelvin Hospital where he met staff who provide the primary percutaneous coronary intervention (pPCI) service which caters for emergency pPCI patients from both sides of the border, along with meeting medical students at the Ulster University at Magee. He and Minister for Agriculture, Food and the Marine Charlie McConalogue were given a tour of the catheteristion laboratory, one of the services provided in Altnagelvin hospital for patients from Donegal. A total of 80 patients from Donegal were accepted for pPCI & urgent catheterization in the 10-month period to February 28th 2022. Western Trust Chief Executive Neil Guckian said, “Cross-border treatment and care provided at Altnagelvin Hospital is an example of collaborative expertise between clinicians, nurses, and management at the hospital alongside HSE colleagues.”

-Another significant milestone was achieved in April for NEIS with the completion of the Operations & Maintenance / Medical Equipment module. This module allows the HSE to manage traditional maintenance activities through the new IBM TRIRIGA platform and is available and intended for use by all HSE and HSE funded Maintenance Departments. The first go-live sites included both HSE and Voluntary Acute Hospitals and a number of CHO areas with the first cohort of early adopters logging maintenance requests from over 1,500 health care buildings. The activities include planned and reactive maintenance tasks required to keep HSE facilities and equipment operating at optimum levels for frontline service delivery. The Midland Regional Hospital Tullamore (MRHT) is the National Digital Health Innovation Lab pioneering the use of a number of digital solutions to improve health care delivery across the HSE. MRHT is also the first of the initial NEIS Tririga O&M pilot sites, pioneering the use of NEIS in a live acute setting. In parallel to the training and implementation at the initial pilot sites, the NEIS team are currently engaging with other areas for adoption, with a planned second phase rollout scheduled for October. For more information, you can access the NEIS Webpage on HSE.ie here NEIS helpdesk is now live and welcomes any feedback, queries or suggestions to NEIS.Support@hse.ie

Professor Mary McCarron, Director of the Trinity Centre for Aging & Intellectual Disability; and Professor Seán Kennelly, Clinical Director of the NIDMS and Director of the TUH Institute for Memory & Cognition.

MEMORY CLINIC IN TUH SECURES LONG-TERM FUNDING A new National Intellectual Disability Memory Service has been set up at Tallaght University Hospital (TUH) to treat people with intellectual disabilities who are at high risk of developing dementia. The new centre is called the National Intellectual Disability Memory Service (NIDMS), a partnership with the Hospital, Trinity College Dublin and AVISTA. Initially a trial clinic, permanent funding has been provided by the HSE National Dementia Office. It is the only one of its kind in Ireland with only a handful of such clinics available internationally. One sibling of a loved one who has attended this new memory clinic said, “My brother received a diagnosis of dementia. I found the whole process from assessment to post-diagnostic support so positive. I was listened to by the staff in NIDMS. My brother is benefitting from having the diagnosis as he now gets home care support hours. He enjoys the one-to-one time, walks and coffee with the paid carer, opening up a new social dimension he has not had previously."

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COOMBE HOSPITAL MARKS INTERNATIONAL DAY OF THE MIDWIFE WITH ANNOUNCEMENT OF RECRUITMENT DRIVE The Coombe Women & Infants University Hospital announced that it is recruiting for 29 new midwives as it marked International Day of the Midwife 2022, a worldwide celebration of midwives and their dedicated work. The vacant posts include Staff Midwives, Community Midwives, Clinical Midwifery Specialists, Clinical Skills Facilitators, Advanced Midwifery Practice and Theatre posts. The Coombe currently employs over 280 midwives. Ann MacIntyre, Director of Midwifery & Nursing at the Coombe Women & Infants University Hospital, said, “Midwives have been providing excellent care to women and babies at the Coombe for almost 200 years, and International Day of the Midwife gives us the chance to celebrate this. We’re delighted to be recruiting 29 new colleagues to join our fantastic midwifery team at the Coombe.” Saira Munir, midwife at the Coombe

Women & Infants University Hospital, said, “The Coombe is a wonderful place to work and I’m very proud to be a part of our fantastic midwifery team. Being a midwife doesn’t come without its challenges, so it’s great to be a part of such a hugely supportive team, from varying backgrounds and levels of experience. To be able to celebrate midwives across the world, and my own colleagues and friends,

Midwives Daniela Popa, Saira Munir with her colleagues and Professor Michael P O’ Connell, Master Obstetrics & Gynaecology. Photo: Jason Clarke

on International Day of the Midwife is something really special.” The theme of this year’s International Day of the Midwife was ‘100 Years of Progress,’ reflecting on progress in midwifery over the past 100 years. Midwives interested in joining the team at the Coombe should contact hr@coombe.ie.

LAUNCH OF CLINICAL SIMULATION FACILITY IN GALWAY BY MINISTER FOR HEALTH A state-of-the-art medical training facility spanning more than 1000m2 with more than 20 immersive learning rooms fitted out to hospital standard and simulating all aspects of a leading healthcare environment was officially launched recently. Based at NUI Galway’s Clinical Science Institute, on the grounds of University Hospital Galway, it is the largest and most modern facility of its kind on a clinical site in Ireland. The facility is a partnership between NUI Galway and Saolta University Healthcare Group. NUI Galway’s Clinical Simulation and Interprofessional Education Facility is unique in its co-location on a clinical site and medical school. It includes: • Skills labs, operating theatres, ICU space, emergency bays, in-patient wards, outpatient consultation rooms, delivery suites.

• Complex manikins range in age from premature infants to adults and maternity manikins simulate pregnancy and childbirth. • Audio-visual system for recording training, streaming and linking to all areas of Saolta University Healthcare Group • Education and training for more than 600 medical students in clinical years and accessible space for more than 4,000 multi-professional clinical staff in Galway University Hospitals. • Observational rooms with oneway glass and multi-functional rooms with mobile furniture, easily switching from clinical to tutorial and debrief rooms. The official opening took place alongside the launch of the National Strategic Guide for the

Implementation of Simulation on Clinical Sites which provides a framework for the resourcing and delivery of sustainable simulation that is multi-professional with a focus in team training for patient safety.

Minister for Health, Stephen Donnelly TD; Prof Martin O’Donnell, Dean of NUI Galway College of Medicine, Nursing and Health Sciences; Professor of Simulation Education Dara Byrne, School of Medicine, NUI Galway and Saolta University Health Care Group; Dr Brian Kinirons, Director of NDTP; Tony Canavan, CEO, Saolta University Health Care Group; NUI Galway President, Professor Ciarán Ó hÓgartaigh; Prof Helen Whelton, Chief Academic Officer, South / South West Hospitals Group; Prof Paul Burke, Chief Academic Officer, UL Hospitals Group; and Professor Anthony O’Regan, Chief Academic Officer, Saolta University Health Care Group and NUI Galway. Photo: Martina Regan

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REFURBISHED LABOUR AND BIRTHING UNIT OPENS ON INTERNATIONAL WOMEN’S DAY

The National Maternity, Ireland’s centre of excellence for maternal and women’s health, officially opened its doors to a fully-refurbished Labour & Birthing Unit in honour of International Women’s Day recently. Five additional ensuite rooms have been added, as well as ensuites added to five pre-existing rooms, bringing the total number of rooms in the unit to 14, 12 of which have an ensuite. A dedicated bereavement suite and hydrotherapy pool as well as a state-of-the-art specialised room to care for immunocompromised patients have also been added to the unit. The introduction of a hydrotherapy pool gives women between 37 and 42 weeks of pregnancy with no medical, surgical or obstetrical risk factors or complications the choice to avail of water immersion or hydrotherapy during labour. Professor Shane Higgins, Master at The National Maternity Hospital, said, “The extension to the Delivery Suite is a significant improvement to the previous facilities, which had become untenable. This unit is larger in size, and enhances the birthing experience for a woman, offering calm and comfortable surroundings and affords respect for privacy and choice. The addition of the hydrotherapy pool and mobility corridor are part of our commitment to holistic care aimed at supporting normal birth.” Speaking about the transformation of care at the opening, Martina Cronin, Labour & Birthing Unit Manager, said, “Today, every woman who comes through our doors, irrespective of their care/support needs, can be provided with that care - choice can be facilitated. Consideration was also given to providing a private, quiet space for bereaved couples and their baby. We believe that the bereavement suite will provide the compassionate and respectful care required at this difficult time for our mothers and their partners.”

Learning Talks Podcast Launched

Leadership, Learning and Talent Management, part of the Capability and Culture team in National HR, has launched a new podcast for HSE staff called Learning Talks=’. The Learning Talks Podcast aims to explore topical issues from areas such as Management, Leadership, HR and People Management. In the first episode, we are joined by Professor Colm Foster of the Irish Management Institute to explore Compassionate Leadership. Colm shares his insight about what compassionate leadership is, the role that selfcompassion plays and some of the skills and behaviours needed to develop a more compassionate leadership approach. We also discuss how compassionate leadership relates to psychological safety and the importance of creating an environment where people can lead with compassion. The Learning Talks Podcast is available now on the Discovery Zone on HSeLanD and can be listened to on your PC or on your phone: To access on your PC: 1. Login to hseland.ie 2. Select Hubs & Resources and scroll down to find the ‘Discovery Zone’ 3. Type Podcast into the search bar and select the ‘Learning Talks’ podcast To access on your Phone: 1. Login to hseland.ie 2. Select the Menu Bars on the top right of the screen 3. Select Hubs & Resources and scroll down to find the ‘Discovery Zone’ 4. Type Podcast into the search bar and select the ‘Learning Talks’ podcast

NATIONAL MATERNITY HOSPITAL JOINS GLOBAL CHAIN OF LIGHT FOR RARE DISEASE DAY The National Maternity Hospital (NMH) joined forces with the 300 million people living with a rare disease, their families and carers worldwide by turning green, blue, purple and pink to raise awareness and generate change for Rare Disease Day. Rare Disease Day is an annual awareness day dedicated to elevating public understanding of rare diseases and calling attention to the special challenges people face. In August 2021, The National Maternity Hospital became the only hospital in Ireland to offer a Perinatal Genomics Service for women and their partners in pregnancy who receive the news that their baby has abnormalities on scan, are at risk of their

baby inheriting a genetic condition, lose a baby in pregnancy or suffer recurrent pregnancy losses. Since then, it has seen over 150 patients at its clinic. The service aims to provide patient centred, timely, equitable and innovative care to couples who are faced with a congenital anomaly or facing a pregnancy where there is a risk of a genetic diagnosis. There is no waiting list and pregnant patients are contacted within 24 hours of referral and seen at a time that suits them to discuss results or further testing. Dr Sam Doyle, a consultant Clinical and Biochemical Geneticist with specialist expertise in reproductive genomics, is the

lead clinician of the service. “Traditionally, patients described a diagnostic odyssey, which went on for years. In that time, many incorrect diagnoses are made along with difficult, sometimes painful procedures and additional hospital appointments. Parents can be devastated by what they are experiencing. They have many questions, which need to be answered, so that they can plan for the health of their baby. Early diagnosis means that patient centred treatment is initiated at birth, indeed in time, there may be in pregnancy treatments, which will improve outcomes,” said Dr Doyle. For further information, visit www.nmh.ie

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‘RENEWED HOPE WE CAN TACKLE WAITING LISTS’ HSE CEO TELLS LIMERICK SURGICAL CONFERENCE

Pictured at Tallaght University Hospital are Paul Gannon, Senior Vice President of Business Development at Kainos; Minister for Health Stephen Donnelly; and Ciara Blair, EPR Programme Manager at TUH. Photo: Shane O’Neill, Coalesce

ELECTRONIC PATIENT RECORD SYSTEM GOES LIVE AT TALLAGHT The new Electronic Patient Record (EPR) system for Tallaght University Hospital (TUH), developed in partnership with digital technology company Kainos, has gone live for the first time. Synergy, based on the Evolve Cloud platform, furthers TUH’s strategic goal of creating a ‘hospital without walls’, ensuring all patients and staff have access to the latest patient information across the hospital and its multiple locations in the community. Synergy provides healthcare staff with rapid, ‘single view’ access to examine and review a person’s test results, medications, discharge summaries and more across the multiple departments that can be involved in a patient’s healthcare journey. The system is already delivering benefits to patients, clinicians and the hospital as a whole. TUH sees and treats over 300,000 patients annually, with the new system having the capacity to facilitate the hospital as it grows and expands its services. The roll-out of Synergy throughout 2021 continued despite the challenges posed by the COVID-19 pandemic and the cyberattack on Ireland’s health infrastructure. EPR programme manager at TUH Ciara Blair, a former occupational therapist at the Hospital, said, “Synergy has taken a number of different systems that struggled to integrate with each other, and streamlined the flow of information. One colleague recently told me how they saved three hours when validating waiting lists, and how that freed them up to complete other tasks instead. Ultimately, this will benefit all patients of the hospital, whether they attend the main campus or any of our community locations.”

Recent easing of COVID-19 restrictions offered “renewed hope that we are moving towards a more normal environment in which we can tackle waiting lists, change and improve how we do many things and build on innovations made during the pandemic”, Paul Reid, CEO of the Health Service Executive, said in his address to one of Ireland’s largest surgical conferences. The Sylvester O’Halloran Perioperative Symposium, hosted by UL Hospitals Group, was hosted online in what is now the single largest national surgical meeting in Ireland. Among the keynote speakers this year were Mr Reid; Dr Catherine Motherway, Consultant Anaesthetist, University Hospital Limerick; and Prof Luke O’Neill, Chair, School of Biochemistry and Immunology, Trinity College Dublin. “Given the precedence which COVID-19 has taken over many important things, it is my intention in the year ahead to devote substantial efforts to the issue of unacceptable waiting times for scheduled care. This will not be an easy task if we do not bring COVID-19 under control again but we have a number of different levers to assist us next year, not least

through the continuation of our strong partnerships with the voluntary and the private sectors,” said Mr Reid. “Through the Multi-Annual Waiting List Plan, being developed jointly with the Department of Health and with the support of the clinical community, we are determined to make significant improvements to unacceptable waiting times, and to embark upon a cycle of yearon-year improvement.” The hosting of the event coincided with the publication of the 2022 Waiting List Action Plan and HSE National Service Plan 2022, both of which set out new targets on waiting lists, with a focus on the longest waiters. Dr Catherine Motherway delivered this year’s Sir Thomas Myles Lecture on ‘COVID-19 and Perioperative Care: A Wake Up Call! Plan for the Future’, focusing particularly on how the pandemic has affected perioperative patients.

CARE CENTRE RESIDENTS AND STAFF HOLD UKRAINE FUNDRAISER Residents and staff in the Waterford Residential Care Centre and their families have held a fundraising coffee morning this week to aid people in the Ukraine. The event was also to demonstrate solidarity with and support for Ukraine from all those on the Waterford Residential Care Centre campus, including St. Aidan’s Unit, the Waterford Home Care Team and the Waterford Integrated Care for Older Persons (WICOP) unit at St Patrick’s Hospital. A total of €910 was raised towards relief efforts, as part of the Irish Red Cross’s Ukraine Crisis Appeal. Barry Power, Director of Nursing at the Waterford Residential Care Centre, said there was an extraordinary response for the initiative. “There are residents living here in the Waterford Residential Care Centre who have memories of wars occurring in the world in their youth and

their thoughts and prayers are with those affected by this current conflict. "Our staff, as healthcare workers, are also conscious of the dangerous circumstances facing people engaged in such work in the Ukraine. It was great, therefore, to be able to have a coffee morning both to register our solidarity but also to make a practical contribution. "The residents were also delighted that Harley - our very popular therapy dog turned up for the occasion! I would like to thank everybody for their kindness and generosity. Our €910 is being donated to the outstanding work of the Red Cross.”

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CONTACT TRACERS THROW THEIR ARMS AROUND THEIR WORKPLACES Energy and creativity of teams embody Values in Action

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taff in the National Contact Management Program (CMP) arrived in the HSE in momentous times as the whole country was grappling with the COVID-19 pandemic. They have become the latest staff population to embrace the 9 Values in Action (VIA) behaviours to create their positive work place culture. In early February, after connecting online and planning events, contact management staff committed to implementing Values in Action and getting their arms around their own workplaces. Demonstrating tremendous energy and creativity, the CMP staff are well underway to living the 9 behaviours and making these central to how they do their work. Moving stories were shared in real time by Contact Tracers where they put themselves in the shoes of the public whom they were supporting, whether a confirmed COVID-19 patient or a close contact. With headsets and laptops in front of them the callers were transported into the unique situation in each person’s home or workplace. They shared stories of toddlers taking first steps whilst a parent was taking a contact tracing call and pausing the process to ensure parents got to capture the magical moment, to terribly sad stories where a close contacts had lost loved ones to COVID-19. One staff member noted, “Some difficult calls can be tough to deal with, especially cases isolating in hospital. The support of shift leads has made these calls easier, I found the encouragement of headspace walks when overwhelmed extremely helpful.”

While the service may have been born out of urgent necessity, the staff are taking steps to make sure that their workplace culture is something that they choose and shape for themselves. And they are bursting with energy and innovation to make this happen. Staff in the Galway Contact Tracing Centre (CTC) have been busy putting the HSE Values into Action since joining the initiative this February. Due to staffing requirements, annual leave requests cannot always be approved on certain days. To overcome this they started a shift swap initiative where colleagues on different shifts could offer to swap with someone else in order to accommodate the day they need off. This has been a huge success, facilitating colleagues and showing an act of kindness. The Hindu festival of colours, Holi, was celebrated in HSQCTC on the 16th March. Staff from over 17 different nationalities joined with our Hindu colleagues in celebrating Holi with bright colours and fabulous, home cooked, Indian food. Fatima and Ayesha explained that the idea of celebrating Holi started as part of the Values in Action movement. There are 16 Indian nationals working in one area of the Contact Tracing Centre, the Data Processing Team. They realised when talking to each other that they had not been home in over three years due to COVID-19 and were missing their favourite festival, Holi. They decided to have a low-key celebration, which, in turn, became the focus of all the CTC as everyone wanted to take part. As well as face painting, staff brought in white tee shirts and

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had great fun painting each other with an array of wonderful colours in the colours station. The third floor of the CTC was adorned with colour themed decorations and a hand drawn mandala art design was put up on the wall. Everyone joined in painting a section with their favourite colours. Then the food came out! Our Indian colleagues took immense pleasure in telling their colleagues about each dish and encouraging everyone to have a taste. It was feast fit for a king! If only every lunch break could be like this. Focussing on the Values in Action behaviours really helped bring the staff of the CTC together to share in this wonderful festival, acknowledging the cultural diversity amongst our staff and joining in celebrating important moments with each other. Another VIA initiative was to highlight our cultural diversity. Flags were displayed with the word Hello printed in the national language to represent each member of staff working in the CTC. It has brought the CTC closer together and has been a talking point amongst the staff, encouraging people to discuss their culture and heritage. This has resulted in staff getting to know each other and realising how diverse a group we are, but united in our response to COVID-19. Similarly, the Cork CTC Team creatively used the occasion of St Patrick’s Day to create a buzz and an atmosphere that spurred connectivity. Everyone was invited to wear the national colours or wear blue and yellow to acknowledge the war in Ukraine. There was also a fundraiser held for Ukraine. Cork CTC have also started to hold a team meeting at the end of each day to discuss any difficult calls, or share nice calls and reflect on anything they have learned from the day.

If you would think the Values in Action behaviours could help improve the culture where you work you can get in touch with your local management or contact the National Engagement & Culture team by emailing info. valuesinaction@hse.ie

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“IT’S ENJOYABLE AND REWARDING HELPING PEOPLE AT THE TIME OF THEIR WORST NEED.” People from all walks of life joining the HSE’s National Ambulance Service

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eople from all walks of life have joined the HSE’s National Ambulance Service (NAS) in recent years building careers and playing an important role in their local communities. 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. Emergency Medical Technicians are involved in the transfer of patients to specialist services and locations and in caring for them. The recent National Ambulance Service recruitment campaign confronts the idea that jobs in the National Ambulance Service (NAS) are only for a very limited range of people. In fact the National Ambulance Service has jobs for people from all walks of life. Explaining the reasons why he joined NAS, James Kelly said he became interested in working for the ambulance service while working as a Fitness Instructor and Personal Trainer. “While working at the gym I did a CFR (Cardiac First Responder) course. I really enjoyed it and after that I decided to pursue an Emergency Medical Technician (EMT) course.” He became an EMT and then went to England where he trained and worked as a paramedic. “It was always my plan to come back and when I did I joined the NAS.” James is now an Advanced Paramedic based in Loughlinstown in Co Dublin which is 20 minutes away from his home. Aoife Walsh worked as a Healthcare Assistant in the Children’s Hospital, Crumlin for almost a decade before deciding to join the National Ambulance Service. Now 30 years of age, Aoife is currently a Post Graduate Paramedic having spent ten months at the National Ambulance Service College as a Student Paramedic.

“I’m working on the road now as part of a crew and I am enjoying being part of the team as well as completing my college course. When you finish you have a degree and while you are doing the course you get paid which is great,” said Aoife. “I’ve always worked in healthcare so the healthcare environment is very familiar to me and I enjoy the work.” Mark Lynch worked as a physical therapist for 14 years in the Kells area before joining the ambulance service. “I worked with all types of athletes like gaelic, soccer and rugby players treating sports injuries and doing sports massages. However I always wanted to work in the ambulance service and when the opportunity came up to join as an Emergency Medical Technician I just went for it. “I really love it. I’ve been an EMT now for five years. It’s very rewarding looking after patients making them feel a bit better and secure. “My current role also allows me to spend more time with my two young children which is great for the family.” Karen Seabrooke worked in Sterile Services Management at a major Dublin hospital for 11 years before joining the ambulance service. While working at Beaumont Hospital, Karen learned all about the preparation and sterilisation of surgical instruments as well as their decontamination. Karen also spent many years working in a pharmacy and also worked as a dental nurse. A few years ago Karen started working for a private ambulance company and also completed an EMT training course and was registered with the Pre Hospital Emergency Care Council. “I’ve been working as an EMT in the Navan area now where I live for the past four years. We work during the day doing interhospital transfers and I also work on the Bumbulance, the children’s ambulance.

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“It’s enjoyable and rewarding helping people at the time of their “You can either be driving the ambulance or attending to the worst need. I would say to anyone if this is what they want to do to patient in the back. I’m passionate about healthcare. It can be very take the risk and apply.” rewarding. I love the job. It’s what you make of it yourself.” As well as recruiting for paramedics and EMTs, the National Brian Coughlan is approaching his 60th birthday and never thought Ambulance Service is also planning to recruit for Emergency Call he would be working for the National Ambulance Service (NAS). “I worked in Eircom in IT for 18 years and was a software engineer. I Takers in the near future. took voluntary redundancy and was looking for work. One day the Vicky O’Meade is a cancer survivor who joined the National Ambulance Service as an Emergency Call Taker in her early Recruitment Agency gave me a call and asked me to do an interview thirties. “In my early twenties I got cancer and I received so much for a job as an Emergency Call Taker. help from the ambulance crews going back and “It’s a job I never saw myself doing but with forth to hospital. They inspired me when I saw training and the support of great colleagues the work that they do. I wanted to know how I am now working as an Emergency Call I could help and when I looked into it I felt I Taker for three years. could work in the Control Room as an “It’s completely different to what I was used To find out more about some Emergency Call Taker.” and never in a million years did I think I would of the great work being carried out by the National Ambulance Vicky worked in child care for a number of years be working for the ambulance service. I like Service, see pages 36 and 37. the variety of the job. You never know what after recovering from cancer and then applied to type of calls you are going to get. join the National Ambulance Service (NAS). “It’s great to be able to help people and you “I always had an interest in the Ambulance feel good when there is a good outcome. There Service and when it came up I just went for it. I is real teamwork here so you are never on your own. There is always wanted a career and now I have it. After the interview process I did four weeks training and now I am part of the training team, training help and support nearby. “I would say to someone interested to try for new Emergency Call Takers. it. I didn’t think I would be able for it and I am working away at it now.”

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Quitting Death of close friend a wake-up call for smoker Lucas

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atching a close friend forced into quitting smoking after a heart attack was a significant wake-up call for 40-year-old Lucas Marques whose quit journey began just over a year ago. “My friend was in his fifties, living on his own when he had the heart attack. He nearly died. It was such a shock and such a wake-up call. He was a smoker and that was a major contributor to his heart disease. I saw directly the impact of smoking. So when I saw him quit in the immediate aftermath I just knew I had to finally do it,” explained Lucas. “I had tried before to quit a couple of times but this just added to my motivation. I saw how my friend had been effectively forced into quitting smoking. I didn’t want to be pushed by some health scare like that.” Already experiencing some shortness of breath when he exercised, Lucas says he knew it could potentially get much worse and did not want to wait for that to happen. A year later and he is now a confirmed and committed quitter. His friend is doing well and is also a confirmed quitter heading for his two-year anniversary. “We were out last year for my birthday and it was funny because we were both saying at that point we just didn’t want to be anywhere near smokers as we couldn’t take the smell. I even wondered how I didn’t

realise when I was smoking the impact it had on others around me,” he said. Originally from Brazil, Lucas came to Ireland 10 years ago to learn English and stayed to become an Irish citizen. Based in Dublin, he has been working in the financial arena with Pobal for over four years which he enjoys. While originally quite a heavy smoker, Lucas says that in recent years he had contained himself to five cigarettes a day but acknowledges that when out and socialising, that was increase substantially. “I would easily smoke a full pack of cigarettes,” he admitted. Lucas says he did not particularly feel conscientious about the impact on his health until he hit his thirties. “I just realised that I wasn’t twenty-something any more. So I initially tried to cut down on the number of cigarettes I smoked but as much as I tried – I just couldn’t get any lower than the five a day and that obviously increased when I was socialising. So I just knew it was an addiction. I did try to quit completely – twice and neither times were successful. It was really hard with the cravings and the withdrawal,” he said. However, the confluence of his friend’s health scare and his own realisation that his fitness levels were dropping led Lucas to participate in a webinar which in turn led him to contact the HSE Quit Team to seek support in giving up smoking. This would constitute his third attempt. Crucially however, this time there would be a plan, support and positive communication. “I made contact with the HSE Quit Team and they were really good. I spoke with a Smoking Cessation Officer; he was really friendly and gave me some great advice. It was great – he was really there for me which was really helpful. He listened to my concerns. So we put a plan together to help over the next few weeks. I got support in using nicotine pads and that really worked for me. He followed up with me over the next number of weeks and kept in contact throughout.” Having now passed his first anniversary, Lucas is delighted to be able to acknowledge that he is now a ‘quitter’. And when he was tempted by the cigarettes Lucas says he knew to use the tips and habits he was encouraged to use – such as drinking a glass of water instead. “I would just remind myself of the reasons why I gave up in the first place. Essentially the main reason I quit was for my health. Even when I was smoking I always tried to run and cycle to keep healthy. One day when I was out cycling, I became very short of breath and I knew something was not right. That and obviously my friend’s heart attack were big wake-up calls.” Overall Lucas is very clear that the most successful way to quit is through a supported structure. The HSE Quit Team were fundamentally the reason he was able to find the strength and resilience to finally make his quit desire happen. “It was so good. They were great – the plan we put in place, the tips, the support, the phone calls, the messages, it all added up and made such a difference. Overall, Lucas sums up his advice: “Keep trying and get help – that’s step number one but it’s also the most important step.”

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MY KIDS REALLY WANT ME TO QUIT THE HABIT IT SMOKING: 42-year-old Sligo native Rory Foley had been smoking since he was 16. He knew he finally needed to kick the habit for good for the sake of his children. “I love my job as a postman. It is the best job I have ever had. I deliver parcels some of the time which involves climbing stairs in apartment buildings. Smoking and climbing stairs are not a good partnership,” said Rory. “However, I have much bigger reasons to quit. I lost my wife to cancer seven years ago. She was just 32 years and my children were seven and two years of age at the time. I do not want to expose my kids to cancer again. I have tried and successfully given up cigarettes before. I entered the pandemic smoke free but fell off the wagon.” This time round he attended the HSE Stop Smoking Service. “This is a free service and I cannot praise it highly enough. Edel Hunt was my stop smoking adviser. She helped me to prepare for quitting and supported me along the journey. I used the patch for two weeks, the spray once and the ‘fidget’ was fantastic for keeping my hands occupied. Edel explained that a big part of smoking is the habit in particular the hand to mouth habit. The nicotine replacement therapy deals more with the craving so it’s the combination of working on both habit and addiction to nicotine that made my quitting journey possible,” Rory explained. He said he slowly began to feel the benefits of quitting. “I put my quitting plans all over social media. This helps me to be accountable. People ask me in the streets if I am still off the cigarettes. This helps me stay determined on days when I have cravings. I have plans this year that do not include smoking. I hope to compete at the European Championships in Brazilian Jiu-Jitsu. I train in the gym two to three times weekly and in Atlantic Jiu-Jitsu Sligo four to six times weekly. I walk out of there feeling energised and determined to stay smoke-free,” he said. “My kids want me to quit smoking. I want to quit smoking for myself. Smoking is like burning money. I am stubborn. I want this to be my last quit attempt.”

You are four times more likely to quit with the help of a Stop Smoking Adviser and Nicotine Replacement Therapy (NRT). If you are ready to QUIT we are ready to help you. Contact the national QUIT support team on 1800 201203 or www.quit.ie

SO UT H E AST ’ S 10 0 TH “ S MOKE F R E E BA BY” D U E ON AS H WE D N E S DAY Over 100 ‘smoke-free babies’ have been born in HSE South East Community Healthcare since January 2020 thanks to the ‘Supporting Pregnant Women to Quit and Stay Quit’ programme. Supported by the government’s Sláintecare strategy for its aims of integrating hospital and primary care services, the programme operates as a free, dedicated support for pregnant women. It takes referrals of pregnant women, in addition to partners and family members, from the four maternity departments of acute hospitals in the South East (University Hospital Waterford, Wexford General Hospital, St Luke’s General Hospital Carlow/Kilkenny and Tipperary University Hospitals) and from primary care and community services in counties Carlow, Kilkenny, South Tipperary, Waterford and Wexford. In its two years of operation, some 1,300 referrals have been made to the ‘Supporting Pregnant Women to Quit and Stay Quit’ programme. Working with specially trained Smoking Cessation Officers, over 300 participants have achieved a ‘quit date’ within weeks. In December 2021, upon completion of its pilot phase, the project has been selected for ongoing funding and two new Health Promotion Officers will be appointed to deliver dedicated services to the maternity population and their extended family. They have seen an average rate of one baby per week or so being born into what previously was a smoking environment but now is not. Marking the success of the Sláintecare integrated care programme and looking forward to it reaching its latest milestone, Kate Cassidy, a Health and Wellbeing Officer with the HSE/South

East Community Healthcare services, said, “Stopping smoking is the best thing you can do for yourself and your baby. We know, of course, that it can be difficult to do. We also know, however, that parents want to give their baby the best possible start in life. By using our 1:1 intensive stop smoking service or telephone support, participants can increase their chances of For more information, contact the Quit line quitting fourfold. • Quit website: www.quit.ie “Nearly half of pregnant • Free Helpline: 1800 201 203 women who set a quit date with • Email support: support@quit.ie • Free text support: text Quit to 50100 their stop smoking service go on • Facebook: www.facebook.com/HSEquit to quit successfully. No matter • Twitter: Tweet@HSEQuitTeam what stage you or your partner are at in your pregnancy, it is never too late to stop smoking. “You will get the support you need and not be judged. Ask your midwife, GP, healthcare provider or practice nurse to refer yourself to the ‘Supporting Pregnant Women to Quit and Stay Quit’. “Once referred, a Smoking Cessation Officer will talk to you about your smoking habits and help you to build a plan to quit smoking. They will help you build confidence and motivate you to quit.” This service, across the South East, is offered free to all pregnant women, women who have had babies or women planning to become pregnant, their partner/spouse and others in the household who want to quit smoking.

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COVID CAPSULE Time capsule will give insight into pandemic life

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Tara De Buitlear, TCC & PCAC member; Lucy Nugent, Chief Executive of TUH; Michael O’Reilly, Assistant Chief Fire Officer; Liz Kennedy, Voluntary Chair, TCC; Deirdre McKeon, Area Manager, Training Centre, Tallaght; Sinead Tighe (representing Tallaght Person of The Year), Alison Baker Kerrigan TUH Arts Officer and Albert Perris, Tallaght Community Council.

allaght Hospital were recently invited to host the burial of a COVID-19 time capsule, which acts as a snapshot of the lived experiences of people in Tallaght during the pandemic. Representatives from the community including members of Tallaght Community Council (TCC), who spearheaded the project, attended the burial of the time capsule at the rear of the hospital. Individuals and groups from across the community contributed items to the capsule which contained hundreds of items, these groups/individuals included

DEFENCE FORCES LEAVE LASTING IMPRESSION AFTER VACCINATION EFFORTS A special Recognition Event was held to pay tribute to and mark the contribution of the Defence Force members when their assignment to the Cavan COVID-19 Vaccination Centre ended. The Defence Forces from the 27 Infantry Battalion based at Dundalk supported the vaccination programme throughout key periods in 2021 and 2022.

Members were primarily involved in logistics and pharmacy support but their roles varied during their time at the centre. Operational Site Manager Eddie Ward said Defence Force personnel left a lasting impression on staff and will be greatly missed. “There is a mutual understanding and respect between vaccination centre staff and the Defence Forces about each other’s roles. I’d like to thank the Defence Forces for their immense contribution towards the success of the COVID-19 vaccination programme. Great friendships and bonds of respect have been formed here at the centre. The Defence Forces were absolutely superb. Their level of professionalism and commitment to the

local schoolchildren, staff from The Square Shopping Centre, a local COPD support group and the Hospital among others. Commenting at the burial of the capsule, Lucy Nugent, chief executive of Tallaght University Hospital, said: “It was a huge honour for the Hospital to be invited to host the community capsule on our campus and be its custodian for the next few decades. We are in Tallaght for nearly 25 years and so many of our staff moved from across the country and indeed the world and have made Tallaght their home, as an organisation we are part of the community and so are our staff. “We are fortunate to have always received so much support from the local community and never more so during the pandemic and all the challenges it has presented and indeed continues to present.”

vaccination programme impressed every member of staff.” Mr Ward also said the Defence Forces need to be credited for their contribution towards the success of the children’s vaccination programme. “They were so warm and attentive to those with additional needs and the most vulnerable in our society. They threw themselves head, heart and soul into the vaccination programme, and really engaged with the children attending for their vaccination. They were instrumental with the success of the 5-11 year olds vaccination programme success.” At the Recognition Event, Defence Force

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Collective effort praised as vaccination centres wind down

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s the vaccination programme began to wind down, a number of vaccination centres closed their doors for the final time over the last few months. Frank Harburn, Saolta General Manager for the rollout of the vaccination programme in the West and North West, paid tribute to the efforts of staff as the final COVID-19 vaccination clinic took place in the Roscommon Vaccination Centre. “The first public vaccination clinic in Roscommon Town took place on March 21st 2021 in the Abbey Hotel and since that date the vaccination team administered over 52,000 vaccines at clinics in the vaccination centres, to residents and staff of long term care facilities, to healthcare staff, to patients in Roscommon University Hospital and to people who are housebound. This is an incredible achievement given that the vaccination team also relocated the centre twice - to Kilbride Community Centre in August and back to Roscommon Town centre in December 2021.” Paul Hooton, Saolta Executive Lead for the vaccination programme, said, “I would like to pay tribute to all the staff in the vaccination centres for their incredible commitment to providing the best service to the thousands of people who have come to the vaccination clinics in Roscommon. The vaccination programme was very fast moving and ever-changing with new vaccines and new age groups becoming eligible which required the staff to adapt quickly; a task at which they excelled with a can-do attitude and a personal approach to every vaccine administered. “This has been a collective effort with many different organisations coming together to deliver a ground-breaking vaccination programme of this scale and I would also like to thank our colleagues in Roscommon University Hospital and Community Healthcare West, the National Ambulance Service, the Defence Forces, Roscommon County Council and other voluntary organisations, for their contribution to the success of the public vaccination centres in Roscommon.”

members were each presented with a specially commissioned rainbow pen. The rainbow pens were handcrafted in Co Cavan. CHO 1 Lead for COVID-19 Vaccination Programme and CHO 1 Head of Service for Health and Wellbeing Cara O’Neill said, “We will never be able to fully express our gratitude to the Defence Forces for coming to our aid during the pandemic. Their contribution has been immeasurable and we wish them all the very best in the future.” A spokesperson for the Defence Forces said, “The role played by the Irish Defence Forces in the inter-agency response to the COVID pandemic has allowed us to show our capabilities and showcase our ability to

respond at short notice to crises on the island. As an organisation we are extremely adept at offering the flexibility and agility required when unexpected situations arise. For those Irish citizens who do not know what it is exactly that we do, our visibility and presence at test centres and especially at vaccination centres provides tangible evidence of the significant role we have played whilst also maintaining a significant overseas commitment.”

Above: COVID-19 Vaccination Programme staff at Roscommon Vaccination Centre, back row from left: Frank Harburn, Saolta Vaccine Programme General Manager; Susan McGinty, Data Quality Lead Roscommon/Mayo Vaccination Centres; Mary Loughnane, Operational Site Manager, Roscommon Vaccination Centre and Ursula Morgan, Director of Nursing, Roscommon University Hospital. Third row from left: Aimee Brady, Administration; Ashley Byrne, Deputy Operational Site Manager; Orla Murray, Administration and Therese Flanagan, COVID vaccinator. Second row from left: Claire McGeeney, COVID vaccinator; Siobhan Carthy, Clinical Lead, Roscommon Vaccination Centre and David Needham, IT. Front row from left: Deirdre Harrington, COVID vaccinator; Jackie Lillis, Administration Lead, Saolta Vaccination Programme; and Carol Keane, COVID vaccinator. Inset: Marking the final COVID-19 vaccination clinic in Roscommon Vaccination Centre were, from left: Siobhan Carthy, Clinical Lead, with Mary Loughnane, Operational Site Manager.

Front: 27 Infantry Battalion Defence Force Members Cpl Gareth Hosey; Pte Jason McConnnon; Lt Ronan O'Neill; Pte Mark Dutton; Pte Bernard Harmon. Back: Cavan CVC staff members Martina Jameson, Responsible Person Pharmacy; Fiona Lynch, Deputy Manager; Eddie Ward, Operational Site Manager; Ann Gaffney, Clinical Lead.

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Wellbeing Tallaght University Hospital programme aims to keep in tune with patient’s wellbeing

Patients feel the benefit of ‘Soothing Sounds’ live music programme

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ive music programme ‘Soothing Sounds’ has returned to Tallaght University Hospital (TUH) after a COVID hiatus to the delight of patients and staff alike. The programme aims to connect with patients and help to improve wellbeing through a mixture of individual or group music sessions. Funded by the HSE and the Meath Foundation, Soothing Sounds was originally delivered in To see the Soothing Sounds video paediatrics from 2017 to 2020. It was then adapted go to https://www.youtube.com/ watch?v=BnPuaysLnLY&t=140s for adult services following an evaluation. Feedback from patients and staff has been positive with one patient commenting that the programme “made chemo a pleasant experience” and a Clinical Nurse Manager describing how it “relaxes patients, is not too intrusive, is enjoyable and makes the setting less clinical.” Dr Sophie Lee, a pianist who began in TUH as a volunteer musician in 2015 and became musician in residence in 2018, said the programme Another day while playing on the oncology ward, Sophie outlined has been transformative. Sophie recently completed her PhD at the how “a lady arrived for her first chemotherapy treatment. As it University of Limerick, supported by the Irish Research Council. Her happened, her bed was right beside the piano, which she was research investigated the effects of music interventions on the welldelighted about as she was a singer. Very excited about having music being of people living with early-stage dementia and their family carers. in the clinical environment, she prepared herself and began to sing “During each Soothing Sounds session I play music that aims to as I accompanied her. This completely lifted her mood and the mood connect with patients and draw them out of themselves. The selected of the room. When she sang, ‘Hey Jude’ by The Beatles, two other repertoire fits the remit of ‘soothing’ within the wards I’m playing in patients joined in and a sing-song ensued on the oncology ward. and is a varied blend of genres such as classical, pop, folk and Irish What had been a silent, individualised, medical setting had now traditional. The music played primarily aims to reduce stress in the transformed into a friendly, social, musical space. The patient environment,” Sophie, pictured top right, explained. commented afterwards on how it was amazing how music changed “At Christmas I was playing piano on a ward and a patient who the atmosphere and how it had affected each person on the ward.” was a pianist came up to me and asked could he play piano for the Arts Officer at TUH, Ali Baker Kerrigan, said, “Soothing Sounds has patients and staff. A nurse came over, sanitised the piano and got been a successful live music programme in TUH since 2017. him set up to play. He performed works by Chopin, Beethoven and “The programme is enjoyed by patients and staff alike, all of whom Gershwin for everyone on the ward! In this moment, staff saw this have noted the positive impacts it has on their wellbeing. This would patient in a whole new light and he got to feel a bit more like himself. not be possible without the funding support of the HSE and The Meath If Soothing Sounds didn’t exist he may never have had the chance Foundation. Our hope for the future is to further expand the programme to play piano while he was in hospital. On reflection, I was struck to other hospital departments so that live music is offered to an by the spontaneity, connection and joy that a live music programme increased number of our patients and staff, in addition to our already vibrant arts and health programme in TUH." can bring to a hospital ward.”

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I M E L DA M AY’ S STA R GA ZE R S E LECTE D FOR ‘ ME N U OF P O EM S’ FO R PATI E N TS A N D STA F F OF I R I S H HOS P I TA LS

Hundreds of copies of a special anthology called Menu of Poems was distributed throughout Irish hospital wards, waiting rooms and other healthcare settings for patients, visitors and staff to enjoy. The initiative is part of the celebrations for Poetry Day Ireland. Menu of Poems takes the form of a short anthology of poetry which is distributed annually to healthcare users in a range of healthcare settings. Produced by Saolta Arts on behalf of Arts and Health Co-ordinators Ireland, supported by Poetry Ireland and HSE Health Promotion and Improvement, over 10,000 people in healthcare settings will receive the Menu of Poems on Poetry Day Ireland. The poetry was selected by Galway poet Rita Ann Higgins, who was asked to include a poem of her own.

It includes poems by Catherine Ann Cullen (children’s poem ‘Eliza Analyser’), Martina Evans’ ‘Gazebo’, Imelda May’s ‘Stargazer’, and Rita Ann Higgins’ ‘Lucky Mrs Higgins’. The poets involved have also kindly recorded the poetry and it will be available at https://saoltaarts.com/stories/menuof-poems/ Since its conception in 2008, Menu of Poems has been a positive development in the lives of both patients and those who work in healthcare settings across Ireland. The poetry is circulated on meal trays in hospitals and other healthcare settings with participating healthcare providers organising readings and workshops for Poetry Day Ireland. Rita Ann Higgins, poet and editor of the 2022 Menu of Poems, said, “It's not unusual to reach for poems at a time

of crises or distress, sometimes poems are all we have to get us over the tough times. Selecting poems for this project was a great pleasure. It made me take down the books I had not read for a while. It was like meeting old friends. In the end the selection made me feel warm and grateful for the powerful voices of Cullen, Evans and May, may the creative force stay with them.” Margaret Flannery, Arts Director at Saolta Arts, explained, “Menu of Poems continues to grow its audience annually and this year we are delighted to introduce two new elements. Rita Ann selected a poem that we will produce in a poster format especially for paediatric health settings and all the poetry is available to listen to online. I would like to thank the poets involved for their recordings as we can reach more people and share the selection widely.”

Above: Clara Monaghan, music therapist; Anita Ennis, Patient Food Services; and Alison Baker Kerrigan, Arts Officer, Tallaght University Hospital, preparing a tray for Poetry Day. Right: Palliative Clinical Nurse Supervisor Barbara Hamilton reading an extract of poetry at St Luke's.

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CAR-T CELL THERAPY

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Revolutionary cancer treatment now available to children in Ireland

AR-T cell therapy, a revolutionary cancer treatment, will now be available for children with acute lymphoblastic leukaemia (ALL) to access in Ireland. Children’s Health Ireland (CHI), the National Cancer Control Programme (NCCP) and the Department of Health marked the launch of this ground breaking immunotherapy treatment being available for the first time, in CHI at Crumlin. T cells are blood cells of the immune system that protect from ‘foreign invaders’ including cancer. Chimeric antigen receptor T cell or CAR-T therapy, harnesses the body’s own T cells and ‘installs new software’ that redirects them to more effectively target and destroy cancer. Unlike standard pharmaceuticals, it is a ‘living drug’ that can grow, expand and form memory and potentially protect the patient lifelong. To date, eligible Irish children have availed of this novel treatment under the HSE Treatment Abroad Scheme. The Department of Health’s National Cancer Strategy 2017-2026 enabled the NCCP to provide funding to establish this service in Ireland, with CHI at Crumlin as the designated National Paediatric CAR-T Centre. Dr Pamela Evans, the Clinical Lead for the CAR-T service in CHI, explained how difficult it has been for parents to bring their children for treatment overseas. “We are so delighted to be able to now offer this treatment to our patients on home ground. We are indebted to our UK colleagues for delivering this therapy to our patients when we could not but the true heroes are the patients and their families who braved the unknown, traveling overseas during a global pandemic to

accept the challenge of this new therapy. The delivery of this therapy in Ireland will simplify the treatment journey and have a tangible impact on children and young people and their families.” Theresa Kenna, mum of Erin (3) who received her CAR-T therapy in London, said the change will make a huge difference to families like hers. “We had to move to London and rent an apartment near Great Ormond Street Hospital when we travelled for Erin’s treatment. We also have two other children so the change was incredible. No one wants to be in a position where you need this treatment for your child. But the fact that this will now be available in Ireland for people at home will make a huge difference to families,” she said. Director of the NCCP Prof Risteárd O’Laoide said, “The repatriation of this service is the culmination of more than three years of collaborative work between NCCP, CHI and the DoH and is one of the most exciting treatment developments we have seen in cancer. It is essentially a life-saving treatment for those children who have relapsed and reached the ceiling of treatment options with their ALL.” ALL is the most common childhood cancer, representing approximately 25% of all cancer diagnoses among children less than 15 years of age. In Ireland an average of 55 children are diagnosed with ALL every year. CAR-T cell therapy requires significant input from many teams to ensure safe and effective service delivery, including Haemato-oncology transplant teams, supported by Neurology, Intensive Care, Radiology, Pharmacy, Immunology, allied health, stem cell laboratory, quality, administration and other specialist services.

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MATERNITY HOSPITALS EXTEND SUPPORTS FOR MARGINALISED GROUPS Trio of Inclusion Health social workers prioritise social justice

Laura Feely, Rotunda; Gretchen McGuirk, Coombe; and Sinead Stakelum, NMH. Gretchen McGuirk, Senior Medical Social Worker, Inclusion Health and Lead for the service at the Coombe.

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s the homeless crisis grows, the introduction of an Inclusion Health Service in the Medical Social Work Departments of the three Dublin Maternity Hospitals late last year could not have come too soon. Inclusion health recognises that marginalised groups, such as asylum seekers, refugees, and the homeless, as well as prisoners and Travellers, experience significant health inequalities in the mainstream health services and these groups need more targeted supports. Gretchen McGuirk, Senior Medical Social Worker, Inclusion Health, who is the Coombe Lead for this newly funded service by the HSE, hopes that it will offer more to the health and wellbeing of those in marginalised communities and unstable accommodation from day to day, as well as making a positive impact. “We have witnessed the direct impact unstable accommodation can have on new parents and their children, and we want to help change this,” said Gretchen. Her experience is shared by her fellow SI MSWs – Laura Feeley in the Rotunda Hospital and Sinead Stakelum in the National Maternity Hospital. All three women have the same goal, and sense of social justice, and believe it can be delivered in a joined-up thinking approach across the hospitals. A significant proportion of referrals received into the Medical Social Work Department in the Coombe alone are due to homelessness. This figure reflects the rise in the number of pregnant women and families who are experiencing homelessness, compared to years before the homeless crisis. The war in Ukraine is expected to increase those numbers in the long term, as more refugees come into the country to try and secure a rapidly diminishing property

pool. All three women are conscious of the impact this may have on the high numbers looking for support across the three Dublin Maternity Hospitals, yet absolutely determined to do their utmost to support new mothers and babies. The number of homeless people in Ireland has doubled in four years, reaching 5,000 in Dublin alone. It’s a stark, and frightening, fact that life expectancy for homeless women is 38. The new Social Inclusion service will aim to streamline care for women and families across the three Dublin Maternity Hospitals, making sure that a co-ordinated approach exists between the three hospitals and the community services to help patients avoid falling through the gaps. Studies have shown that homeless people suffer from an increased number of complex medical and mental health conditions. They are more likely to experience barriers accessing health and social care services, and frequently miss hospital appointments. A referral is received into the Inclusion Health Senior Social worker in the Medical Social Work Departments of the Coombe, Rotunda and NMH if a patient is homeless or at risk of homelessness. Gretchen, Laura and Sinead meet with them to assess their psychosocial needs, offering emotional and practical support, and connecting them with community services. The Social Inclusion Social Worker also advocates for the patient and empowers them within their own situation. They will work with homeless and community services to ensure an appropriate and safe discharge plan for mothers and babies that meet all of their needs. “Those first days for mother and baby are so special and we want to support them to have the best start possible,” said Gretchen.

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New and IMPROVED Impressive €2m Injury Unit opens at Ennis Hospital

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he doors of the new €2m Injury Unit at Ennis Hospital have opened, bringing an immediate improvement in the clinical environment and experience for healthcare staff and the thousands of patients who use this service every year. A purpose-built facility adjacent to the main entrance of Ennis Hospital, the new Injury Unit replaces the existing unit that has operated out of the main hospital building since 2013. The new Injury Unit boasts five separate patient assessment bays, with the highest standards in Infection Prevention and Control (IP&C) compliance. There is also a brightly decorated waiting room and a separate triage area. Other utilities include a clinical room, storeroom, senior nurse manager’s office space, and a nurses’ station. Joe Cassidy, Acting Director of Nursing at Ennis Hospital, said the

Ennis woman Maria Conlon was the first patient to be treated at the new Injury Unit in Ennis Hospital. Maria is pictured in the new unit with (from left): Dr Ruth Goodall, Injury Unit Physician; Mhairi Barron, Candidate Advanced Nurse Practitioner; and Brenda Bleach, Registered Advanced Nurse Practitioner.

new unit would bring immediate improvements for staff and significantly enhance the overall patient experience at Ennis Hospital. “The existing Injury Unit within the hospital had no dedicated waiting area or triage room, and space for only three patient assessment bays. With demand for Injury Unit services on the increase in Ennis and across the Midwest, the opening of this new facility could not be more timely. It is a first class working environment for our staff and provides the local population with the kind of patient experience they deserve when they need treatment for injuries,” said Joe. UL Hospitals Group has three Injury Units—in Ennis, Nenagh and St John’s Hospital—where tens of thousands of people over the age of 5 years are treated every year for minor injuries such as sprains, breaks and burns. In 2021, of the total of 33,853 patients who attended

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all three units, 11,219 attended Ennis. This was a 17.6% increase in demand on 2020 usage of the Ennis unit, returning it to pre-pandemic levels of use. The Group’s Injury Units help to ensure that the Emergency Department at University Hospital Limerick can prioritise emergency care for the sickest and most seriously injured patients who need it most. For patients over the age of 5 years who suffer sprains, breaks and burns, the Injury Units are the most efficient treatment pathway. The IU teams can also treat sports injuries, including hand and ankle injuries, and can remove foreign bodies from the eye, ear and nose. Staff also provide quick access to diagnostics and x-rays, make the necessary arrangements to refer patients to specialist care when required, and arrange follow-up appointments within the Injury Unit where necessary. The Ennis Hospital Injury Unit is staffed by an expert team, led by Dr Cormac Mehigan, Consultant in Emergency Medicine. The team is composed of emergency medicine physicians, advanced nurse practitioners, nurses, health care assistants and administrative support, working together to provide a high quality and timely service for people with a wide range of non-emergency injuries. Registered Advanced Nurse Practitioners (RANP) and Candidate ANPs play a particularly important role, with their ability to perform full episodes of care on patients from admission to discharge, as well as organising follow-up appointments and ongoing reviews, and referral to expert care when required. Dr Mehigan described the facilities in the new Injury Unit as a leap forward for patient experience, and a significant step up in the clinical environment, befitting the standards of service being delivered by his team. “The Injury Unit in Ennis, and the units in St John’s and Nenagh, are an excellent alternative for people where we can provide fast, effective treatment for minor injuries that don’t require a lengthy wait in the Emergency Department in UHL. It’s a good idea for people to familiarise themselves with the kinds of injuries we can treat in the Unit. That information is available on the HSE website in addition to the contact numbers for each Injury Unit if you need to call ahead.”

All three Injury Units are open seven days, 365 days a year. No appointment is necessary. The Ennis Hospital Injury Unit (open 8am-8pm) can be contacted on 065-6863121. The Nenagh unit (open 8am-8pm) can be contacted on 067-42311, and the St John’s Hospital unit (open 8am-7pm), can be reached on 061-462303. For information on Injury Unit services, go to this link on the HSE website, or Google ‘HSE, Injury Units’: https://www2.hse.ie/services/injury-units/

Clockwise from left to right: Members of the Injury Unit team at Ennis Hospital: (from left) Dr Ruth Goodall, Injury Unit Physician; Evan Wallace, Registered Advanced Nurse Practitioner; and Brenda Bleach, Registered Advanced Nurse Practitioner. Members of the Injury Unit team at Ennis Hospital: (from left) Mary Fitzpatrick, Senior Staff Nurse; Dr Cormac Mehigan, Consultant Emergency Medicine and Injury Unit team lead; and Rachael Flynn, Clinical Nurse Manager, CNM1. Clinical Nurse Manager, CNM2; Jo Crowe and Staff Nurse, Fiona Tubridy at the entrance to the new Injury Unit in Ennis Hospital.

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RAPID CARE

MY STORY

St John’s Hospital Injury Unit treated more than 12,500 patients in 2021

Cratloe resident Kate Gilroy “can’t speak highly enough” about the care she received at the Injury Unit in St John’s Hospital. Registered Advanced Nurse Practitioner, Suzanne Lynch (front), with colleagues Angela Carmody Culhane (candidate ANP) and RANP Evan Wallace.

Clinical Nurse Manager 2 Eileen O’Connor (front) with, from left, Dr Shahoub Sherif, Registrar, and Dr Gareth Quin, Consultant in Emergency Medicine.

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or the minor injuries such as sprains, breaks or burns that befall tens of thousands of people in the Mid-West every year, efficient and effective treatment is readily to hand in Injury Units at St John’s, Ennis and Nenagh Hospitals, with no need for lengthy waits in the region’s busy Emergency Department. In late October 2021, Co Clare resident Kate Gilroy found herself in need of such attention when, during renovations of the kitchen in her Cratloe home, a granite counter-top crashed on to one of her feet, flattening the big toe. “I was in shock, and didn’t know what to do. I was panicking, because I knew I needed help. Luckily, I have a relative who works in healthcare, and who was able to tell me that there was an Injury Unit at St John’s Hospital, and that would be the best place to go,” mum-of-three Kate recalled. The Injury Unit at St John’s Hospital is staffed by an expert team of three full-time Registered Advanced Nurse Practitioners (ANP) and one trainee ANP, along with two registrars, administrative support and led by Dr Gareth Quin, a senior Consultant in Emergency Medicine. The team provides timely treatment for injuries that are nonthreatening to life or limb, but which still require expert and prompt medical attention. In the heat of the moment for a panic-stricken Kate Gilroy, her mind was dominated by the shock of injury and the uncertainty of what lay ahead. “As I was being driven to Limerick, I didn’t know what to expect. I have no experience of hospitals, apart from having my children. Nothing like this had ever happened to me before,” she said. A few months on from the incident, Kate is thankfully well on the

road to full recovery, and her standout memory from the experience is not the injury itself, but the efficiency, professionalism and the calmness of the staff, and the swiftness of the process. “When we got to St John’s the first surprise was the access, and the fact that we were able to drive right up to the front door. Given the injury, that was really important. Also, they saw me straight away. At that point, my foot was just dripping in blood. What really surprised me was how quickly the staff took control and immediately put me at my ease,” she said. On duty that day was Registered Advanced Nurse Practitioner (RANP), Suzanne Lynch. RANPs are a crucial component of the Injury Unit, playing a leading role with the ability to perform a full episode of care on patients from admission to discharge, as well as following up and ongoing review, and referral to expert care when required. Kate recalled, “I can’t speak highly enough of Suzanne and her colleagues, and the care they gave me that day. I was gripped by fear and didn’t even want to look at my injury, but after making sure that I had the proper pain relief, she calmly talked me and my husband through what she was going to do. And by the time I’d come back from X-ray she was able to reassure me that I would be okay, and she was able to treat and dress the injury and discharge me in what seemed like a very short period of time – certainly a lot shorter than I’d been expecting.” After some follow-up appointments in the Injury Unit with Suzanne and subsequent referral to the Fracture Unit at University Hospital Limerick, Kate is now fully recovered, and back to enjoying the cycling, running and walking that are her favourite pastimes. She is making sure that all her friends and colleagues know about the services available in the Group’s Injury Units, following her satisfactory experience at St John’s. As Kate found, patients, including children over the age of five years, can rest assured of accessing treatment in an Injury Unit in a fraction of the time they would expect to wait in the busy Emergency Department at UHL. One of the key functions of the Group’s three Injury Units is to ensure that the Emergency Department can provide treatment for the most seriously ill or injured patients. RANP Suzanne Lynch is equally keen to ensure that the public take all injuries, even minor injuries, seriously, and to get medical attention if necessary. “One of the things we’ve noticed in the past year, is people not presenting with injuries early. If you have an injury such as a cut, or a sprain or a burn, for example, it’s important to get it attended to sooner rather than later. The longer you leave things, the greater the chances are that you will have a more complicated recovery.”

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ENHANCING CARE IN THE COMMUNITY Programme aims to deliver more care through GPs and primary care

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he HSE’s Enhanced Community Care programme aims to deliver increased levels of healthcare through general practice, primary care and community services to meet the needs of our growing population and attract and retain the very best healthcare clinicians and staff. The reorientation of the health service towards integrated primary and community health services is a key goal of Sláintecare, and the rollout of the Enhanced Community Care (ECC) Programme reflects this ambition. The ECC Programme is a practical demonstration that the Government Sláintecare policy is actively working to change Ireland’s health service model to be less dependent on the acute hospital system, providing more care in the

community, as close to home as possible. The programme supports the implementation of a population needs approach, enabling better local decision making, while communities will also be involved in determining the health needs of their local areas. The ECC Programme has been allocated funding for 3,500 additional staff and the establishment of 96 Community Healthcare Networks, 30 Community Specialist Teams for Older Persons, 30 Community Specialist Teams for Chronic Disease, national coverage for community intervention teams, and the development of a volunteertype model in collaboration with Alone. Staff recruitment for the ECC Programme is well under way with over 1,900 staff recruited or at an advanced stage. To minimise any risk to existing services, the

ECC Programme is casting a wide net when it comes to recruitment, with a range of processes in place to attract new recruits via international and national recruitment campaigns. Joe Ruane, Chair of the Head of Service for Primary Care Group, believes the new structures for integrating ways of working are attractive to people thinking of joining the HSE workforce. “The ECC Programme is providing a work environment that is adaptive and flexible for staff. It’s bringing together teams of professionals from different disciplines to provide joined-up care for the people using our services. This coordinated and proactive approach is not just about maximising staff skill sets it’s also leading to better health outcomes for patients.”

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Room to improve

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Innovative project improves hospital experience of service users with intellectual disabilities

service innovation project funded by Nursing and Midwifery Planning and Development Unit Cork and Kerry, to improve the experiences of service users with intellectual disabilities ran from April 2021 – November 2021 in South Infirmary-Victoria University Hospital (SIVUH). The project included introducing Health Passports, education of staff, developing an easy-to-read web page and developing a new perioperative care pathway for service users with intellectual disabilities. According to Claire Benson, Project Lead, many of the changes implemented benefit service users of many different profiles, not just those with disabilities and ‘promote a culture of person-centred care’. Quiet Zones can be used for service users with autism or who are hard of hearing, the accessible webpage may be beneficial for service users who have difficulty reading or who do not use English as their first language, while the Health Passports for children can help parents to prepare their child for their hospital visit even if they do not have a disability. Claire also explained that noted that health services can be improved for service users with intellectual disabilities very simply and at minimal cost to the health service. “This project is helping us to meet our Sláintecare goals by promoting a culture of person centred care. We have shown how simply these changes can be introduced and are disseminating our findings throughout the South/Southwest Hospital Group to encourage more hospitals to make changes to how care is delivered,” she said.

THE PROJECT VISION INCLUDED TO:

1. Develop a clear perioperative pathway for service users with intellectual disabilities. 2. Provide staff with education for caring for service users with intellectual disabilities and to implement health passports for service users with intellectual disabilities. 3. Introduce “social stories” to allow familiarisation with the hospital and perioperative process. 4. Ensure service users with intellectual disabilities and their carers would feel included in their perioperative care. PERIOPERATIVE PATHWAY

A new perioperative pathway is in place which encourages each department to highlight to the next if a service user has an intellectual disability and to implement reasonable adjustments prior to transfer. For example, in the case of a service user who does not like loud noises, staff have introduced Quiet Zones. Quiet Zone posters can be put up wherever a service user is receiving care and requires only essential staff to enter the area. Noise levels are reduced accordingly by minimising staff and crowds and turning off any unnecessary noise such as radios. “As well as implementing reasonable adjustments, we now aim to place service users with intellectual disabilities either first or as early as possible on theatre lists to reduce waiting times and prevent prolonged fasting which may cause undue stress,” said Claire.

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LOURDES HOSPITAL LAUNCHES THEIR INTELLECTUAL DISABILITY LIAISON SERVICE

HEALTH PASSPORTS

The HSE Health Passport is now given to all adults with intellectual disabilities. This fantastic resource was developed as part of a previous service innovation project in Letterkenny. “As we meet many children who have other disabilities, we wanted to have something available for them also. Therefore, we developed the SIVUH Health Passport for Children which was adapted from the HSE Health Passport. This passport is offered to all children attending SIVUH for a perioperative visit,” she said. “We developed a hospital social story which tells service users all about their hospital visit. This is attached to their Health Passport which they receive before their admission. Now, when a service user with an intellectual disability steps into hospital it isn’t their first time seeing a person in scrubs or a blood pressure cuff. This eliminates some of the fear around their hospital visit. “ STAFF EDUCATION

Some staff education was delivered at a local level by Claire. The hospital also developed a link with COPE Foundation. Dave Quinlan, Advanced Nurse Practitioner in Positive Behavioural Support, very kindly agreed to provide an NMBI accredited course for staff in the SIVUH Conference Centre in September 2021. All attendees found the course most interesting and beneficial to their practice. They also linked with University College Cork to discuss the potential for Continuous Professional Development and a webinar on the topic of providing care to service users with intellectual disabilities in the acute care setting is now in progress as a result of this.

Our Lady of Lourdes Hospital was delighted to officially launch their new Intellectual Disability Liaison Service in March, coinciding with World Downs Syndrome Awareness Day. Carmel Daly, Clinical Nurse Manager 2 CNM 2 Intellectual Disability Liaison Service, was in attendance on the day to outline the purpose of her role. Ms Daly’s primary aim is to support people with an intellectual disability, their families and carers as they access acute hospital care. The service will enable, to the fullest extent, the integration of health services (Acute and Community) for people with Intellectual Disabilities, including safe and appropriate access, right person, right place, right time. This service innovation is supported by the Nursing and Midwifery Planning and Development Unit (NMPDU) in Ardee and colleagues in Intellectual Disability Services across Louth and Meath. The event was supported by colleagues across all disciplines within the hospital and members of the Senior Management Team including Fiona Brady, General Manager, Our Lady of Lourdes Hospital; Adrian Cleary, Director of Nursing, Our Lady of Lourdes Hospital; and Petrina Donnelly, RCSI Group Director of Nursing and Midwifery. The staff from the hospital welcomed representatives Mike Egan and Brendan Stevenson from the Louth/Meath Down’s Syndrome Association who were there to raise awareness and celebrate the ‘Lots of Socks’ campaign. Over the last two years as a result of COVID restrictions, it had not been possible to celebrate World Down’s Syndrome Day on site and launching the ID service on this day made it even more special.

IMPROVING ACCESSIBILITY

Many service users with intellectual disabilities have difficulty understanding the information they are provided in hospital. The hospital now has an easy-to-read page on its public website which includes an easy—to-read admission letter, information about anaesthetics and information about Health Passports. This resource can be continuously updated going forward. Claire explained that she recently heard about a new initiative called A-D Caller. The A-D Caller campaign, developed by Caroline Flanagan from Able-Disabled Wexford, is a very simple idea which reduces anxiety in service users with disabilities when calling a service or business. They can identify themselves as an ‘A-D Caller’. This explains their situation in a very simple way without needing to go into detail about their disability or medical history. Immediately, the person answering the phone will understand that this is a priority call and adjust their response appropriately. “SIVUH is delighted to be the first hospital in Ireland to recognise A-D Callers. A-D Caller provided a very interesting information session about the campaign in November and we have lots of posters up throughout the hospital explaining the initiative,” she added.

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HEALTH PASSPORT Nursing collaboration achieves adoption of Health Passport in Wexford

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urses from Wexford Public Health Nursing Service, Wexford General Hospital, and Wexford Residential Intellectual Disability Service worked collaboratively to implement the HSE Health Passport for people with intellectual disability across community, acute and intellectual disability services in the Wexford region. This initiative recognised the benefits of using the HSE Health Passport to support people with intellectual disability communicate aspects of their health and social care needs, to help healthcare professionals better understand the coexisting and presenting conditions of people with intellectual disability, and to make the required reasonable adjustments for their safety, health care and well-being. Support was sought from the Nursing and Midwifery Planning and Development Unit (NMPDU) to advance this initiative and a working group was established. A collaborative approach was adopted and the work of the group culminated in the launch and implementation of the HSE Health Passport and development of an online education programme, hosted in the RCNME South East catalogue on HSELand. The group’s work continued, despite the difficulties encountered because of COVID-19 and the HSE cyber-attack, and was launched during a webinar on International Day of Persons with Disabilities. This was attended by more than 70 participants from across multiple acute, community and residential services in Wexford and nationally. The enthusiasm and collaborative work demonstrated by these nurses has ensured the successful implementation of the HSE Health Passport. They have inspired change and motivated others to provide appropriate, equitable and better informed care for those with intellectual disability in Wexford. Their efforts have highlighted the importance of looking beyond individual areas of work, to seek out collaborative opportunities to inspire and inform change. It has demonstrated the need for resilience and perseverance in challenging and unpredictable times, with the work continuing even when more immediate priorities were presented and dealt with. The compassionate and enabling leadership style adopted by those involved in steering this quality improvement has delivered innovation that enables service improvement. Its success and sustainability will rely on a collaborative, compassionate, and patient-centred mind-set amongst frontline workers to overcome traditional challenges and herald a safer and more equitable service for those with intellectual disability. By recognising the role of cross-boundary collaboration and supporting staff to understand the gaps between the current status quo and the desired quality of care for this small but significant patient group, these nurses have steered practice change across three distinct, yet interrelated services. Their initiative can directly affect the quality of care provided with the potential to reduce morbidity and mortality for people with intellectual disability accessing health and social care services. Whilst building and sustaining healthcare quality improvements and safety can be daunting, this collaboration and successful adoption of the HSE Health Passport across acute, community and intellectual disability services in Wexford demonstrates a willingness to balance real complexities of patient care with the central issues of human safety, security and positive healthcare outcomes. Prioritising person-centred care in this organised way creates excellence in care provision which benefits all persons, including those providing this care and support.

Glenda Rooney, CNM3, Theatre and Surgical Directorate, Wexford General Hospital, Sharon Farrar, Liaison Public Health Nurse for Clients with an Intellectual Disability, Wexford Public Health Nursing, Anne Power, cANP, Wexford Residential Intellectual Disability Service

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‘I’m really happy and want to stay in my new home with my friends forever’ Donegal Disabilities Service user describes delight of new home

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ichaela Keon moved from the outskirts of Donegal Town to her new home in November 2021. Her new home is a four-bedroom bungalow which is located within walking distance of local amenities. The house was designed to a high standard with facilities to support the independence of the residents. Michaela has described the experience of moving into her new home “We moved into our new home on November 29th 2021. At first when my key nurse told me about my new home I was nervous and not sure of moving. When staff took me to see the new house I really liked and became excited as I was moving from the country into town,” she explained. “I liked picking my new room. I helped pick curtains and blinds and pictures for the sitting room, I picked lamps for the hallway. “I enjoyed shopping for all my personal bedroom items. I went for

the colour pink and staff took me shopping loads of days for our things we wanted. I liked picking my own things and things for the house. Michaela said she spent evenings visiting the house before they moved. “Our families all came to the house on November 12th and we loved showing our new house and we enjoyed afternoon tea with everyone. My mummy is very happy and she says she is jealous of my new home,” she said. “I am really happy living in my new house. I can walk to the shops, chemist, doctor and cafes from my house, our neighbours are nice and friendly, my bedroom is very cosy and warm and I have my own bathroom. I am really happy and want to stay in my new home with my friends forever. “We planted loads of new flowers at my new house at the weekend and next weekend I am planting a memory tree for my Daddy and I will be able to see tree from my bedroom window which I like.”

NEW HOME PROMOTES INDEPENDENCE FOR PEOPLE WITH COMPLEX NEEDS A new home providing residential accommodation for five people with physical and sensory disabilities has opened in Co Monaghan. Drummond Lodge, a Community Group Home at Carrickmacross, was officially opened by Anne Rabbitte, Minister of State, Department of Children, Equality, Disability, Integration and Youth. This new development has been realised through partnership working by HSE Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo, Resilience, Monaghan County Council and Respond Voluntary Housing Association. The accommodation consists of five bedrooms with shared living facilities such as the kitchen and living room and the garden area. It has been built to a high standard with all the necessary specifications and requirements for people with complex and high support needs to promote their independence and to live their life in a home they can be proud of. Individual residents have chosen their own decor for their bedrooms and each bedroom is bespoke to each person. Leo Kinsella, Acting Chief Officer for Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo, said “In Cavan and Monaghan the range of specialist disability services that are provided to people with physical, sensory and intellectual

Minister Anne Rabbitte officially opens Drummond Lodge Community Group Home, Carrickmacross

disabilities and autism include Day, Residential, Respite and community based health and social care services. Through partnership working with HSE, Resilience, Monaghan County Council and Respond Voluntary Housing Association it is great to be able to provide the residents with a new home at Drummond Lodge and the supports they need to live their best lives.” Monaghan County Council and Respond Voluntary Housing Association were successful in securing funding for the development of Drummond Lodge with the support of the HSE. Drummond Lodge will be operated by Resilience on behalf of the HSE which will fund the service. Resilience, a leading Irish health and social care company has been providing support to people with disabilities across the country since 2011.

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For information on the campaign and how you can get involved visit www. understandtogether.ie.

COLLECTION OF 25 DEMENTIA BOOKS NOW AVAILABLE IN 330 LIBRARIES NATIONWIDE

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he aim of the Dementia: Understand Together campaign is to inspire people from all sections in society to create dementia inclusive communities. Over 40 national partner organisations, together with more than 400 community champions from all over Ireland, are supporting the campaign and leading the way in creating communities that actively embrace and include those living with dementia and their families. Through an initiative of the ‘Healthy Ireland at Your Library programme’ and supported by the ‘Dementia Services Information and Development Centre (DSIDC)’ a selection of 25 dementia books is now available in 330 libraries nationwide. Libraries are at the heart of our communities and by providing dementia resources and information they signal a warm welcome to those affected by dementia.

The development of the specially curated selection offers a range of perspectives on life with the disease and follows on a need identified by people with dementia and their loved ones for greater information and support. The collection features titles on the subject of dementia, from slowing the onset of the disease to ways to improve our brain health, from first-hand accounts of people living with dementia to ways to improve life through nutrition, music and the arts. Partnering with libraries on this initiative allows those affected by dementia, including those who may not be engaging with formal services, to gain helpful information about the condition in a space that is accessible to them, as and when they choose. The introduction of the collection has been supported by the delivery of dementia awareness training, provided by the DSIDC. It gave information on the different types of dementia and their symptoms, tips on creating a supportive

environment and how best to assist and communicate with the person with dementia when visiting the library. Visiting these welcoming public spaces gives people with dementia not only access to information, but also the opportunity for social engagement and to participate in other inclusive services libraries offer. On behalf of public libraries, Colette Byrne, Chair of the Libraries Development Committee of the Local Government Management Agency and Chief Executive of Kilkenny County Council, said, “We are delighted to announce details of this list of Top 25 Dementia Books which we hope readers will find both useful and engaging. It wasn’t easy to settle on our final 25 and, with new books arriving all the time, we will continue to review and add to our listing as appropriate. “These books speak to the experiences not only of doctors, psychologists, carers, but, most importantly, of people with dementia. We look forward to sharing our insights on the different books and to pointing readers in the right direction of the most suitable titles depending on the particular interest they might have. “It’s all part of the Healthy Ireland at Your Library programme which is about providing enhanced health and well-being book collections, and a range of programmes and events, to support people in managing their own health.” For Fiona Foley, Senior Project Manager with the National Dementia Office, libraries offer a key resource in supporting people with dementia to live full and active lives. “If the pandemic has taught us one thing, it is that we are social creatures and that social interaction is a vital part of our health and well-being. It is no different for people with dementia. Unfortunately, people with the condition may experience stigma and retreat from social interaction as a result of this. That is why this new initiative by Ireland’s libraries is so fantastic in extending a warm welcome to people with dementia to their local library as part of an inclusive community, and in providing training to staff to make the service as supportive and accessible as possible. “Finding out as much as possible about dementia, the supports available, the importance of staying socially active and keeping your brain exercised, can all help your health, well-being, and quality of life.” A national PR campaign promoted this initiative to raise awareness of the new resource available across all 330 libraries nationwide.

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Rollout of new certificate in Dementia Care and Support Programme

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rish Times Training and the HSE are proud to announce the rollout of a new QQI Level 5 Special Purpose Certificate in Dementia Care and Support Programme. This programme is the official HSE training standard for Health Care Support Assistants. The number of people living with Dementia in Ireland today is 64,000; this number is expected to double by 2045. Two thirds of the current figure are living at home, and approximately 45% of all homecare services in Ireland are provided to people living with Dementia. There is an emerging consensus on the need to realign care with the kind of support that matches the wishes of people with dementia and their families. This programme has been designed to address this need. The new programme aims to develop skilled, reflective and self-aware Health Care Support Assistants who are equipped to care for people with dementia with humanity, empathy, and dignity, so that they may live well for longer in their own homes and communities. The programme has been designed by the National Dementia Office, HSE and DCU in consultation with people living with dementia, family carers and experienced healthcare staff from all levels of community care. This highly experienced team also previously developed and delivered the Dementia Skills Elevator empowerment programme 2014-2017. The team then worked in partnership with Irish Times Training to accredit the programme as a QQI award. It is currently being delivered by Irish Times Training through the HSE and the Alzheimer Society of Ireland and will be piloted over the coming months. The development of the programme will support the government’s Sláintecare Action Plan 2019, and implement

the National Dementia Strategy which states that a priority Irene Gibson, PhD candidate and for the HSE is to ‘best configure resources currently invested Director of Programmes and in home care packages and respite care to facilitate people Innovation, National Institute for with dementia to continue living in Prevention their own and homes and Cardiovascular Health; Johnson,the Chief communities, for as long as possible and Neil to improve Executive, Croí; and Dr Lisa Hynes, supports available to carers.’ Head of Health Programmes, Croí.

ABOUT THE PROGRAMME The target learners for the programme are Health Care Support Assistants working with people living with Dementia in their homes. The overall approach is that the learner is not only learning about the illness but also about themselves, their ability to recognise stress, practice selfcare, establish and maintain boundaries, to build relationships of trust, develop ethical approaches and fundamentally take a strength-based, rather than loss-based approach to Dementia care. The programme consists of six interconnected units, combining face-to-face and live virtual delivery workshops, and is supported by practical and reflective exercises. Central to the programme is a workplace learning element which is supported by an experienced supervisor. The National Dementia Office has worked with over 900 trainers and supervisors over the past two years to ensure they are equipped to support this learning method. It is worth noting that the programme differs from other education courses as it challenges learners to examine their own belief systems, attitudes, and understandings of what it means to live with dementia. Trainers will be required to challenge these beliefs and values and to support learners as they embed new values into their everyday language and practice.

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15/06/2022 11:58


Busy Wheels Mobile Intensive Care Ambulance Service (MICAS) has busiest year to date

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HSE service which transfers critically ill patients between hospitals has had its busiest year to date having carried out a total of 469 critical care retrievals. The Mobile Intensive Care Ambulance Service (MICAS) is one of three critical care retrieval services that the National Ambulance Service (NAS), provide as part of NAS Critical Care & Retrieval Services (NASCCRS). MICAS is the adult service specialist critical care retrieval service available throughout Ireland to assess, stabilise and transfer critically ill adults between hospitals. NASCCRS also includes specialist neonatal and paediatric services: National Neonatal Transport Programme (NNTP) and Irish Paediatric Acute Transport Service (IPATS). 2021 was the busiest year to date for MICAS with 469 critical care retrievals, including a large number of transports linked to COVID-19 and consequent ICU requirements. This compares to 290 critical care retrievals carried out in 2020. The patients MICAS retrieves require a level of medical support over and above that which can be provided by an ambulance crew. This can include ventilation, invasive pressure monitoring, sedative and cardiac medication infusions and even Extra Corporeal Membrane Oxygenation (ECMO). The latter is provided in partnership with the Mater Misericordiae University Hospital. This year the service celebrates 25 years in operation. “Patients requiring MICAS retrieval are typically being moved from one intensive care unit to another. However, patients may also be moved to/from emergency departments, interventional radiology units and operating theatres as well as non-critical care areas in smaller hospitals,” said Dr David Menzies, a consultant in Emergency Medicine at St Vincent’s University Hospital in Dublin and the HSE National Clinical Lead for Adult Critical Care Retrieval services. “The philosophy of care in MICAS is to provide the highest quality care to critically ill patients whilst transporting them to a facility that meets their medical needs by an appropriately qualified and skilled team of critical care staff. It ensures every patient is transported in a

way that maximised, not only their medical care but the safety, dignity and comfort of the patient and their families.” MICAS provides a critical care doctor and critical care nurse together with a critical care ambulance and NAS emergency medical technician (EMT) to facilitate the inter hospital transport of critically ill patients. More recently, a cohort of critical care paramedics has also joined the service, providing much needed resilience during the recent pressures on ICUs nationally. Medical and nursing teams are provided by the National Ambulance Service and also in partnership with hospitals including: Mater Misericordiae University Hospital, Beaumont Hospital, St Vincent’s University Hospital, Cork University Hospital and University College Hospital Galway. Patients requiring MICAS retrieval include critically ill patients, who require an increase in the level of care provided (e.g. dialysis) when the facilities needed for this are not available at the referring hospital or patients who require specialised treatment in a specialised centre e.g. the use of an ECMO life support machine, neurosurgery, cardiothoracic surgery. Patients may also be transported in order to access a critical care bed elsewhere due to capacity issues at the referring hospital. The service also facilitates repatriation of critical care patients to their local hospital for on-going care when appropriate, maximising available capacity in the hospital system. MICAS currently provides a critical care retrieval service for patients aged 16 years and over from three sites (Dublin, Cork and Galway). The safe transport of a critically ill patient requires a structured approach to: assessment, diagnosis, stabilisation and management of clinical conditions as well as knowledge of logistics and transport specific equipment in the ambulance environment. Usually, an ICU bed must be secured in the receiving hospital prior to activation of the MICAS Team. Exceptions to this include mandatory transfers from smaller hospitals without critical care facilities, or patients who are being transferred directly to theatre or interventional radiology.

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Referrals to MICAS are coordinated through the Critical Care and Retrieval Desk at the NAS National Emergency Operations Centre (NEOC) in Tallaght. Once a call is received, the NEOC dispatcher will connect to the MICAS consultant coordinator for the day. The MICAS coordinator will conference in the referring consultant, the consultant on call for MICAS, and the receiving consultant or additional specialists if required. The referring/ receiving consultants will then decide on a clinical plan and timeframe for the retrieval. Commenting on the service, Dr Menzies said, “It is generally accepted that trained specialist retrieval teams have lower rates of morbidity, mortality and adverse clinical events. I believe that an increasing number of transports undertaken by MICAS will result in a reduction in adverse clinical events in transfer and increased staff and patient satisfaction. Additionally, the use of the specialist retrieval team removes the need to deplete the referring hospital of resources. The expansion of critical care retrieval activity recently due to COVID-19 has demonstrated the importance of this service, which is likely to get busier still as the national trauma system rolls out.”

The expansion of critical care retrieval activity recently due to COVID-19 has demonstrated the importance of this service, which is likely to get busier still as the national trauma system rolls out.”

CUH AND NAS JOIN FORCES TO MANAGE PATIENTS IN THE COMMUNITY VIA THE ALTERNATIVE PRE-HOSPITAL PATHWAY (APP) TEAM Responding to the rising trend of ambulance use for non-emergency calls, the National Ambulance Service (NAS) is moving from an Emergency Medical Service (EMS) to a Mobile Medical Service (MMS) which aims to deliver the right patient care in the right setting. This re-design of emergency care delivery has inspired the development of numerous hospital avoidance initiatives including the introduction of a telemedical clinical hub, a mental health signposting desk and Community Paramedics amongst others. At Cork University Hospital (CUH), the Alternative Pre-hospital Pathway (APP) Team is a bespoke model of pre-hospital healthcare delivery which complements the national shift toward integrated community care. Founded in November 2019, the APP Team is a Community Emergency Medicine collaboration between CUH and the NAS. The team responds to low acuity 112/999 emergency calls in the Cork area and aims to provide definitive patient care in the community or to refer patients to the appropriate community or specialist service. This precludes the need for ambulance conveyance to the Emergency Department (ED) and frees up emergency ambulance resources for critically ill or injured patients. The APP Team is comprised of a Registrar in Emergency Medicine (EM) and an Emergency Medical Technician (EMT) in a NAS response vehicle. Running 7 days a week from 10am to 8pm, the team operates out of CUH ED and covers a mixed urban and rural population of approximately 300,000 people within a 40

minute drive time of CUH. The team is tasked to calls considered low acuity by the ambulance dispatcher. Calls may also be generated by Paramedics and Advanced Paramedics (APs) who have assessed patients and deemed them amenable to definitive treatment by the APP Team in the community. Real-time clinical oversight for the APP Team is provided by a Consultant in EM via tele-medicine. The team meets monthly to facilitate detailed discussions regarding cases and operational issues. The APP Team provided 2,200 episodes of patient care in 2021, with a median of 6 patients treated per shift and a median age of 61 years. The overall non-conveyance rate was 70%. 715 (32%) of patients attended were aged over 75 years, with a non-conveyance rate of 66%. There were no reported complaints or un-expected re-presentations. The most common presentations seen by the APP Team were general medical, low falls, drug and alcohol related presentations, urological complaints and respiratory complaints. Where follow-up was arranged the majority was organised with the patient’s GP but could involve referral to Outpatient Clinics, review by Clinical Nurse Specialists (e.g. Epilepsy and Diabetes), home visits by the Integrated Care Team or Public Health Nurse, scheduled appointments with the Acute Medical Unit or Psychiatric Community Assessment Hub, or referral to St Finbarr’s Assessment and Treatment Centre for the elderly. Having been assessed by an Emergency Doctor on the APP Team, patients

requiring hospital transport were often able to bypass the ED process and be seen directly by the specialty team. Providing definitive care to patients at the first point of contact is a key aim of Irish healthcare delivery as described in the Sláintecare report. “Increasing demand for emergency care and an aging population is necessitating a re-design of traditional models of emergency care delivery and the Alternative Pre-Hospital Pathway (APP) Team is one such response," said Professor Conor Deasy, Consultant in Emergency Medicine at CUH. Professor Deasy has said that the data generated by the APP Team demonstrates that in a cohort of patients with low acuity complaints for whom an emergency ambulance was called, 70% of them were suitable for management in the community, avoiding the need for conveyance to an emergency department. “This is good for service providers as resources are finite, and great for the patient,” he said. The APP Team at CUH ED is just one example of how novel collaborative initiatives between community, pre-hospital and hospital services are driving the health service towards delivery of patient-centred integrated community care.

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STEPS TO HEALTH CHALLENGE 2022

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our team co-ordinators tell us why they love it

lmost 600 co-ordinators registered teams to take part in our annual Steps to Health Challenge and are busy motivating their teams to walk daily and enjoy the contact with colleagues. Along with HSE staff, colleagues from Tusla, safefood, the Department of Health, the Department of Social Protection and others have also joined in this year’s challenge. Audrey Burkley and Fiona Barrett take on the team co-ordinator role every year. Cork-based public health nurse Audrey said, “The Steps to Health Challenge is a great way of pushing me off the couch to get active. Many of us are still feeling the huge effect that COVID-19 had on our staff including redeployment and the enormous restrictions in our work places. “The Steps to Health Challenge really helped to get us active and connect with each other during those difficult times. “I’m delighted to be a Steps team co-ordinator again this year and to be able to get out walking with colleagues without all the restrictions. We make sure to do pre and post stretches and walk together as a team, starting small and gradually building up every day to achieving as many steps as possible, depending on each team member’s capabilities. “Aside from walking, we love the opportunity for chats and discussions knowing that great thoughts can be conceived while walking with colleagues! “Personally, an early morning walk is a blessing for the whole day and it is a privilege to be able to walk and be mindful of nature

around me. It’s a marvellous HSE opportunity encouraging physical activity and camaraderie.” Fiona Barrett, another keen annual team co-ordinator at University Hospital Kerry, equally enjoys its benefits. “My fitness level had been declining slowly last year and while I had begun to notice it more and more, I couldn’t find the energy or the motivation to get moving after finishing work. I have two young kids and some back problems and they became my excuse of not being able to do any physical activity. I had become reluctantly accustomed to hearing myself say ‘I’m too tired or my back is too sore’,” she said. “So when the email came through calling for registrations for the Steps to Health Challenge, I took it as a sign to reverse my sedentary behaviour. It was the kick start I needed to become a more active me, for my health and for my kids. I also had some family occasions looming and was dreading finding an outfit that I would have felt comfortable in and looked good too. So, if I was to shed a few unwanted pounds doing the challenge I would have got an extra bonus. Steps to Health did benefit – I became more active, found and wore the outfit with confidence and the scales moved favourably!! “Steps to Health gives us the opportunity to socialise with colleagues at break times, while chatting to clear our heads and moving to get any rigid muscles working again. Slow and steady wins the race! “This year’s Steps to Health Challenge is much more fun than last year as more of us are in workplaces. We continue to be careful and don’t forget our colleagues still working from home. WhatsApp and Facetime are great ways to walk with them in twos.”

Above: Audrey Burkley enjoying a solo moment during the Steps to Health Challenge Below: Fiona Barrett and team members Sandra Walsh, Michelle O’Sullivan and Lisa McCarthy, University Hospital Kerry

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15/06/2022 12:00


Charlie Bird Climb COVID testers reach summit in nationwide charity effort

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alway COVID-19 community testing team, representing HSE Community Healthcare West, together with ETI Security and C2 Security, laced up their climbing boots for the recent fundraising event with Charlie Bird in aid of Pieta House and Irish Motor Neurone Disease. The team successfully reached the summit of Diamond Hill in Connemara National Park and raised €2,070 for the charities, adding to the €2.4m raised nationwide. In preparation for the climb, the staff members had all been taking part in the HSE Community Healthcare West Health and Wellbeing Steps Challenge. “Not only did the Steps Challenge reignite our motivation for exercise, but it was fantastic in helping us to achieve our goal to climb Diamond Hill. It also had the knock on effect of team bonding and increased morale amongst staff. The day of our climb was exciting and spirits were high,” said one of the team. “We set off in convoy to Connemara after work. After a quick photo shoot at the bottom of the Hill we embarked on our climb. While it was a real challenge due to varying fitness levels, the team remained together in the spirit of the day. It was a beautiful day and reaching the summit was amazing.

“We were all very aware of the reasons for our climb, the charities we were fundraising for and the multiple other climbs taking place across the country. We used our time at the summit to reflect on that and discussed the work of the charities and their services. It was a very enjoyable and thought provoking afternoon and we would not hesitate to engage in charity work in the future. As a team we are very proud to have played our part.”

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15/06/2022 12:01


Travelling towards mental health equity in Ireland Community Healthcare West project scoops runners-up spot in innovation competition

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s and from March 1st 2017, the Irish State has officially recognised Travellers as a distinct ethnic group, indigenous to the island of Ireland. Although this acknowledgment seems to be merely symbolic, it has significant implications for the health services. By recognising Travellers as an ethnic group, the State assumes the responsibility to establish mainstream services fully responsive to their cultural requirements, as outlined by several HSE frameworks including ‘Sharing the Vision’. For this reason, in 2018, the HSE recruited seven Mental Health Service Coordinators for Travellers posts, who work within the community mental health services across Ireland and develop initiatives to create cultural competency to increase Travellers’ access to services and improve their mental health outcomes. Travellers are disproportionately affected by mental health problems and suicide compared to the general population, they are overrepresented in the mental health services and experience sub-optimal engagement with the health services due to discrimination, low literacy and distrust. In 2021, the Traveller Mental Health Coordinators developed a project which won the runner-up prize at the Galway Finals of the 2021 HIHI-HSE Spark Ignite Competition, which rewards innovative initiatives designed by HSE practitioners. The project was named ‘Travelling towards mental health equity’ and aimed at addressing one problem: the fact that mental health services in Ireland are ‘one size fits all’ and very rarely take into account the needs of disenfranchised ethnic minorities. Despite recent efforts of Mental Health Reform and the Mental Health Commission to create guidelines for mental health services working with ethnic minorities, there is a lack of a coordinated national approach that addresses systematically the specific needs of Travellers. Jacopo Villani, Mental Health Service Coordinator for Travellers, HSE Community Healthcare West, explained, “Our project aims at overcoming these problems by creating the world’s first Traveller Inclusion Quality Framework. This will entail the development of Quality Standards for mental healthcare professionals working with Travellers, in collaboration with members of the community. It also requires the creation of an Accreditation System which would enable mental health teams all over Ireland to adhere to the Quality Standards and achieve a Certification of Competence of engaging and delivering services to Travellers. “As a starting point, we are planning to engage with Traveller Groups and HSE Traveller Health Units all over Ireland to develop

these quality standards, and to identify gaps within the existing guidelines for mental health services working with ethnic minorities. We want these Quality Standards to be specific and attainable, but mostly, relevant for Travellers; that is why hearing Travellers’ voice would be our priority. Once these standards are developed, we would like to pilot them and evaluate if over time, Travellers engaging with teams that adopt these standards fare better than patients from other areas.” He said there are huge returns on investments from this approach. “Besides increasing the skills and knowledge of mental health teams and improving community trust, there is a significant cost-saving by reducing Travellers no-show rates at appointments. Our own assessment in one region has shown that approximately 25% of Travellers tend to miss mental health consultations, which corresponds to a loss of hundreds of thousands of euros nationwide,” he said. “Travellers are often blamed for not engaging with services. It would be beneficial if we, working in the health system, were able to change perspective and instead of ‘blaming the victim’, we could ask ourselves, “Why are Travellers not engaging with the health services? Can we tweak the way we operate to accommodate the needs of a marginalised community that faces disproportionate socioeconomic barriers?” It has been evidenced that services that adapted their practices in order to ensure compatibility with the cultural characteristics of specific communities are four times more effective. Therefore, let us work together to create more equity to transform our healthcare system so that it can provide effective care for all.”

“Why are Travellers not engaging with the health services? Can we tweak the way we operate to accommodate the needs of a marginalised community that faces disproportionate socioeconomic barriers?”

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15/06/2022 12:02


LET THE FUN BEGIN Festivities resume for nursing home residents

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ver the last two years, COVID-19 restrictions have meant that usual seasonal events and festivities that residents and staff greatly enjoyed and looked forward to in Clonskeagh Community Nursing Unit (CCNU) unfortunately couldn’t be celebrated as they once were. This year, as COVID-19 restrictions have eased, the team at CCNU were keen to bring back some joy and celebration for their residents and were delighted to once again be able to plan some seasonal activities and events. In February, the Home Action Team organised a ‘best decorated house/floor’ event for Valentine’s Day which was judged by residents and a special afternoon tea was served. In Dementia Care, where feelings matter most, the way a resident experiences conversations can make or break their day. Valentine’s Day celebrations were enjoyed by many with many residents not wishing the day to end. When St Patrick’s Day came round, the team enjoyed embellishing corridors and communal areas with Irish-themed decorations. A photo booth was set up for residents and staff to take photos and picture collages were developed. Naturally, green was the theme of the day, and residents and staff were all encouraged to wear something green. Their Home Action Team also organised Irish dancers to perform on the day and residents enjoyed Irish coffees and sang Irish songs.

When Easter came around, the team decorated communal areas with spring flowers. All residents were also given Easter eggs to help celebrate the occasion with chocolate, an essential part of Easter celebrations! As COVID-19 hasn’t gone away, the team in CCNU had to ensure that strict infection and prevention control guidelines were followed during all events and gatherings. Most of the activities are delivered either individually or in small pods, but for those that weren’t able to attend in-person gatherings, some events were also televised to all the rooms via an internal communication system. The decorations around the Unit also added additional stimulation, promoting positivity and enthusiasm. The team are looking forward to planning more events and activities like these for residents throughout the year.

LETTERKENNY STAFF PUT A SPRING IN THEIR STEP

The staff at Letterkenny University Hospital (LUH) geared up for a six-week walking programme recently. The programme ran at lunchtime every Tuesday and Thursday and was facilitated by a trained walking leader provided by Donegal Sports Partnership. Paul Friel, Senior Health Promotion Officer at LUH, said he believes there is a huge opportunity for staff to meet and unwind in a comfortable environment. “Walking is free, has proven to reduce stress and is a social outlet for many people. By changing the work environment to include accessible walking routes, we can help raise awareness of the many benefits of physical activity to our overall health and wellbeing,” he said. “The national Physical Activity Guidelines recommend adults should get at least 30 minutes of physical activity five times a week and with Letterkenny Town Park on the doorstep of the hospital, staff were able to avail of a safe, secure and guided programme to engage in moderate or vigorous physical activity. All levels were

welcome and we encouraged staff to bring a family member, friend or work colleague along. Participants were able to join at any time throughout the 6 weeks as it was a ‘come and try’ approach to physical activity.”

Staff from Letterkenny University Hospital enjoying lunchtime sunshine on the first day of a six-week walking programme.

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YOUR OPINION COUNTS Actions already been taken forward in response to Staff Survey

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he Your Opinion Counts Staff Survey 2021 has enabled us to build a more accurate picture of how staff feel about working in Health Services in Ireland. This feedback comes at a time when we are emerging from a challenging period for our health service and presents concrete suggestions on how we can work together to deliver safer, better healthcare by improving workplace culture, staff recognition, increasing frontline numbers and improving working conditions. Staff described their experience during this period: how new ways of working emerged and created greater opportunities for collaboration with colleagues. They co-designing new and innovative ideas and and this all helped to accelerate change, improving the quality of care and staff confidence. There is now an opportunity to further build on this learning by responding to the Staff Survey results and taking the actions required. Better collaborative decision-making in teams and creating more opportunities to recognise the achievements of staff will ultimately improve the culture of the organisation. This will, in turn, build greater trust and confidence in our services, amongst staff, patients and the public. Staff feedback is invaluable and will be used as the basis for ongoing discussions between managers and staff over the coming year. National HR has put in place a quarterly reporting process to track the progression of actions from the Staff Survey across Hospital Groups, Community Health Organisations, National and Corporate Services.

READ THE HSE STAFF SURVEY REPORT 2021 HERE: HTTPS://WWW.HSE.IE/ENG/STAFF/STAFF-ENGAGEMENT/RESOURCES/ YOUR-OPINION-COUNTS-STAFF-SURVEY-20211111.PDF

TO DATE A RANGE OF ACTIONS ARE BEING TAKEN FORWARD BY CHOS, ACUTE HOSPITALS AND NATIONAL SERVICES INCLUDING: • Improving recognition of staff achievements, contributions, projects and initiatives. • Improving local induction programmes e.g. having face-to-face meet and greet departmental inductions and the establishment of buddy systems. • Ongoing recruitment in line with Service Planning to continually build the workforce in line with the objectives of Sláintecare. • Conducting exit interviews to identify trends and patterns in relation to staff turnover and assist with identifying areas to improve the work environment. • Dignity at work on line training will now be made mandatory, local services to ensure that staff avail of this training. • Development of a Culture Guidance resource and related available supports. • A range of measures to improve communication and information sharing e.g. staff apps, HR drop-in clinics, shared files, webinars and face-to-face town hall meetings. • Expanding the availability of Coaching and Mentoring Programmes for staff. • Focus on Diversity, Equality and Inclusion e.g. multicultural days. • A range of supports and guidance on improving staff Health and Wellbeing e.g. EAP programme, H&WB local committees, wellness seminars and information shared with staff. • Expanding the use of digital solutions to enhance work processes e.g. NiSRP online automated system saving time for staff • Providing flexible working opportunities where possible. • Learning & Development ongoing training and development provided for staff. • Staff skills development opportunities to improve staff retention.

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A DAY IN T H E L IF E

OF A CNSP IN CASTING AND SPLINTING Catherine Howells, CNM/CNSp, CHI Crumlin, gives a run-down on her typical day and explains how completing the Professional Certificate in Musculoskeletal Casting and Splinting in 2019 has empowered her to use her knowledge and skills to support the patients in her care

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work as a CNSp in CHI, Crumlin and am part of the cast room nursing staff. Along with my colleague CNSp, Olga, our role focuses primarily on the care of children with a diagnosis of Developmental Dysplasia of the Hip (DDH). We are both nurses with a qualification in Casting and Splinting, a specialist area of nursing we are very passionate about. I have a varied daily schedule encompassing a wide range of duties. As part of the Orthopaedic team, I work in the Outpatients Department (OPD), operating theatres and wards, both inpatient and surgical day ward. I am the liaison person for DDH patients and their families and the multidisciplinary team for inpatients and outpatients. Prior to completing my days’ work, I update the DDH database. This is an important part of my role as a CNSp. The DDH service database gives information that can be used for both research purposes and also for future service planning.

MORNING My day starts between 7am or 8am. Emails and voice messages are checked. As part of my role I provide support, counselling and education to families pre-operatively, post-operatively and throughout their treatment. We are the key link between home and hospital providing support, advice and problem solving. We provide a drop-in service for children and their families attending the DDH service if they are having any concerns with their spica cast or hip orthosis. I plan and arrange for any patients that may need reviews of their spica cast or hip orthosis. Orthopaedic clinics start between 8am and 8.30am. We attend all elective orthopaedic clinics as we are responsible for the caseload of children attending with DDH. Some elective Orthopaedic clinics have dedicated DDH slots allocated to help accommodate the growing number of DDH patients attending the service. We are present during the clinic consultations to represent the child and family and to be able to follow through with explanations and counselling for patients and families. At the clinic I provide a range of specialist services including removing spica casts, adjusting casts if required for patient comfort and fitting hip orthosis as required. This all requires specialised casting and splinting skills, to provide a comprehensive and quality assured service, to the DDH patient cohort. Twice monthly, Olga and I manage and run a nurse led Rapid Access Hip Clinic, under the supervision of an Orthopaedic Consultant. We are the link and resource to the community, including GPs, AMOs, and PHNs, and other hospitals with regard to referrals about concerns of DDH in a child.

Catherine with her class on the RCSI graduation day in 2020.

I also facilitate a Virtual Hip Clinic (VHC) of x-ray reviews with the Orthopaedic Consultant. This clinic was initiated by us nurses as referrals to the Rapid Access Hip Clinic often included children who already had hip x- rays performed. We had concluded that the wait time for the Rapid Access Hip Clinic was increasing due to demand. Therefore, we felt if we streamlined appointments offered based on an x-ray review at the VHC, then we could triage patients more efficiently and discharge if appropriate. All patients who attend the VHC are contacted by telephone and results are discussed with parents. This is also accompanied by a copy of the dictated letter that is sent back to the referring source. Parents will receive from us an information leaflet on DDH, if appropriate. As trained cast nurses, we have the opportunity to empower our patients and families with knowledge.

AFTERNOON Afternoon clinics commence at 1.30pm and if not there I attend the operating theatre which runs in conjunction with clinics. As part of our role, we are always in theatre for all hip procedures. These include hip arthrograms, closed reductions and open hip procedures. We are responsible for application, adjustments and /or removal of hip spica casts and any hip orthosis that are applied in theatre. We are involved in organising and planning the management for ongoing care for this patient cohort. Post operatively I review all patients on the surgical day ward or in patient wards, to provide education and support to the family while they care for their child in spica cast or hip orthosis. By providing adequate and essential information, the child and their family are empowered to maintain their independence while living in cast. There is an assumption that the sole function of a plaster nurse is to apply and remove plaster casts but, the truth is the role is very varied depending on the area or unit. It can be demanding but I enjoy the challenge that every day brings, every patient and family are unique and bring their own set of challenges. I had years of experience before the opportunity arose to complete a postgraduate qualification in my speciality. I completed the Professional Certificate in MSK Casting and Splinting at Cappagh Hospital in 2019. Attaining this qualification brought new insight and further added to my enthusiasm for the job I do. In addition, because of completing this RCSI post-grad programme, I have become part of a particular cohort of nurses who hold this qualification. As a result, I have even more colleagues with whom I can collaborate, discuss, learn and get support from. It was a really engaging experience because of the mix of theory and practical workshops. No doubt the bespoke Casting Centre at Cappagh National Orthopaedic Hospital makes for an engaging learning environment and contributed to my enjoyment of the programme. I highly recommend it as an area or speciality to consider for anyone considering a new and interesting nursing post graduate course. It is a very rewarding job that allows great autonomy in the workplace and great scope to further cultivate your career. The qualification in Casting & Splinting is attained from the RCSI and credited by the NMBI. Details can be found on the RCSI website or on the National Orthopaedic Hospital Cappagh website. HEALTH MATTERS SUMMER 2022 | 43

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H.E.A.R.T. AWARDS

Local midwives and nurses honoured for excellent care during the pandemic Back: Karn Cliffe, Director of Nursing and Midwifery with the Dublin Midlands Hospital Group; Maura Loftus, Director of the Regional Centre for Nursing and Midwifery Education (RCNME) Tullamore; Sandra McCarthy, Director of Nursing, MRHP; Sr Mareena Shiji Mole Mathew, Staff Nurse and overall award winner; Ann Marie O’Shea, Advanced Nurse Practitioner Adult Respiratory Services, award winner; Dr Mary Nolan, Interim Director of the Nursing and Midwifery Planning and Development Unit Midlands. Front: Fiona Moore Nurse Practice Development Co-ordinator MRHP; Paediatric Nurse and award winner Dolores Tynan; Emma Mullins, Clinical Midwifery Manager and award winner; Maureen Revilles, Director of Midwifery MRHP.

Staff Nurse Sr Mareena Shiji Mole Mathew the overall H.E.A.R.T Nurse or Midwife of the Year 2021 at MRHP

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r Mareena Shiji Mole Mathew has won the overall accolade for nurse of the year at the first-ever H.E.A.R.T. Awards for Nurses and Midwives at the Midland Regional Hospital Portlaoise (MRHP). Her award was presented by Maura Loftus, the Director of the Regional Centre for Nursing and Midwifery Education in Tullamore. Sr Mareena who works on the Slieve Bloom Medical Ward at MRHP won praise for her very high standards of care and empathy while also advocating strongly for her patients. Her role in supporting her colleagues and teaching student nurses was also complimented. She is originally from the state of Kerala in India.

H.E.A.R.T. stands for Honesty, Empathy, Accountability, Respect and Teamwork. Sandra McCarthy, Director of Nursing at MRHP, said, “I am proud of how our nursing staff here responded to the recent pandemic. During the most challenging of years, they proved you really do see the best of people in the most difficult of times. It’s really important that we recognise that excellence. Recognition is an expression of appreciation and gratitude. Employee recognition is a form of positive feedback. It is important for the individual and their team to recognise and value those outstanding contributions.” Maureen Revilles, Director of Midwifery at MRHP, added, “During COVID women still required maternity care, delivery and postnatal care and support with breastfeeding. I want to pay tribute to my team who adapted their services to ensure women and their families continued to have positive birthing experiences, in challenging circumstances for women, their support partners and wider families.” Dr Karn Cliffe, Assistant Director of Nursing and Midwifery with the Dublin Midlands Hospital Group said all of those receiving awards ‘exemplify the very best in the profession’. “I would like to praise the courage of all nursing staff in Portlaoise for their personal sacrifice and life-saving work in meeting the challenges of COVID head-on. Rather than back away from the unknown, they put themselves on the frontline amid increased medical risk showing great courage and resourcefulness. They will I am sure continue to make a real difference in the lives of their patients,” she said.

THE FIVE AWARD WINNERS ARE: 1.

Sr Mareena Shiji Mole Mathew was the overall H.E.A.R.T Nurse or Midwife of the Year 2021. 2. Melissa Dunne, the Interim Assistant Director of Nursing Medical Services won the H.E.A.R.T Award for Nurse Leader of the Year in 2021. She was nominated for her role as Clinical Nurse Manager of the Day Services and Covid Ward during 2020/2021. 3. Emma Mullins, Clinical Midwifery Manager, won the H.E.A.R.T. Award for the Midwife Leader of the Year 2021. Emma was nominated for her compassion and commitment to women in her care as well as her exemplary leadership, support and thoughtfulness towards her colleagues. 4. Ann Marie O’Shea, an Advanced Nurse Practitioner at Adult Respiratory Services won the H.E.A.R.T. Award for Developing

Practice Nurse or Midwife Leader of the Year 2021. Ann Marie was nominated for her professional knowledge, her dedication to patients and her support for colleagues during the pandemic. 5. Dolores Tynan a recently retired Paediatric Nurse was presented with the H.E.A.R.T special recognition award. Dolores received an exceptional number of nominations from her colleagues who highlighted her commitment to patients, support for her co-workers as well as her professionalism and knowledge. The winners received a glass plaque, while all the nominees were presented with a gold coin. All of those who received awards were nominated by their peers in recognition of their outstanding care, compassion and commitment to nursing and midwifery at the Midland Regional Hospital Portlaoise.

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“I cannot say enough about this course and really needed it in the current climate. I feel recharged and energised."

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Leadership programme encourages nurses and midwives to reflect on pandemic journey

urses and midwives are being encouraged to take time to pause and reflect on their leadership journey during the pandemic with a new ICARE programme. The aim of the ICARE leadership programme is to support nurses and midwives of all grades to use this learning to help themselves and others, not just to survive, but to be the best they can possibly be in these challenging times. The programme has been delivered by the National Clinical Leadership Centre for Nursing and Midwifery (NCLC), Office of the Nursing and Midwifery Director, HSE, which supports the clinical leadership development of all grades of nursing and midwifery nationally. It has been developed to meet the leadership needs of nurses and midwives during the pandemic. Since September 2021, the NCLC team have delivered the ICARE programme to over 420 nurses and midwives. The feedback has been excellent and it is evident from that, that the content and delivery is meeting the needs of participants, at this challenging time. The ICARE Framework for Courageous Leadership is a one-day leadership programme developed by Prof Brian Dolan and Lynda Holt, Health Services 360 (UK) to provide nurses and midwives with an opportunity to reflect on their leadership journey during the pandemic, so that they can continue to do the things that matter to them, seek support on their leadership journey and lead others to do the same. Health Service 360 have been delivering this programme to nurses and midwives in the UK, Australia and New Zealand during COVID-19. The feedback from participants has been excellent. The National Clinical Leadership Centre for Nursing and Midwifery (NCLC) team have undertaken the train the trainers programme and are now delivering the one-day ICARE programme for all grades of nursing and midwifery up to and including Assistant Director of Nursing and Midwifery or equivalent grades. The NCLC team, in collaboration with Health Service 360, are currently developing an ICARE programme for Director of Nursing and Director of Midwifery grades.

IN THE PROGRAMME, PARTICIPANTS ARE SUPPORTED TO: • •

Reflect on their leadership experience during the pandemic Use their learning to understand the challenges and opportunities they currently face as clinical leaders • Engage with each component of the ICARE model to enhance their personal and professional leadership skills and knowledge • Use the networking and collaboration to learn from each other and share their experiences Some examples of the positive feedback that nurses and midwives have given include, “Good for any grade really as it focuses on every day coping within our work environment and dealing with ourselves and colleagues”; “I cannot say enough about this course and really needed it in the current climate. I feel recharged and energised. Compassion is so needed now and knowing that you can be strong and compassionate and say no just lifted a massive weight from my shoulders. Thank you so much, you actually don't know how much this has helped me”; “The model itself was really helpful in forming a framework for leadership skills and a great reference for the future.” The NCLC continues to receive a large number of requests from services to deliver the ICARE Leadership Programme to support their nursing and midwifery workforce.

PODIATRY COLLABORATION LEADS TO BETTER PATIENT OUTCOMES An innovative collaboration between the community podiatry service and the public health nursing service at Blanchardstown Primary Care Centre has been successful in providing better patient outcomes. The successful collaboration of two disciplines can improve patient outcomes, whilst also reducing acute admissions, and allowing early discharge in the Primary Care system. Senior Podiatrist Angela Ferris presented a poster at the All-Ireland Conference on Integrated Care 2022 in UCD, co-authored with Andrea Collins, Senior Enhanced Nurse, entitled ‘Integrated Care Pathway for the Diabetic foot: a Community Podiatry and Public Health Nursing initiative’. “A 10% reduction of diabetes patients requiring inpatient foot ulceration treatment would save around €7m per annum. The management of diabetic foot disease requires a collaborative, multi-disciplinary approach,” said Andrea. “These two ‘tributaries’ of health care are complimentary in the management of the diabetic foot, and can work together in order to accomplish common goals. Integrated care is integral in offering holistic, patient-centred care, built around the complex continuum of our patients’ needs, practitioners’ strengths, and overall desirable outcomes. “This service is transferable and can be replicated in any Primary Care Centre."

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REHABILITATION CARE PATHWAY The Specialised Rehabilitation Unit (SRU) is a recovery-focused rehabilitation inpatient unit providing therapeutic input for people with severe and enduring mental illness and complex needs

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he SRU is a ‘significant component of this rehabilitation care pathway’ described within a Model of Care (MOC) for these service users, which was launched back in 2019 by the HSE National Mental Health Services. Dr Donal O’Hanlon, Consultant Psychiatrist HSE and Chair of the MOC working group, said, “The MOC outlines a care pathway designed to meet the needs of a small, but significant number of people within mental health service who require rehabilitation. A significant component of this rehabilitation care pathway described within the MOC is the SRU.” Is it estimated that as many as 10% of people attending mental health services have complex mental health needs that often require rehabilitation in a setting like a SRU. Jim Ryan, Assistant National Director, HSE Mental Health Services, explained, “Back in 2018, to address the problems associated with a number of service users requiring rehabilitation and residing in acute inpatient units for prolonged periods of time, the HSE National Mental Health Services commissioned two national Specialised Rehabilitation Units (SRUs), a 12-bedded unit in Highfield Healthcare and a 15 bedded unit in Bloomfield Health Service. Due to the success of this rehabilitation programme, the HSE commissioned a further 100-bedded SRU in Highfield Healthcare which was opened in January of this year.” The SRUs, which are available to service users throughout the country, provide assessment, treatment and interventions that assist and support people to manage their often debilitating mental health symptoms in order to maximise their potential for recovery while also improving their overall quality of life. However, it is important that SRUs are not viewed as standalone units but rather as a whole rehabilitation and recovery care pathway that provides a continuum of care that facilitates recovery. Although not a linear process, the supports include SRUs, community rehabilitation residences, community rehabilitation and recovery services (including community rehabilitation teams), individual accommodation options and occupational and employment supports. A key component of the SRU process was establishing the National Referral Committee (NRC). The NRC is an expert group made up of mental health clinicians and senior managers. Their main purpose is to provide governance on behalf of the HSE National Mental Health Services. Paul Braham, Senior Operations Manager, HSE National Mental Health Services, said, “The NRC are responsible for reviewing all SRU referrals prior to being forwarded to either Bloomfield’s or Highfield’s SRU clinical team for assessment. They’re also responsible

for reviewing the national SRU waiting list along with all new SRU referrals on regular bases.” Once a SRU application is reviewed by the NRC and deemed appropriate, the HSE National Mental Health Services organise for the referral to be sent to one of SRU teams for assessment. The assessment process consists of the SRU multidisciplinary team (MDT) firstly reviewing the referral followed by an onsite visit by at least two members of the SRU MDT. This visit involves the SRU MDT meeting both the service user along with the local referring Community Retaliation Team (CRT) or Community Mental Health Team (CMHT) and carrying out a full assessment. Following the onsite visit, the completed assessment is reviewed by the entire SRU MDT and only then is a decision made on whether the service user can be offered a SRU placement. To date, a total of 52 people have been admitted to the SRUs with an average length of stay of 16.5 months. Prior to admission, the service user is invited to visit the SRU. Colum Bracken, Director of Nursing, Highfield, said, “The focus of this pre-admission visit is for the SRU team to meet the service user and start to build a rapport with them. Furthermore, the pre-visit allows the service user to tour the SRU and to see how it operates. This in turn allows them to make a final decision on whether they would like to be admitted to the SRU or not.” Through a graduated approach, SRUs provide an array of treatments and intervention that support the improvement of Service Users’ overall health and wellbeing. “All SRU interventions are delivered in terms of a service user’s mental health. They are reviewed in relation to treatment resistant psychosis with a number of service users meeting the criteria for treatment resistant psychosis and have required a trial of Clozapine. All medications are reviewed and adjuncts where necessary are added. All service users receive a rehabilitation assessment which involves a functional and social OT assessment and intervention, looking at their skill sets and how best to utilise these,” said Dr Marina Bowe, Consultant Psychiatrist, Highfield. Dr Kevin Foy, Consultant Neuropsychiatrist, Bloomfield, said, “The corner stone to any SRU programme is group work in addition to individual work. It includes interventions such as Mutual Support Group, Wellness Group, Basic Psychotherapy Groups, Staff Support Group, Sensory Group, Peer Support, Decider Skills, Social Skills Group, Sexuality & Relationship Group, Discharge Group, Tai Chi, cooking, creative therapies and community group activities.

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For further information on the SRU referral process please go to https:// www.hse.ie/eng/services/list/4/mentalhealth-services/rehabilitation-recoverymental-health-services/

He went on to explain, “The SRU also has a number of individual programmes such as self-care and living skills, anxiety management, physical health issues, environmental challenges, family and relationship issues, family interventions and future accommodation needs. Individual psychotheraputic interventions utilised include Cognitive Behavioural Therapy (CBT), Management of Emotional Dysregulation, and support for relationship problems, trauma processing and supportive work. Service users also have the opportunity to engage with individual peer support.” Another key element of the SRU process is the discharge process with discharge planning commencing from the outset of a referral being made to the NRC. It requires each Community Health Organisation (CHO), Mental Health Head of Service to give an undertaking that a community rehabilitation residence will be provided for the service user on discharge from the SRU, where they will receive input from their local community rehabilitation team in order to continue on their recovery journey. Furthermore, in order to ensure all key stakeholders are fully aware of the transitioning process, it is essential that the service user, family members, SRU MDT and allocated Care Coordinator are involved in the discharge process from the outset of the service user’s SRU journey. A Care Coordinator is a nominated mental health clinician from the referring community rehabilitation team or community mental health team.

Aoife Farrelly, Senior Mental Health Social Worker and allocated Care Coordinator, said, “Care Coordinators have a vital role within the SRU process, as they’re the main point of contact for all relevant stakeholders, including the SRU MDT, the referring team, the service user and their family members. They need to attend meetings with the SRU MDT at least every three months or more often if required. They remain involved in the service user’s care throughout their time in the SRU and also continue to provide appropriate support for the service user following their discharge from the SRU.” The concept of rehabilitation and recovery within mental health services has considerably changed in recent times. With the development of A Vision for Change (2006) and more recently Sharing the Vision (2020) along with the MOC for People with Severe and Enduring Mental Illness and Complex Needs (2019) and the establishment of the National SRUs, Irish Mental Health Rehabilitation & Recovery Service’s focus has moved towards supporting service users to discover a purpose and meaning to life with an emphasis on realising a person’s full potential rather than solely focusing on a ‘cure’ or remission of symptoms. With this in mind and while also acknowledging that the SRU is only part of the rehabilitation journey and not an end in itself , it is envisaged that mental health rehabilitation and recovery services will continue to progress and expand in the coming years.

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Sharing the Vision A mental health policy for everyone Implementation plan launched

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n ambitious new plan that has been unveiled will improve ‘transparency, accountability and governance’ over the reform of Irish mental health services. The HSE has launched the first of three implementation plans to support Sharing the Vision – A mental health policy for everyone 2020 – 2030. The policy sets out a programme to enhance the provision of mental health services and supports from mental health promotion, prevention and early intervention through to acute and specialist mental health service delivery. Jim Ryan, Head of Operations, HSE Mental Health, and chair of the HSE Implementation Group (HIG), explained, “The HSE has primary responsibility for the implementation of the majority of the policy recommendations. Through the HSE Implementation Group, we will continue to drive the implementation through effective interagency and interdepartmental collaboration. Our learnings from Connecting for Life and Vision for Change show that clear accountability and ownership are vital for successful implementation. “This plan will ultimately improve transparency, accountability and governance over this major reform of our mental health services. We will continue to invest in and enhance our services to modernise delivery of mental health care. Above all, we will work in partnership with service users and families, in order to achieve the goal of a modern mental health service.” Minister of State for Mental Health, Mary Butler, who launched the policy, said it was of “paramount importance for her to establish the National Implementation and Monitoring Committee (NIMC) in 2020 to drive Sharing the Vision forward, to put the policy into practice and to ensure regular reporting to me as Minister for Mental Health”. “A number of specialist groups are now in place, progressing the priority issues of women’s mental health, youth mental health transitions

The implementation plan can be accessed online at www.hse. ie/eng/about/who/mentalhealth/sharing-the-vision/sharingthe-vision.html

(from child to adult mental health services) and Acute inpatient bed capacity. A reference group of service users and family members will be established by the end of Q1 2022. This is of critical importance, as service users, family members and carers must have strong input into all aspects of policy design and delivery so that service improvement can be informed by their perspective and lived experience,” she said. “I would like to acknowledge the enormous work of the NIMC, the HSE, and all other partners and stakeholders from across government, the public, and voluntary and community sectors in the development of this implementation plan. The Sharing the Vision Implementation Plan 2022 - 2024 will enable us to build on innovation and progress achieved, and maintain the momentum necessary to put policy into practice and provide better mental health services for us all.” Yvonne O’Neill, National Director of Community Operations, HSE said the implementation plan sets out a clear road map for the continued reform of our mental health services. “It presents an ambitious change programme with the majority of planned activities led by the HSE. While the policy will be implemented over a 10-year period, many of the short-term recommendations of Sharing the Vision have already been significantly progressed. These include developments in areas such as digital mental health services, mental health promotion, perinatal mental health, the national clinical mental health programmes and reform of the mental health legislation,” she said. “With the important learning from A Vision for Change, I am confident that the HSE is in a strong position to build on the progress already made to deliver on this shared vision for our mental health services for the coming ten-year period.” The plan was developed by the HSE and the Department of Health, in collaboration with a range of Government Departments and state agencies and has the approval and endorsement of NIMC. John Saunders, Chair of NIMC Steering Committee, said, “The Implementation Plan will serve as a key enabler for the implementation of Sharing the Vision, outlining the chronological process of implementation, setting key milestones to be met each year, and illustrating the inputs and outputs necessary for implementation. I would like to commend all involved in the development of this plan, and I am confident that with its publication we are one step closer to realising the ambition of Sharing the Vision.”

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COMMUNITIES ASK

Hello, How Are You?

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ello, How Are You? is about connecting and engaging in open conversations about mental health. The campaign asks individuals, communities, workplaces, friends and family to say hello and ask the question how are you? in a meaningful way, using a simple fivestep framework (Hello. Engage. Listen. Learn. Options). Asking this small question and having one conversation can make a real difference in someone’s life. Creating, maintaining and staying connected with others helps tackle loneliness, creates a sense of belonging and purpose and builds relationships. Because of it’s signposting to help aspect, it also leads to increased help-seeking behaviour on behalf of individuals. Hello, How Are You? was initially started as a local campaign by Carlow Mental Health Association in 2015 and later piloted in several other counties. In July 2021, Mental Health Ireland set up a co-production group made up of Mental Health Ireland staff, HSE staff, people with lived experience from across Ireland, representatives of Mental Health Associations and relevant organisations, to work to launch this campaign nationally. Several Hello, How Are You? events took place across Ireland recently. In Community Healthcare East, public events included tea and coffee mornings in family resource centres in Dundrum and Greystones, Saint John of God, Leopardstown Racecourse and Gateway Mental Health Association, a mental health fair in Newcastle, afternoon tea in Enniskerry Parish Parochial Hall, chats and refreshments on Blessington Square, information stands in local libraries, shops and pharmacies, and group walks. An event was also held in the HSE building in Bray Civic Centre. The main focus for this event was to connect people with each other and to promote the Hell,o How Are You? five-step framework).

Campaign bookmarks and cards helped facilitate conversations over refreshments provided by the Health & Wellbeing Team and culinary samples supplied by some of the staff. There was also a raffle for an Easter basket kindly donated by the CSMU team. It was a wonderful opportunity to meet other people in the building, and with cake being the common denominator. There was an occasion that drew people to the one place and talk.

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Cancer the cause of one third of all deaths

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HSE National Cancer Control Programme publishes Early Diagnosis of Symptomatic Cancer Plan 2022-2025

he National Cancer Control Programme (NCCP) has launched the Early Diagnosis of Symptomatic Cancer Plan 2022-2025 which aims to provide a strategic, comprehensive approach to increasing the proportion of symptomatic cancers that are diagnosed at early stage disease (stages I and II) in Ireland. One in two people in Ireland will develop cancer at some point in their lives. For most cancers, survival rates are significantly improved when cancer is diagnosed at an early stage. Cancer is Ireland’s leading cause of mortality, accounting for approximately one in three deaths (30.8%) in 2019. For many cancers, stage at diagnosis is the most important determinant of survival. Lung cancer is Ireland’s leading cause of cancer mortality, but survival is greatly influenced by stage at diagnosis - 71% of patients diagnosed with early stage (stage I) disease survive for at least one year following diagnosis, compared to just 16% of those diagnosed with late stage (stage IV) disease. Five year survival for colorectal, breast and ovarian cancer is high for early stage (stage I) disease (95%, 94% and 83% respectively), falling to just 10%, 19% and 15% respectively for late stage (stage IV) disease. The NCCP Early Diagnosis of Symptomatic Cancer Plan 2022-2025 defines six high-level priority objectives and the actions required to achieve these objectives (Figure 1). These objectives guide the overarching approach to increasing the proportion of symptomatic cancers that are diagnosed at early stage disease (stages I and II) in Ireland. “Diagnosing cancer early, before it has grown or spread to other parts of the body, increases your chances of curative treatment and is one of the most important ways to increase survival. Stage at diagnosis is the most important determinant of survival for most major tumour types. Increasing the proportion of cancers diagnosed early is a key step in improving cancer survival in Ireland,” said Dr Heather Burns, Specialist in Public Health Medicine, HSE NCCP. Dr Una Kennedy is a GP based in Glasnevin and also works as GP Advisor to the HSE NCCP.

Please see HSE NCCP for more information www.hse.ie/ cancerearlydetection or if you are interested in collaborating on areas of the plan contact prevention@cancercontrol.ie

“Factors that influence the early diagnosis of symptomatic cancer can be broadly categorised into four groups - disease factors, patient factors, healthcare professional factors and health system factors,” she said. “The stage at which symptomatic cancer is diagnosed is influenced by the complex interplay between these factors. The implementation of this plan aims to address these factors. “We are urging people to be vigilant for any change to their health that could indicate cancer. If you notice symptoms such a new cough lasting for more than three weeks, breathlessness more than is normal for you, a new or changing lump, unexplained weight loss or unexplained bleeding, get it checked by your GP without delay.”

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2%

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Screening in focus Research on ‘Exploring and understanding perceptions of screening services in Ireland’ published

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6%

There is confusion he National Screening around the role of Service undertook a THE RESULTS OF THE RESEARCH ARE AVAILABLE screening with some largescale research ON SCREENINGSERVICE.IE/ people believing screening project in 2021 to help PUBLICATIONS is for those who have us understand how symptoms. people in Ireland feel about Many people don’t feel screening. The aim of the research confident when it comes to was to identify and explore peoples’ spotting symptoms. Around a fifth of people perceptions of screening services in don’t think they need to look for symptoms or Ireland and what drives and inhibits them to aren’t at risk of developing cancer/ diabetic attend screening. retinopathy if they attend regular screening. There were three elements to the research: interviews with healthcare professionals, a national survey and focus groups. The MOTIVATORS AND BARRIERS TO interviews with healthcare professionals SCREENING provided us with initial insight into the Across the screening programmes, the experiences of people attending screening. motivators for attending screening are: The national omnibus survey was carried • peace of mind out among 2,000 adults. The survey covered a • fear of developing cancer in the future number of areas, which provided us with • receiving the invitation letter people’s motivators and barriers to attending • advice from a GP or other healthcare screening. It also highlighted peoples’ practitioner knowledge gaps and what further information • part of their normal healthcare routine they needed in order to understand screening. Qualitative focus groups allowed for a deep A fear of finding something wrong is the dive into the results of the survey, probing main barrier to attending screening. The areas that needed more clarity. process itself – being uncomfortable, The research captured the awareness, embarrassing or a fear of the process – is knowledge, trust and understanding of also a strong barrier. screening programmes. It showed high For those who don’t attend screening, awareness of the four screening programmes additional reasons provided include a fear of among those eligible for the different finding something wrong or no symptoms/ programmes. It is positive and reassuring to feel fine. For some, not knowing if they’re see that there are high levels of intention to eligible or how to access screening can be participate in screening. barriers. Overall, people feel positive about screening There was clear direction as to what programmes as they offer an important, good information people would like more of, service and they understand the importance of including symptoms and how to reduce their attending health checks. risk. This information will empower However, there are low levels of knowledge self-care among people. when it comes to the different cancers and A combination of speaking to trusted retinopathy. There are knowledge gaps among healthcare professionals, particularly GPs, as some people when it comes to how to reduce well as the HSE website are the most used their risk of disease. sources of information across all four services.

NEXT STEPS We are committed to including the voice of our patients in our work, in order to inform and reform the way we deliver our services. The research will support us in delivering a truly person-centred service. The insights garnered will shape and inform our work to better engage the different audiences, addressing barriers to attending screening, to deliver evidence-based communications. We will continue to build trust with the public by communicating with them in an open and honest way, ensuring that people have all the information they need to make informed choices about screening.

WE AIM TO: • Increase understanding of screening and why it’s important – ensure clarity of information across communications and continue to explain the role of screening. • Increase awareness that cancer can develop between screenings (interval cancer) and that not all abnormalities will be picked up by screening (limitations of screening). • Reduce fear and encourage screening as a normal part of people’s health and wellbeing • Empower self-care by providing information on symptoms and how to reduce your personal risk of developing disease. • Continue to engage with GPs and other healthcare professionals to encourage screening attendance and provide information.

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Bedside

Innovation

Innovation at the bedside improving patient quality of life

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frontline innovation has led to one elderly lady regaining her independence and being able to return to live in

her own home. St John’s Hospital, Limerick hosts a research unit from the University of Limerick known as the Rapid Innovation Unit (RIU). The RIU is researching the application of 3D printing at the point of care to drive innovation on the frontline and improve patient quality of life. The team has a dedicated lab within the hospital that houses a suite of state-of-theart 3D printers and technology. With experienced design researchers on the ground, challenges at the bedside can be addressed in only hours by through collaboration with clinical staff. The Rapid Innovation Unit Project Team includes Dr Aidan O’Sullivan, Technical Lead; Dr Kevin J O’Sullivan, Research Lead; Siobhán Quinlan, Clinical Lead; and Prof Leonard O’Sullivan, Director. Recently the MDT team in the Clinical Recovery & Support Unit (CRSU) and RIU worked together to deliver a solution for a wonderful patient in St John’s. Maureen is a 68-year-old lady who was admitted to the CRSU in November 2021. She required emergency bowel surgery in September 2021, spending 30 days in intensive care and has advanced rheumatoid arthritis. While Maureen was recovering well in the CRSU, it was identified that due to her rheumatoid arthritis, she was having difficulty gripping utensils to feed herself. As she was unable to feed herself independently it would not be possible to discharge her home to live independently. Both regular cutlery and the special arthritic cutlery were unsuitable for Maureen to use, as she described herself, “This big chunky stuff bought online is too awkward and I knew it wouldn’t work for me.” Maureen did not want to be depending on people to feed her and wanted some ‘small bit of independence, this makes me feel human’. Maureen was determined to be discharged home where she could live

independently again. The Clinical Nurse Manager (CNM) contacted RIU to see if they could help. Maureen informed the RIU team that all she wanted to be able to do was ‘butter a cut of bread’. After meeting with Maureen, the RIU team were able to design and print a bespoke holder to adapt cutlery to fit her hands in a matter of hours. The holder was shaped to fit the contours of her hand, with flattened sides that suited Maureen’s grip. Three versions were created to suit a knife, fork, and spoon, and the result enabled Maureen to feed herself. Maureen also had considerable difficulty in managing her stoma bag due to her lack of dexterity. This was another barrier to her living independently and there was a huge effort by the MDT to enable her to realise this. A member of the medical team contacted RIU to identify if some intervention would assist her to manage the stoma bag. Using pouch stoma bags, the RIU team printed an insert to slide into the pouch which a handle on it with the same style of enhanced grip. This gave Maureen the ability to manipulate the bag into the correct position, giving her more control in removing the adhesive backing, and allowing her to change the bag herself. Maureen was delighted with the result and the independence she regained. “This handle has saved my life as I was fearful about changing the bag, it was easy once it was customised for me,” she said.

The physiotherapist worked with the RIU team to modify Maureen’s walking stick. The team reduced the curve on the handle, shortened the length, and printed a larger grip to maximise Maureen’s control. “I couldn’t manage the curve in the walking stick, so again the RIU customised if for me and now I can grip it. This makes a huge difference holding onto the stick without the stick falling out of my hand and gives me more confidence,” she said. Prior to discharge a member of the RIU team interviewed Maureen about her pending discharge and the three design interventions. Maureen highlighted her delighted and her overall goal was to continue to live independently. She had secured independent living in sheltered housing and met the criteria to live independently with oversight from a care team. Maureen has since been in touch with the RIU team and informed them that she is managing very well with her customised equipment and is now dreaming of ‘a robot to do everything’.

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Thousands of students from all over Limerick, Clare and Tipperary took part in the two day Junior Health Sciences Academy ‘Early Careers’ Event 2022. Pictured with some of the students at the launch of the event were Miriam McCarthy, Health Sciences Academy manager; Donncha O’Treasaigh, Director of Schools at Limerick and Clare Education and Training Board; and Spin South West radio presenter Louise Cantillon.

Consider Healthcare Early Careers showcase encourages TY students to consider career in healthcare

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eading sports and media stars praised the work of dedicated health professionals during a special careers event in Limerick aimed at inspiring thousands of teenage students to seek a career in healthcare. The Junior Health Sciences Academy Early Careers showcase, held virtually over two days in early March, was hosted by the Health Sciences Academy (HSA), together with Limerick and Clare Education and Training Board and Limerick Education Centre. The HSA is a partnership between HSE Mid West Community Healthcare, UL Hospitals Group and University of Limerick, with the aim of improving the health and wellbeing of people in the Midwest. As part of this partnership, the Junior HSA aims to support students in early careers, health promotion and leadership in health. The Early Careers showcase gave more than 10,000 Transition Year students valuable information about the educational courses and careers that are open to them in healthcare in the Mid West region. One of the year’s biggest events of its kind, the virtual event was open to students throughout Ireland, and recorded a big attendance of students from Limerick, Clare and North Tipperary. Among the highlights of the two-day programme were insightful ‘fireside chats’ with leading figures from the worlds of sport and media, who imparted some of the lessons learned during their careers to help the students as they prepare to embark on their own. Munster Rugby star and World Cup winner with South Africa Damien de Allende encouraged the students to keep a balance in their lives while studying and assessing their career goals. “Once I put my mind to something, I try to do that 100%. My mindset, when in High School, was that I wanted to play professional rugby, but I also wanted to try other things. I was going to do whatever it took to be successful, and that worked out. But I've always learned to do things with a smile on my face, and have fun while I'm doing it. There is a time to laugh, and a time to be serious, but in any given

moment just realise that you probably know what you're doing.” Irish hockey international Sarah Hawkshaw gave a revealing insight into the important role played by the likes of physiotherapists, nutritionists and psychologists who work with the national side. The Tokyo 2020 Olympian, herself a Public Health Sciences graduate, said their support is crucial to the team’s success. “They do a lot of ground work off the pitch that isn’t always seen, but is so important in elite sport. It’s all the 1% differences that you have to make. They contribute so much to our programme.” All-Ireland winning hurler with Galway Joe Canning also spoke highly of the medical staff who supported him during his career. Offering his advice to the teenagers in attendance, the former Hurler of the Year encouraged them to take on challenges and broaden their horizons. "The biggest thing for me in any walk of life is not being afraid to fail. A lot of people in today's world are afraid to feel bad about themselves, or to feel failure. But I think failure is sometimes a good thing. It's a part of life. I'm a firm believer that if you don't fail you don't learn. Failure can give you the opportunity to become better again.” Over the course of both days, students also heard directly from healthcare staff, including doctors, nurses and midwives, paramedics and allied health professionals – working in both hospital and the community settings. In all, staff representing 20 different professions described their working days, their career journeys and offered advice to second level students considering a career in healthcare. Students also learned all about college life from those enrolled in the various health sciences programmes at the University of Limerick, including Nursing, Midwifery, Medicine, Physiotherapy, Occupational Therapy, Speech and Language Therapy, Human Nutrition and Dietetics, Occupational Therapy, Psychology and Paramedic Studies. UL staff were also on hand to give advice on programmes and entry requirements.

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‘RESILIENT AND FLEXIBLE’ SLÁINTECARE FUND FACILITATES NEW WAYS OF WORKING Projects focus on integration of care across all health and social care

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ealthcare staff working daily with patients are often best placed to know where improvements can be implemented. Through Sláintecare Integration Fund projects, these frontline staff have demonstrated their leadership and innovative skills to develop and implement alternative ways of meeting patients’ needs. The Sláintecare Integration Fund (SIF) champions collaborative working across the Acute, Community and NGO sectors to drive a bottom-up approach to implementing change, driven by national health policy, priorities and clinical care pathways. Budget 2019 provided €20 million for the establishment of a ring-fenced SIF to support service delivery, which focuses on prevention, community care and integration of care across all health and social care. From 2019 to 2021, the SIF supported 123 HSE and NGO sector projects, to test and evaluate innovative models of care, providing a ‘proof of concept’ with a view to continuing or scaling successful projects through mainstream service delivery. The SIF focused on developing an evidence base, and creating a ‘learning culture’ to test and try new ways of working where successes and challenges were used as learning opportunities. It built trust through partnership and collaborative working in co-designing improvements. These elements have been key to informing policy and decision makers about innovative ways of meeting citizens’ needs. The pilot projects funded under the Sláintecare Integration Fund include: • New integrated care pathways across hospital and community settings for the care of older people and people with chronic diseases; • The shift of procedures to lower acuity settings, social inclusion measures, hospital avoidance measures; • HSE National priority Healthy Living programmes and promoting patient selfcare and improving healthy behaviours.

Some of the key results of the projects funded include: • 106 projects were mainstreamed into the healthcare system through budget 2021/2022; • 38 of these projects were mainstreamed through Enhanced Community Care funding as part of the roll out of community specialist teams for Older Persons and Chronic Disease Management teams; • There are plans in place to rollout four projects relating to Urology, Neurology, Orthopaedics and Ophthalmology which tested new patient care pathways.

Overall, these projects resulted in 15,145 reduced referrals to scheduled care, 19,397 acute inpatient bed days avoided, and 8,112

patients were removed from waiting lists. The SIF programme has proven to be both resilient and flexible. The challenges faced by healthcare staff over the course of the programme have been immense and they have responded by developing new ways of working and adapting/ diversifying their service delivery model to include online and virtual options. This allowed for increased access and greater reach for these health care services. The Department of Health would like to acknowledge and thank all the organisations funded under the Sláintecare Integration Fund for their dedication to the provision of quality healthcare, and to acknowledge the commitment and resilience shown by organisations in the face of the unprecedented challenges presented by the COVID-19 pandemic.

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iving Well is a six-week Stanford model Chronic Disease Self-Management Programme (CDSMP) for adults with long-term health conditions. It supports people to develop practical skills and confidence so they can better self-manage their condition and make changes for a healthier life. This group programme is delivered by trained peer leaders who are themselves managing a chronic or long-term condition. CDSMP was delivered in some parts of Ireland since 2005, and was of high value to participants. However, its delivery was sporadic due to inconsistent funding streams, models of delivery were disparate and access was geographically inequitable. The Self-management Support Coordinators, Health and Wellbeing in six Community Health Organisations applied for and received Sláintecare Integration Funding to pilot a streamlined approach to delivering CDSMP within the HSE. With a focus on community-led support to stay well and manage chronic health conditions as independently as possible, Living Well meets many of the goals of Sláintecare, as well as crossing over with other health policies and priorities, including Healthy Ireland. Typically delivered face-to-face, Living Well successfully pivoted to an online delivery model to face the challenge of COVID-19. 1,225 participants have participated in the programme since August 2020, with over 120 programmes delivered online. • Completion rates for online courses are 92% compared to 75% for in-person courses. • Satisfaction levels with the project are at 94%, and participants have had very positive experiences with the programme, as borne out in some of their feedback comments. “Our facilitators had a very respectful, caring approach. They brought their own life experience and health issues to the table which put us all on the same level and gave authenticity to their position,” said one participant.

Trinity College Dublin is a research partner in the project, and evaluation results show very positive outcomes for programme participants so far. • Significant decreases in levels of anxiety and depression. 40% of participants met the criteria for being in the clinical depression category at the outset of Living Well. This fell significantly to 21% for the same participants 6 months after they completed the programme. There has also been an increase in: • Health-related quality of life • Self-efficacy for managing health • Perceptions of support available • Digital confidence for Living Well and other online and virtual healthcare services As well as demonstrating the multiple benefits for people living with long-term health conditions, the evaluation has provided key insights into the successful delivery of Living Well in the health service. This has helped secure ongoing funding to continue service delivery in the six CHOs that received Sláintecare funding. Recognising the benefits of collaboration to enhance the delivery of the Living Well programme, the six individually funded CHO SIF Living Well Project Leads (Self-management Support Coordinators) established the National Living Well Working Group in 2019. This facilitated partnership working on 'common' aspects of project implementation, thereby, standardising project delivery, sharing learnings and avoiding duplication; this increased efficiencies in programme delivery, strengthened programme recognition, led to quality improvements and greater integration of Living Well into health service pathways. Also benefiting from engagement on the Working Group, CHO4 has since delivered 13 Living Well programmes and CHO3 commenced delivery in March 2022. This collaboration across all 9 CHOs provides a strong foundation for the mainstreaming and upscaling of CDSMP within the HSE.

Self-management programme helps reduce stress and anxiety Watch the most recent Living Well Sláintecare webinar here More information on the HSE Living Well programme can be found at www.hse.ie/livingwell

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Dr Niall Dalton, Gold Medal winner at the Annual NCHD Conference at University Hospital Limerick, with Dr Sarah Porter who was awarded a prize for best poster. Below: Prof Paul Burke, Chief Academic Officer, UL Hospitals Group, and Dr John McManus, Training Lead, UL Hospitals Group, with Dr Niall Dalton, Gold Medal winner at the Annual NCHD Conference at University Hospital Limerick. Photos: Brian Arthur Photography

ROBOTIC ASSISTED SURGERY IMPROVING OUTCOMES FOR WOMEN AT UHL

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OBOTIC assisted surgery is improving patient outcomes for complex gynaecological patients at University Hospital Limerick: that's according to research conducted by Dr Prerna Kamath who took home a silver medal from the annual NCHD (non-consultant hospital doctor) conference held in University Hospital Limerick in March. Patients are now benefiting from reduced length of stay, quicker recovery times and better outcomes compared to open and laparoscopic surgery. Dr Kamath’s study examined 50 cases completed in UHL between January 2019 and September 2021. The rate of complications within 30 days was low (4% of cases) and there were no cases of post-operative infection. The average operation time was 2 hours and 34 minutes while the average length of stay was one day, all patients having been admitted on the day of surgery. “Robotic assisted surgery in UHL certainly seems to be the future of surgery for some of our more complex patients. For my research, I looked at the intraoperative and postoperative outcomes post robotic assisted benign gynaecological surgery, and it had very favourable outcomes for patients with a high body mass index and large fibroids. The results are in line with international standards and show better postoperative outcomes compared to open surgery,” said Dr Kamath. Robotic procedures can also help preserve fertility. In the case of a myomectomy, for example (involving the removal of uterine fibroids relatively common in Caucasian women), an open procedure comes not only with the usual risks and increased length of stay but also an increased risk of hysterectomy. The annual conference aims to help NCHDs enhance their research experience, while providing them with an opportunity to present research, audit and quality improvement projects from this training year. More than 150 posters were submitted in the cross-faculty conference at the Clinical Education and Research Centre (CERC) incorporating Medicine, Surgery, Paediatrics, Anaesthetics, Obstetrics and Gynaecology, Radiology, Orthopaedics and Emergency Medicine, with prizes for best poster presentation in each department. The conference was opened by UL Hospitals Group CEO, Prof Colette Cowan who acknowledged the hard work and dedication of

all NCHDs since the onset of the COVID-19 pandemic. “NCHDs are the lifeblood of our hospitals and make such a tremendous contribution to the care of our patients across the region. Throughout their clinical careers at UL Hospitals Group they have all shown great leadership, courage and resilience when faced with very challenging circumstances,” said Prof Cowan. Taking home the top prize at the conference was Dr Niall Dalton for his research on the barriers to physical activity and quality of life indicators in children with type 1 diabetes. According to his research, almost nine in 10 children attending the paediatric diabetes clinic in UHL were achieving 60 minutes of physical activity per day despite the barriers presented by the condition. However, some of the participants did acknowledge that the risk of hypoglycaemia was a major barrier to engaging in physical activity. This finding reflects the metabolic challenges associated with activity engagement for children and young people with Type 1 diabetes. The NCHD conference is spearheaded by Training Lead at UL Hospitals Group, Dr John McManus who is committed to enhancing education and research at UL Hospitals Group. “This has been an extraordinary year of challenge for all healthcare workers, and the NCHDs have been at the forefront of these challenges on a daily basis. To have the resourcefulness and foresight to bring these projects, is a huge testament to these individual award winners and all those who supported them. The breadth and depth of the submissions for this year’s conference is a testament to the tenacity of our NCHDs,” he said.

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200 YEARS OF VACCINES Reflecting on nearly 200 years of vaccination programmes in Ireland

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or nearly two centuries, vaccines have helped make the world safer – from the very first vaccine developed to protect against VISIT smallpox to the newest mRNA WWW.IMMUNISATION.IE vaccines used to prevent severe cases of #LONGLIFEFORALL COVID-19. Vaccines protect us as individuals and help us protect each other as members of the global community. The 2022 theme for World Health Organization (WHO) European Immunisation Week is ‘Long Life for All’. It reinforced the importance of equitable and expanded access to vaccines, to contribute to a long and healthy life for everyone. Reflecting on the European Immunization Week, Dr Lucy Jessop, Director of Public Health, HSE National Immunisation Office, said, “Vaccination is one of the most cost-effective health interventions available, saving millions of people from illness, disability and death each year. The WHO says a comprehensive vaccination programme is a cornerstone of good public health in any country. “The current National Childhood vaccination programmes offer vaccines to protect against 13 vaccine preventable diseases (see table 1). However, there have been government funded public health vaccination programmes in Ireland for almost 180 years when the Smallpox vaccine was first made available (see table 2). We have now had on-going research worldwide into vaccination to prevent death and disease for almost two centuries.” A QUICK HISTORY OF VACCINES IN IRELAND Smallpox vaccination was made compulsory for all children born in Ireland from 1863. After the introduction of smallpox vaccine deaths from smallpox began to fall, the last reported death from smallpox in Ireland was reported in 1907. WHO declared smallpox eradicated worldwide in 1980. Tetanus/diphtheria vaccine was introduced in 1940s. In 1938 there were thousands of cases of diphtheria in children with 318 deaths reported. Deaths from diphtheria began to fall year on year. The last death notified from diphtheria in Ireland was in 1967. Nevertheless deaths from diphtheria still occur in unvaccinated children in Western Europe. Salk (polio) vaccine was introduced in Ireland in 1957. A few years after introduction of universal childhood vaccination, polio infection was almost eliminated. The last reported Irish case of polio was in 1984. However, over 7,000 people still suffer from post-polio syndrome in Ireland and cases of polio still occur in other parts of the world. Several vaccines to prevent meningitis have now been added to the immunisations schedule including haemophilus influenzae type b (Hib vaccine) in 1992, meningococcal C vaccine in 2000, pneumococcal vaccine in 2010 and meningococcal B vaccine in 2016. In 1999 there were 536 cases of meningitis caused by meningococcal infection and two cases of meningitis caused reported. More than 100 cases of meningitis caused by haemophilus influenzae type b were reported most years before introduction of (haemophilus influenzae type b) Hib vaccine in 1992. Cases of meningococcal meningitis have dropped more than 80% since these vaccines were introduced. Meningitis cause by haemophilus influenzae type b is now very rarely seen.

In 2010 HPV vaccine was introduced for girls to prevent cervical cancer and in 2019 this was extended to include first year boys to protect them against cancers and genital warts caused by HPV virus. Countries where there is a high uptake of the HPV vaccine in those aged 12 to the 13 years of age are seeing a huge drop in the number of cancer is vaccinated women. The rotavirus vaccine was introduced in 2016 to prevent severe diarrhoea in children. Reported cases of rotavirus infection fell by more than 70% by 2018. Almost 200 years of vaccination campaigns delivered to millions of people have greatly reduced the burden of infectious diseases that killed and maimed children and adults in Ireland. It is important to remember that though the vaccination programmes were so successful many of the diseases are only a memory yet, other than smallpox, these diseases have not gone away.

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INFECTION CONTROL New national IT system for managing Infection Prevention and Control unveiled

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he HSE is introducing an IT System for managing Infection Prevention and Control. This system will be available across Acute and community services. The Office of the Chief Information Officer (OoCIO) and the Antimicrobial Resistance and Infection Control Programme (AMRIC), are working to deliver this project in collaboration with Acute and Community services. This project will deliver improved patient safety in relation to infection prevention control. This will deliver higher quality healthcare. The COVID-19 pandemic has highlighted how challenging it is to manage the threat of serious infectious diseases. Healthcare systems have faced unprecedented challenges during this pandemic. IT surveillance systems can support testing, contact tracing and outbreak management. These all help to provide safe care for our patients. The project will also deliver benefits to staff. These benefits include reductions on time spent on common daily Infection Prevention Control (IPC) tasks. This releases IPC teams to support staff on the frontline to provide safe care for patients and service users. These systems integrate data from different hospital systems. This provides actionable insights, and facilitates more efficient clinical intervention, reporting, and accessibility. The system will also support enhanced clinical audit. There will be a more comprehensive approach to management of Infection Prevention Control risks. THE SYSTEM WILL:

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Provide increased information flow. Improve our health systems ability to track compliance. Enable personalised, preventative and proactive care. Deliver enhanced health workforce productivity. Create greater efficiencies in obtaining patient information. Improve record keeping, administration and referrals. Assist in the timely management of outbreaks. Reduce the length and incidence of outbreaks. Replace manual tracking with a suite of reporting, monitoring and outbreak management tools. Generate real-time alerts. Support a proactive service rather than the current reactive.

If you would like further information please contact the AMRIC team project manager Deirdre.Mullins@hse.ie

THREE NEW INFECTION CONTROL COURSES IN E-LEARNING NOW AVAILABLE The AMRIC team has added three new courses to the e-learning suite. They are available now on www.HSeLanD.ie. The courses support all health and social care staff in IPC and AMR. All courses are NMBI and RCPI accredited and learners are awarded 2 CEU from NMBI and 2 CPD credits from RCPI for each of the new completed courses.

THE THREE NEW COURSES ARE: AMRIC CLOSTRIDIOIDIES DIFFICILE INFECTION This course aims to help you prevent, recognise, and manage Clostridioides difficile (C.diff) infection as you implement IPC and AMS practices to keep the people you care for safe. This course is designed for all staff within the health services. AMRIC CLEANING AND DISINFECTING THE HEALTHCARE ENVIRONMENT AND PATIENT EQUIPMENT In this course you’ll learn best practice for cleaning and decontaminating the healthcare environment and equipment across all settings where healthcare is delivered. This course is for all staff working in healthcare environments and where patient equipment is used. It is particularly useful for those involved in cleaning and monitoring the healthcare environment and equipment. AMRIC MANAGEMENT OF BLOOD & BODY FLUID SPILLS This course aims to support your understanding of the principles of managing of blood and body fluid spills and the equipment required when treating spills of any size. This course is aimed at all healthcare workers who manage blood and body fluid spillages in the healthcare environment.

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NEW REGIONAL HEALTH AREAS Restructure will bring decision-making closer to frontline

The six RHAs are further broken down into 96 Community Healthcare Networks (CHNs). CHNs deliver primary and community services to an average population of 50,000 people each. The CHN framework supports multi-disciplinary teams to bring decision-making closer to the point of care. CHNs also function to provide targeted and coordinated care based on the identified health and social care needs of local communities. The detailed design of the new model of service and associated RHA structures will take place during 2022, and there will be active engagement with the health and social care workforce around the country, all key stakeholders and the public in finalising the design. RHAS AND SLÁINTECARE

This new structure originated in the report of the Oireachtas Committee on the Future of Healthcare (the Sláintecare Report). The report identified that a robust system of leadership, governance and accountability is critical for delivering integrated care. he Government has opted to As part of its recommendations, the report calls proceed with setting up six REGIONAL HEALTH AREAS AND for the “geographic alignment of Hospital Groups Regional Health Areas (RHAs) COMMUNITY HEALTHCARE and Community Health Organisations … to support within the HSE, on the basis of NETWORKS population-based health planning and delivery” the geographical boundaries The six RHAs will cover the and for the establishment of regional bodies that agreed by the Government in July 2019. The following areas: will “be accountable at a regional level for Cabinet decided that the design of the • Area A: North Dublin, Meath, implementing integrated care”. It also notes, “The RHAs will be completed in 2022. There will Louth, Cavan, and Monaghan; HSE in future will become a more strategic be a phased introduction of the new bodies • Area B: Longford, ‘national centre’ carrying out national level in 2023 and they will be fully operational Westmeath, Offaly, Laois, functions and regional bodies will be established from 2024. Kildare, and parts of Dublin to ensure timely access to integrated care, with Each RHA will be able to plan, resource, and and Wicklow; regional health resource allocation.” The deliver health and social care services for the • Area C: Tipperary South, Government approved the Sláintecare needs of its unique population. This will result Waterford, Kilkenny, Carlow, Implementation Strategy and Action Plan 2021in improved accountability and governance Wexford, Wicklow, part of 2023 in May 2021, which committed to the in terms of finance and performance. It will South Dublin; implementation of Regional Health Areas. also empower frontline staff and bring • Area D: Kerry and Cork; Area The Department of Health and the HSE will now decision-making closer to the frontline. E: Limerick, Tipperary and progress the development and implementation of RHAs will enable and empower staff to Clare; a clear plan for the implementation of Regional provide services that are: • Area F: Donegal, Health Areas with input from the RHA Advisory • Integrated, locally planned and Sligo,Leitrim, Roscommon, Group. The Sláintecare Programme Board and delivered Mayo, and Galway. HSE Board will play central roles in terms of • Easier to access and navigate oversight of the planning and implementation of • Available closer to home RHAs and the stepping down of CHOs and Hospital Groups. At the moment, community health and social services are planned, funded, and delivered separately from hospital services. There are nine Community NEXT STEPS Healthcare Organisations (CHOs) and seven Hospital Groups, which You will see these changes happening over the next two years in provide services to various parts of the country. Hospital Groups and a planned and evidence-based way. We will provide regular Community Health Organisations (CHOs) serve populations that are updates on the progress of each stage of the design and grouped in different ways, which makes it challenging for the health implementation plan. system to deliver integrated care. We also want to give you the opportunity to share your feedback The creation of six Regional Health Areas aims to address this. RHAs are so we can address any areas of concern as implementation geographically-based units with clearly defined populations. They align progresses. We will be planning workshops, webinars, townhalls community and hospital services within specific areas. The HSE will retain and sharing information across all our communications channels a strong but leaner central organisation, with more service provision to keep you informed at every step of the process. developed at a local level.

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NEW PUBLIC

HEALTH AREAS Six new Public Health Areas established paving the way for Sláintecare Regional Health Areas

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ith effect from the 1st of May, six new Public Health Areas will be established paving the way for the Sláintecare Regional Health Areas. This also marks the appointment of the first Consultants in Public Health Medicine in Ireland with the appointment of Area Directors of Public Health.This is a significant milestone in the history of the Public Health Medicine service in Ireland and marks an important turning point in the implementation of the fundamental reforms required to realise the vision of the new service delivery model. The launch of the Public Health Area high level governance structure represents the first visible deliverable of reform. Over time, implementation of the Public Health Areas with consultant leadership for all domains of practice working in a multidisciplinary team will deliver significant measurable impact for the population’s health and the health service. Deirdre McNamara, Programme Director for Public Health Reform, said the establishment of the Public Health Areas and Area leadership structure is the ‘first critical step on the journey to transforming our Public Health medicine service to deliver better health and health services for our population’. “Our Public Health Teams have been at the forefront of pandemic response over the past few years and now they will be paving the way for the establishment of the Regional Health Areas and ensuring a strong focus on population health and prevention,” she said.

Chief Clinical Officer, HSE, Dr Colm Henry, said, “I wish our new Area Directors of Public Health every success in their new roles. I look forward to working them all to shape the future of our Public Health Areas over the months ahead to ensure a cohesive approach to service delivery across all Public Health Areas. Together we can build an agile, intelligence-led public health medicine service to protect and promote health, improve health services and tackle inequalities in health.” Dr Áine McNamara, Area Director of Public Health (Area F – West North West), said: “It is a very exciting time for Public Health. Over the past two years there has been a significant investment in strengthening our workforce. As we move forward with the implementation of reform, the new area structure will allow us to establish specialised teams to better protect health, profile the health needs of our communities, and tackle the most significant public health issues to help those in our areas to live healthier lives.” The new Area Directors of Public Health are:

• • • • • •

Dr Fionnuala Cooney, Area B (DPH Midlands and CHO 7) Dr John Cuddihy, Area C (DPH South East and CHO 6) Dr Anne Sheahan, Area D (DPH South) Dr Mai Mannix, Area E (DPH Midwest) Dr Áine McNamara, Area F (DPH West / North West) Dr Deirdre Mulholland, Area A (North East / CHO 9)

Reform brings exciting time in Public Health As we move forward with the implementation of reform, the establishment of the Public Health Areas paves the way for ensuring a strong focus on population health and prevention, according to Dr Áine McNamara. Dr McNamara, who took up the consultant post as Area Director of Public Health, Area F (West and North West) in March 2022, said it was a ‘very exciting time for Public Health’.

She is an experienced public health professional having worked across the domains of public health medicine for 20 years. “Although many people are more aware of who we are due to our pivotal role in the COVID-19 response, our health protection function is just one of the domains of public health. Our main responsibilities are to focus on prevention and intervention activities which promote the overall

health and well-being of our population and to reduce health inequalities,” she said. “Public health consultants are leading on major national health protection issues at the moment including the Ukrainian response and the international Monkeypox outbreaks. We are involved in issues related to environment and health, managing health threats, emergency preparedness, epidemiological investigations of

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disease patterns, performing public health risk assessments, communicating risk and developing public health medical advice.” She said she welcomes the Public Health reform process, which she has contributed to, and is ready to be a central part of the process and lead the implementation of an integrated, all-hazards health protection service. “One of the priority areas for the Area Director of Public Health at the moment is to lead strategic reform to ensure a strong public health function for the delivery of an agile, dynamic and intelligence-led public health service. The new model establishes strong clinical leadership across each of the domains of public health practice and will strategically align public health expertise within the system to contribute effectively to major service design, policy implementation, reducing health inequalities and improvements in health. “The Public Health areas are part of the new hub and spoke service delivery model for Public Health Medicine. Within this new model the national centre will coordinate, set standards and policies, provide leadership and centralises critical expertise. The hubs

will input into that National function, respond to service and the delivery needs, retain our local expertise and importantly identify and implement improvement initiatives within our health areas. We will work closely with our colleagues in the acute and community sector to support population needs based service planning and resource allocation within our areas and support the implementation and improvement of integrated models of care. Dr McNamara said the Area Directors of Public Health will be supporting the optimum delivery of health care by using populationbased needs assessments. “Over the course of the pandemic we have seen a significant strengthening of the public health work force and the establishment of Public Health Areas will allow us to consolidate highly specialised staff to deliver public health interventions to the population. We have recruited nurses, doctors, surveillance and epidemiology staff who will be core to the consultant led multidisciplinary teams which can focus on protection and intervention activities,” she said. “This will allow us to profile the health needs of the population, looking at what

Public Health has key role in health and prevention Progressing the public health reform agenda while maintaining a high-quality service is the main challenge ahead, according to Dr Fionnuala Cooney. Dr Cooney has taken on the role as Area Director of Public Health in the new Area B CHO7/Midlands: Dublin South, Kildare, West Wicklow, Laois, Offaly, Westmeath and Longford. Despite the many tough tasks ahead, she said she is very positive about the delivery of a public health service into the future under the new service delivery model. “I started in my role on March 28th 2022 and my experience to date has been positive. Area B is being formed through the amalgamation of the Public Health team in HSE-Midlands with the Public Health team in CHO7, within HSE-East. The work involves maintaining current services while also planning a staged, incremental process working towards one team serving the new Area. We have great personnel who are working hard on this transition. Their solution-focused approach and commitment is enabling the process and the momentum is building as the Reform process progresses,” she said. Dr Cooney highlighted that Public Health has a key role in the prevention of disease and enhancement of the health and wellbeing of the population. “I see Public Health having key roles in facilitating the development of built and natural environments that are conducive to health, as well as supporting health service development and continuing to protect the population from threats,” she said, noting that the new service delivery model will have Public Health “ultimately aligned with other key services and will enable Public Health to promote actions for the prevention of disease as well as progressing the

we need to do to reduce health inequalities and address high impact public health issues to help those in our communities live healthier lives.” She explained that a key challenge of the reform process will be to ensure critical service delivery in tandem with implementing reform. “An initial priority for me will be to balance immediate service requirements with the need for implementing structural/operational changes. Central to this is our workforce – I will support staff with a focus on resiliencepeople are exhausted after two years of responding continuously to wave after wave during the COVID-19 pandemic. We will look at workforce mobilisation, training and development, and engagement. “As a service we need to map out and understand our operational needs. This will enable effective resource planning and prioritization of resources. We also need to put mechanisms in place to identify key lessons so we can improve current services. We have to adopt a continuous improvement perspective and create the environment in which real effective strategic change can happen.”

Sláintecare vision in the new Areas of a universal health service providing the right care, in the right place, at the right time”. The new Area B Public Health Director said that COVID has made people more aware of public health now. “They have a better understanding of our role in protection of the population from new threats such as the recent pandemic which arose from new, emerging infection. However, the public may not be aware of the other areas of our work which include health improvement, health intelligence, health service development and reducing health inequalities….but public awareness of the full scope of our work should improve under the new service delivery model,” said Dr Cooney. She said that she believed that public health is better equipped post-COVID to help prevent incidences and issues like the pandemic. “We have international, regional, national and local systems for the surveillance of notifiable infections, including new diseases and emerging threats. We are set-up so as to be able to cascade health alerts and to implement a range of preventive actions, as needed. These actions can include provision of accurate, clear, factual information, education and raising awareness throughout the health system and wider society, provision of evidence-informed advice on infection prevention and control, recommendations on isolation and quarantine, advisories on immunisation and antimicrobial treatment for prevention and/or treatment and many other control activities to prevent or limit the spread of infection,” she explained.

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Elaine Birkett, Organisation Development Practitioner; and Tara O’Rourke, Assistant Staff Officer, HSE Organisation Development and Change, Change & Innovation.

CHANGE AWARD HSE recognised as Best Organisation Transformation Initiative by IITD HSE Organisation Development and Change has culture of systemic change through most To find out more about scooped a top national award. Their submission challenging times. the work of Organisation Development and Change in Sinéad Heneghan, CEO of awards host IITD, ‘Delivering Change in Health Services’ took home the the HSE or to access resources said of this year’s submissions, “This year, there award for Best Organisation Transformation Initiative for “Delivering Change in at the IITD National Training Awards, which recognise was a clear focus on initiatives that delivered on Health Services” you can visit and promote excellence, best practice and innovation. organisational and professional needs, integrating https://www.hse.ie/eng/staff/ The awards are the premier learning and development best practices with high standards of resources/changeguide/ event for the industry and were presented at a ceremony professionalism. The quality of systemic thinking in Naas in early April. and practice was very high, this is essential when Shortlisted organisations undergo a robust process to be considering people development initiatives within the context shortlisted. Elaine Birkett and Lisa McDaid, Organisation of organisational change and development.” Development Practitioners from OD and Change, represented the organisation “Similarly, it is inspiring to see such investment being maintained and even enhanced in a period of maximum and their programme of work at a pitching event in March. “We were very clear we were representing not only our area of work but disruption – with a focus on the ‘what’ and ‘how’ of people development clearly appreciated as integral to the ability of more so the incredible agility, creativity, innovation and dedication of all health care colleagues and teams we meet across the organisation, and we an organisation to manage its way through a period of were very proud to do so,” explained Elaine. unprecedented disruption and change.” “As part of our presentation we spoke about the importance of the network and relationships that support our work on building capacity for delivering Email: changeguide@hse.ie change in health services. There are many collaborators along the journey Follow us: @HSEchange_guide like HSeLanD and the RCSI Graduate School of Healthcare Management who Visit: Change & Innovation Hub HSeLand worked with us on the CPD programme,” added Lisa. To win a National Training Award from IITD is a huge honour and the finalists demonstrated the importance of communications and engagement with their eco-system of internal and external stakeholders throughout their experiences. The HSE were recognised by the judges with an excellent initiative focused on the ability of this significant organisation to be agile and embed a

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Breastfeeding Support Breastfeeding initiative is change in action

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new initiative by public health nurses in Dublin North has been helping to increase support for breastfeeding mums in their area. The Breastfeeding Observation Assessment Tool (BOAT) by Public Health Nurses (PHNs) was a case study completed by Agnes Flynn, Community Healthcare Network Manager, Clontarf Area, CHO9. This project was completed as part of an MSc Quality and Safety in Healthcare Management at RCSI Graduate School of Healthcare Management. The aim of this project was to increase the use of a BOAT by PHNs in Dublin North to provide appropriate support for breastfeeding mothers. Ireland has the lowest breastfeeding initiation rates in the world. PHN-led breastfeeding support groups have been shown to have positive effects on a mother’s breastfeeding experience and duration. “Breastfeeding assessment tools guide and support a PHN’s assessment of the breastfeeding dyad between mother and infant and supports the development of a care plan. A pre-COVID-19 audit in Dublin North showed that 34% of breastfeeding charts audited had one completed. Due to the pandemic, there was reduced face-toface time on notification visits and all face-to-face breastfeeding support groups were suspended,” explained Agnes. Using People’s Needs Defining Change - Health Service Change Guide to support this project, the three key change priorities of focus were Engaging Staff, Investing in Teams and Modelling Shared Values. The project interventions included providing, developing and delivering breastfeeding educational supports for PHNs to increase the use of the BOAT, establishing three online breastfeeding support groups and a community-based lactation support clinic for breastfeeding mothers in Dublin North. The Heath Service Breastfeeding in the Healthy Ireland Action Plan (2016-2021) also highlights the importance of ongoing breastfeeding support for healthcare professionals.

An audit of the use of the BOAT showed that 91% of breastfeeding charts audited had a BOAT completed. Three online breastfeeding support groups were established in the area. A community-based Lactation Support clinic was also established. This demonstrates a more flexible and adaptive approach to organisational performance as focused on in the HSE Service Plan (2021). The project’s success contributed to improving breastfeeding supports for mothers, and improving staff’s level of breastfeeding knowledge, and gave a great sense of achievement to all involved. “The importance of the role of public health nurses who have long been involved in facilitating breastfeeding groups was found to have positive effects on breastfeeding mothers’ experiences and contributed to breastfeeding duration. Normalising of breastfeeding contributed to mothers continuing to breastfeed. COVID-19 has posed challenges to facilitating face to face breastfeeding support groups and all have been postponed indefinitely during the pandemic,” said Agnes. “Strong foundations of open communication, staff engagement surveys and very visible management supports, all foster a culture of learning in the organisation. Compassionate leadership, strong staff engagement and a culture of learning supported this project through the challenges of the pandemic. Despite the many challenges faced including having to pause the project for a short while, staff have consistently demonstrated a clear commitment to the long history of supporting breastfeeding in the area. In leading PHN teams to date, I have engaged with staff to adopt the organisation’s Values

in Action, Care, Compassion, Trust and Learning, thus fostering a culture of trust, respect, and patient-centeredness. These values are also enablers of change. The importance of quality teamwork, linked to quality of patient care was very evident throughout the project. “Participation in the National Breastfeeding PPG Review Group facilitated my sharing skills and knowledge gained from this project which is aligned to national and organisational policies. This will contribute to the next national BOAT audit.” The project is currently being implemented across Dublin North West and Dublin North Central and in other CHOs nationally. The literature review and the audit which was completed as part of this project is supporting the National BOAT Audit rollout. Agnes wishes to thank all including Gonne Barry DPHN, her ADPHN colleagues, PHNs in Dublin North and in particular project leaders Deirdre Flynn, PHN, and Aoife McGinley, PHN, who all contributed to the success of the project. Thanks also to Dr Mary O’Neill for her continued support and guidance during the project.

For more information you can contact Agnes Flynn at mary.flynn5@hse.ie You can also view a poster presentation on the BOAT Project and the assessment tool here: https://changeguide.hseland. ie/media/u0qhfmgw/agnes-flynnposter-presentation-and-boat-tool-forphns-2021.pdf

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VIRTUAL REHAB helping patients with chronic lung conditions

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ommunity-based Pulmonary Rehabilitation (PR) is a service that has been running for three years in Dublin South West. It is run by physiotherapists from the Respiratory Integrated Care team in Chronic Disease Hub 3, who provide a PR service to those in their catchment area, as part of the Enhanced Community Care Program. It is an eight-week exercise and education programme delivered to patients with COPD and other lung conditions in a group session. PR is one of the most effective and efficient treatments for patients with chronic lung conditions. Before the COVID-19 pandemic, PR in the Dublin South West area took place in the exercise gym in the Russell Centre, Tallaght Cross West. However when the pandemic began, patients no longer had access to this vital programme. Patients with COPD were advised to stay at home and avoid social contact as much as possible, preventing them from accessing faceto-face PR sessions. These COVID-19 restrictions encouraged the community-based PR staff in Dublin South West to explore other options for service delivery to their clients. Using the HSE approved platform ‘Attend Anywhere’ the staff were able to increase availability, adherence and engagement by offering ‘virtual pulmonary rehabilitation’ to COPD patients from the safety and comfort of their own homes. Feedback from patients has been very positive as demonstrated by the following quotes: “I didn’t feel alone”; “I felt more confident and reassured”; “I have improved a great deal with moving in fact I am now capable of going upstairs without too much difficulty”; and “I found the programme helped my self-confidence, improved my stamina and it also took the fear factor out of my ability to push myself when exercising”.

“Although virtual PR will not replace traditional face-to-face PR, it will be helpful in the future to have this option for people who cannot travel to a gym for various reasons."

One of the biggest challenges has been the barrier for some patients who do not have the technology or the ability to use it. For those able to access the programme, some experienced technical issues including: “The on-line software was sometimes unreliable”; “problems with wifi connections caused delays and missed communications”; and “I never had a clear screen”. “Although virtual PR will not replace traditional face-to-face PR, it will be helpful in the future to have this option for people who cannot travel to a gym for various reasons. It may also help in minimising the DNA rate. We will be better able to support patients who are confident with technology, possibly those who still work or those who are housebound or have transport issues,” said Claire Baily Scanlan, Clinical Specialist Physiotherapist. “Another area of expansion for the PR staff in Dublin South West was the provision of PR for patients post-COVID-19. The infrastructure of the PR programme combined with the experience of the staff and the availability of a reliable telehealth platform meant that our service was uniquely positioned to provide an adapted rehab approach to assist post-COVID-19 clients recover -nfection. Those discharged from hospital after treatment for COVID-19, and potentially those managed in the community are likely to report significant ongoing physical and functional impairment. “There was a need to develop an appropriately targeted and safe rehabilitation programme to support the recovery of this population. The commonly reported symptoms of cough, breathlessness and fatigue are symptoms that can be managed within the existing PR programme. “Our PR approach was well placed to deliver such a programme for this group. However, the broader recovery needs of the postCOVID-19 patient may well extend beyond the traditional boundaries of PR. Existing services will likely need to extend their scope of practice and collaborate with the wider multi-disciplinary team in order to ensure that these recovery needs are met in an adapted rehabilitation programme,” added Claire. “Virtual PR has been shown to be effective for a select group of patients who have both the equipment and technological literacy to engage in it. It will continue be a vital method to enable continued access and prevent service interruption in the future.”

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VIRTUAL FRACTURE ASSESSMENT CLINICS IMPROVE PATIENT EXPERIENCE AND ALLOW FOR ASSESSMENT IN A TIMELY MANNER A consultant-led virtual process now commonly used to manage fractures in patients, is improving outcomes and providing a cost saving of over €22 million to the health service, according to the National Clinical Programme for Trauma and Orthopaedic Surgery (NCPTOS). From March 2020 to October 2021, over 65,000 patients were assessed remotely through virtual Fracture Assessment Clinics. In analysis of the services during this time, it was found that the majority of these patients were discharged (63%), 36% required an onward referral and only 1% converted to surgery. This analysis concluded that the cost savings to the health service was over €22m. Paddy Kenny, Joint National Clinical Lead NCPTOS, highlighted the impact this service re-design has had on all 18 trauma sites where these clinics are now operational at the recent virtual Fracture Assessment Clinic seminar held at RCSI.

He noted, “Virtual Fracture Assessment Clinics (vFAC) were adopted early during the pandemic and are now part of clinical practice delivering safe, effective and efficient care to patients presenting with stable fractures. These clinics are multidisciplinary in nature and are led by a consultant orthopaedic surgeon.” Virtual Fracture Assessment Clinics have been identified by the HSE as a safe patient-centred, efficient and cost-effective service that can assist in enabling patients to be assessed in a timely manner and in line with international best practice standards. The virtual fracture assessment clinics are a proven method of ensuring that only patients who require ‘in-person’ appointments are booked to attend the hospital’s fracture clinic, thus improving the experience for patients and optimising hospital resources. In an opening address to a recent

Introduction of Intentional Rounding for Healthcare Assistant Staff in Clontarf Hospital Clontarf Hospital is a 160-bed rehabilitation hospital which aims to deliver an excellent rehabilitation service for patients to enable them to achieve their optimum level of independence, health and wellbeing. A multidisciplinary team provides input for all patients. In 2020, Intentional Rounding was introduced for healthcare assistant (HCA) staff. IR is a structured process whereby staff carry out regular checks on individual patients, usually one to two hourly, using a standardised protocol to assess and manage their fundamental care needs. This relates to four key elements, or the 4 Ps of Intentional Rounding: personal hygiene and continence needs, positioning, pain and placement of items. At the beginning of the COVID-19 pandemic, we recognised the need to have a structured process to ensure essential care for all patients. As the number of staff on sick leave increased due to Covid-19, it was vital to ensure continuity and high standards of fundamental care delivery.

seminar on virtual fracture assessment clinics, Dr Colm Henry, HSE Chief Clinical Officer, said, “Remote consultations now constitute a significant way in which our services are delivered with the use of both video and audio enabled care, remote monitoring and online supports and therapies both in Acute and Community services. Both the HSE and the Department of Health recognise the value of this service redesign with its inclusion in the HSE National Service Plan 2022.” Led by David Moore and Paddy Kenny, as joint national clinical leads, the National Clinical Programme for Trauma and Orthopaedic Surgery is a joint RCSI and HSE initiative aimed at improving and standardising the quality of care, improving access for patients, and providing a framework for the HSE, hospital managers, clinicians and the multidisciplinary teams caring for trauma and orthopaedic patients.

Ward-based education was provided to HCA staff outlining the background of Intentional Rounds and how IR can help reduce falls and pressure ulcers, while providing reassurance to patients that they are checked on a regular basis. Working in collaboration with HCA staff, the hospital developed an IR booklet that is user-friendly and efficient. This improved communication between staff and provided evidence of essential care and continuity of care for patients. IR provides HCA staff with an opportunity to document and communicate any issues of concern, e.g. skin care, pain, hygiene needs. This record is kept at the point of care. We are currently in the process of formally evaluating IR and feedback from HCA staff has been positive. Staff state that IR acts as a prompt to ensure safety checks (call-bells are within reach), and that hygiene needs, toilet opportunities, hydration and mobilisation are attended to in a timely manner. Communication between HCA and nursing staff has improved and issues arising from IR are discussed and documented. In addressing key performance indicators such as falls, pressure ulcers, complaints, IR is highlighted as a quality improvement initiative and strategy to enhance patient outcomes. It acts as an aid in the provision of safe patient care. Increased vigilance and visibility of staff carrying out IR at regular intervals, for each patient, will help provide an environment and culture of safety and person-centred care in Clontarf Hospital.

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NURSING POLICY PORTAL

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n electronic policy portal system has been introduced in Public Health nursing services to make it easier for all nursing members to keep up to date with relevant local and national Policies, Procedures, Protocols and Guidelines (PPPGs) The system, which was introduced in January 2022, facilitates the management distribution and engagement compliance tracking of policies within the CHO area. It also facilitates uploading of local and national PPPGs identified within the CHO area to a central location. The portal was designed to make it as easy as possible for users to engage with PPPGs, and to demonstrate compliance with requirements for mandatory documents. The system itself is a modern web application with simple, clean navigation, email notification and effective reports.

THE OBJECTIVES OF THE SYSTEM ARE AS FOLLOWS: • • • • • •

Improve awareness Increase compliance Save on administrative time Reduce unnecessary complexity Optimise user experience Easy log in and no fuss navigation

All PPPGs are uploaded by a nominated person (named as a super user of the system) to the portal, and this provides assurance to management within the public health nursing (PHN) service that the most recent guidance documents are available to staff members, at all times, which is paramount in relation to providing a safe, quality evidence-based service to all clients within the PHN service. The system requests each user to confirm they have read and understood the contents of each PPPG which is reviewed within the portal. Users are grouped to designate which policy is mandatory reading for which users. The portal also has the ability to filter reports for management which identifies specific

The implementation team members for the electronic policy portal

PPPGs that have been reviewed by group or individual staff members. This provides assurance that mandatory legislative documentation has been reviewed as requested and to ensure that staff members have read local PPPGs in order to appropriately inform their practice. COVID-19 pandemic remains at the forefront of frontline care and this portal provides governance in relation to guidance documents issued to staff members due to the rapidly evolving information and frequent changes which is emerging on an daily / weekly basis. The legacy practices of managing hardcopy distribution and requiring signature sheets be returned and filed are no longer suitable in terms of administrative overhead, infection control risk, or practical usability in the modern delivery of informed public health nursing care. The introduction of the electronic policy portal for public health nursing services is a national project, jointly funded by the Nursing and Midwifery Planning and Development Units (NMPDU) and Primary Care in each CHO area as a quality improvement initiative. It is a HIQA requirement that staff have access to robust PPPGs to guide best practice, and nurses also have a responsibility to ensure their practice is based on best evidence. Following successful funding applications to the six NMPDUs and Primary Care, a national implementation group, led by Ina Crowley, ONMSD, drawn from Professional Development Coordinators (PDCs), ADPHNs, and DPHNs was established to oversee the systematic roll out of the policy portal, supported by a lead named DPHN in each CHO area. There are now 3,000 users of the system governed by 31 Directors of Public Health Nursing across eight of the nine CHOs in the HSE nationally, who will now be automatically notified of new or updated PPPGs relevant to their practice area. The system will provide these users with an effective means of engaging with the PPPGs and, for DPHNS and ADPNS, will simplify

compliance tracking on who has and hasn't engaged with the mandatory reading PPPGs. This is a demonstration of a highly successful national initiative with a project timeline bringing it from innovation to implementation within 12 months. The portal enables staff members to log on from any device and easily access the most up to date guidance documents relevant to their area. It is very user friendly as it will be a ‘read only’ portal, staff are not required to input any data into the portal, other than to click to say they have read and understood a PPPG at the end. Staff can trust that the system will host the most up-to-date evidence-based PPPGs as the system allows for them to be removed and amended and reloaded. This will reduce time for both staff members and management. The system will alert staff to amendments and it automatically notifies the super users of PPPGs that are due to be updated. The system will automatically send an email to notify staff when a new PPPG relevant to them is uploaded to the portal, and prompts them to access it. The system will also send reminder emails. This will ensure that all staff are aware of new PPPGs On the system, the super users for each area can allocate some PPPGs as mandatory reading to specific nursing groups, but all PPPGs uploaded will be available for them to read. This means that the nurse can access all PPPGs as required but only receives notification/ reminder emails for PPPGs mandatory to their specific role. Staff will no longer have to manually sign a signature sheet and return to ADPHN as staff can now click to confirm that you have read and understood the PPPG on the system there and then. The system holds a log rather than the ADPHN. This system is very valuable for quality improvements in care delivery and patient outcomes by ensuring distribution of evidence based PPPGs to all community nursing teams and thus standardising practice across areas.

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CPD achievements by Irish NRC SNOMED CT SNOMED CT is an international clinical terminology coding system used in Electronic Health Records. Its purpose is to facilitate accurate recording and sharing of clinical and related health information with semantic interoperability. SNOMED CT was recommended by HIQA Reports in 2014 and 2021 and was endorsed by the Department of Health in 2017. As a result, the HSE established the Irish National Release Centre (NRC) for SNOMED CT in 2019, which developed a SNOMED CT Strategy (2020-2023). In the interest of promoting clinical education and awareness of SNOMED CT in the Irish healthcare system, the Irish NRC requested continuous professional development points (CPD), with endorsements from Irish Clinical Professional Bodies to promote the SNOMED CT Foundation Course in 2021.

TO DATE, CPD APPROVAL HAS BEEN ENDORSED BY THE: • RCSI for Physicians, (9 Credits), • NMBI for Nursing and Midwifery professionals, (35 CEU Credits). • HSCP healthcare professionals can also avail of this course by applying one CPD credit per hour of this new learning, alongside self-assessment and reflection on the impact of this learning on their clinical practice. • Currently in the process of seeking CPD approval from other Professional Bodies.

Retirement of NiSRP Programme Director Staff, colleagues and management at HSE Merchant’s Quay bid farewell to NiSRP Programme Director, Miriam Keegan who retired at end of March after 43 years of dedicated service to the HSE. Miriam was given a fitting send-off and all her colleagues wish her well in her retirement. Go maire sibh bhur saol nua.

The NRC will relay updates in any future CPD development. In alignment with Irelands SNOMED CT Strategy 2020-2023, the Irish SNOMED NRC will continue to promote SNOMED CT educational opportunities to healthcare professionals nationally. The ultimate aim being to build experts in SNOMED CT, enabling standardised interoperable clinical data sharing in all future Electronic Health Records. As part of the strategy, one of its aims was to build experts in SNOMED CT. Clinical education on SNOMED CT will ensure the clinical engagement required for successful implementation of SNOMED CT in the health services’ Electronic Health Records. At the moment there are eLearning courses available such as the SNOMED CT Foundation Course. This course is available on the eHealth Ireland SNOMED NRC website www. ehealthireland.ie/strategic-programmes/snomed%20ct/ under the resources tab and it is also available on HSEland. This is a free online course as Ireland is a member country of SNOMED International.

Wendy McDonnell, Miriam Keegan, John Smith, Ciara O’Connell at Miriam’s send-off.

SOME OF THE LEARNING OUTCOMES FROM THIS COURSE ARE: • To gain awareness and knowledge of SNOMED Clinical Terminology, (CT), its benefits and how it could be used in your location and daily clinical practice. • Understand why clinical terminology, data business and why record it electronically. • How to explore clinical content on the SNOMED CT Browser. • Clinical input and engagement required to lead and develop concepts, components, subsets and refsets in SNOMED CT. • Implementation and mapping of SNOMED CT.

NiSRP Implementation Update My HSE Self Service is now available in HSE Midlands, Mid-West and North West. The map below shows the latest national picture of areas on SAP HR/Payroll and My HSE Self Service. Staff in HSE South will be next to see the benefits of the system. The SAP HR/Payroll integration and the rollout of the NiSRP Self Service online tool for employees and managers means the previous reliance on paper will be replaced with improved processes to record HR actions and maintain accurate staff records. All staff in South will also have access to My HSE Self Service giving them control of their own information. NiSRP are in early stages of implementation in HSE South and will continue to work closely with staff there over there coming months. NiSRP Support: www.hse.ie/nisrpselfservice

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CONSENT POLICY Revised HSE National Consent Policy 2022 and e-learning programme launched

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r Colm Henry, Chief Clinical Officer launched the revised HSE National Consent Policy and e-learning programme in March 2022. The revised policy represents an extensive rewriting of Parts 1 and 2 of the previous National Consent Policy. However the core principles underpinning valid informed consent and good practice, and the emphasis on supporting people and on good and effective communication, are unchanged.

WHO IS THE POLICY AND E-LEARNING PROGRAMME FOR?

WHY IS CONSENT IMPORTANT?

Part 1 and Part 2 of the policy have been revised to reflect important legislative and policy changes and new case law and directions since 2013. This includes, but is not limited to, the Children First Act 2015, the Data Protection Act 2018 and the Health (Regulation of Termination of Pregnancy) Act 2018. A further change since 2013 relates to NATIONAL Part 2 of the policy. While this policy CONSENT retains the position that the age of POLICY consent to medical treatment is 16 years, it recognises that the legal basis for this has not been definitively established in the Irish Courts. The language in the revision has also changed. According to Professors Mary Donnelly and Shaun O’Keeffe, CoChairs of the HSE National Consent Policy, the revised policy is based on the law as it stands, however, “the language – in particular, an emphasis on the importance of the will and preference of a person who may lack capacity – has been changed in preparation for the Assisted Decision-Making (Capacity) Act.”

Consent is an essential part of respecting the autonomy and selfdetermination of the person who is accessing your service. It is consistent with the principles of good practice in communication and decision-making with the person. It is a process of communication between a patient and their doctor, providing sufficient information for the patient to ‘make a choice’, about their proposed intervention, in other words, a patient-centred approach. Describing the consent process, Dr Siobhán Ni Bhriain, Consultant Psychiatrist and National Clinical Director, Integrated Care, HSE, said, “Consent can be a once-off interaction, for example, the taking of a blood test, or can be a complex series of interactions between clinicians and patients as a patient makes their journey through the healthcare system. Whether implied (the patients actions indicate that they are happy to go ahead with that blood test by rolling up their sleeve) or explicit (saying or signing a form agreeing to an intervention/investigation), consent should always be sought by explaining the nature of and reason for any treatment/investigation.” She continued, “As the direction of healthcare moves towards a culture of empowering patients to manage their own health and well-being and including patients and service users in the development of healthcare policy, using the principles of consent enables the persons understanding of healthcare in general. Part of the process of consent includes advising on the options available, the pros and cons of various approaches, e.g. pharmacological and/ or non-pharmacological treatment for certain conditions and enabling people to make informed choices. It also includes opportunities to check and re-check that the patient is happy with the planned approach.” Tony Ward, Chartered Accountant, has views on why consent matters to him. “Where consent is not appropriately sought from a person, service user, customer or patient it is usually because the other person has made an assumption as to that person’s ability to choose for themselves and such assumptions are often badly flawed. For me it is about not making assumptions in a negative way. There are services available for people who need assistance making decisions and that is fine, but for everyone else, unless a reason to the contrary, please assume that they have the capacity to make their own decisions.”

The revised policy and e-learning programme is for all staff who work in the HSE and HSE funded services. The policy and e-learning programme will help prepare staff to ensure that valid consent is sought for every intervention.

WHAT HAS CHANGED IN THE POLICY?

our health service

WHAT IS INCLUDED IN THE E-LEARNING PROGRAMME? The e-learning programme has two modules – one on the general principles of the consent policy and the second on consent for children and young people. Certification is awarded when the modules are completed. The e-learning programme has top-tips, further learning suggestions and important links to other resources designed to help staff apply a person-centered approach to their practice. A short video, What is Consent?, has also been developed, containing recordings of people who have used HSE services speaking about their experiences of consent in health and social care services.

The National Consent Policy is now available at www.hse.ie/ nationalconsentpolicy in addition to a detailed list of Frequently Asked Questions. The E-Learning programme is available on HSELand. If you have any questions on the revised National Consent Policy feel free to contact the HSE National Office of Human Rights and Equality policy by emailing adm@hse.ie.

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NEW FRAMEWORK A COHESIVE NATIONAL APPROACH TO RESEARCH GOVERNANCE

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esearch is a fundamental cornerstone of evidencebased practice. Clinical trials and clinical investigations are at the heart of all medical advances, while other health research activities such as those involving the analysis of existing data or patient experiences are essential to inform the best way to improve health and social care service delivery. While the Irish healthcare delivery system hosts a significant amount of research activity, there are many factors that make the process difficult and cumbersome. A lack of standardised procedures and support systems combined with the need to comply with regulatory, ethical and legal requirements, have resulted in the development of a fragmented approach to the overall process of research governance. In order to address these difficulties, and to enable a cohesive national approach to

research governance across the HSE and its funded bodies, the HSE launched the HSE National Framework for the Governance, Management, and Support of Research in September 2021. The implementation of this framework is essential to address existing challenges, and will require a number of initiatives on a national scale, including the reform of the Research Ethics Committees system and the development of research support and management structures at local level. Also, the implementation of the framework will be enabled by the roll out of a National Electronic Research Management System (NERMS) that will contribute to streamline and coordinate existing processes. NERMS will have a tailor-made design to suit the complexities of both the HSE organisational structure and the Irish regulatory and legislative requirements. It will have a web based interphase and will host a standardised research registration form incorporating a research ethics

committee application with simultaneous governance processes and approvals, in a manner proportionate to each study’s level of risk. It will replace current paper-based practices, and provide an opportunity to standardise and simplify procedures for research approval and oversight. The system will have reporting capability which will allow access to accurate data about research activity hosted at local, regional and national levels. This information will inform future research strategies and priorities, and assist with understanding the health system's weaknesses and strengths. This project is being led by National HSE Research and Development in consultation with key stakeholders and has recently received an award from the Public Service Innovation Fund 2022 from the Department of Public Expenditure and Reform, which aims to support innovative ideas from across public service organisations and turn them into a reality.

Internal Controls Improvement Programme commences second year We are now commencing the second year of the three-year Internal Controls Improvement Programme which was approved by the Chief Executive Officer and the Executive Management Team in March 2021.

THE KEY OBJECTIVES OF THE PROGRAMME ARE: • strengthening internal controls and compliance levels • promoting staff awareness of their role in safeguarding our resources • revising and revamping the National Financial Regulations (NFRs) • improved reporting and monitoring tools • enhanced training programme Stephen Mulvany (CFO) is programme sponsor with Mairead Dolan (ACFO, National Finance Division) and Monica Percy (GM, Governance & Compliance) as project leads. The delivery of this multi-work stream programme involves significant input from the Governance & Compliance team as well as support from various HSE personnel (Subject Matter Experts and user groups) and external consultants. The programme team recently completed a ‘road test’ of the first draft of the revised NFRs through collaboration with the project team, SMEs and external consultants. The revised NFRS

were reviewed by a cross-section of staff from across the HSE, with key findings and practical feedback gathered and analysed. This is an important step towards the overall aim of making these key controls documents more user friendly and assessible to HSE staff. Currently this feedback is being incorporated into the revised NFRs and key user groups from across the HSE, voluntary and statutory organisations will have a further opportunity to provide feedback. The Controls Assurance Review Process (CARP) is an annual process whereby all staff at grade 8 level and above are asked a series of specific questions to help assess the current effectiveness of internal controls. The delivery of enhanced reporting of the CARP findings were provided to each division, CHO and Hospital Group Lead, with a focus on key areas for improvement, proposed actions and relevant supports available. This process will also make a significant contribution towards enhancing our system of internal controls and will be embedded into our controls reporting and monitoring going forward. Our programme of controls focused webinars will be continuing in 2022 so watch out for Staff News updates on those. In addition – we recently launched our YouTube channel, which includes training videos on NFRs – which is available to view at your convenience. If you have any related questions or require support, please contact the Governance & Compliance Team at Govn.Compliance@hse.ie

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PATHFINDER HSE Capital & Estates Pathfinder climate action programme gets under way

HSE

Capital & Estates has kicked off meetings with technical advisors and design teams for its new Pathfinder Programme set up to help meet climate action targets. The Government has published the National Climate Action Plan and have passed the Climate Action and Low Carbon Development (Amendment) Bill 2021 in July 2021 which now places a mandatory legislative obligation on the Health Services Executive to achieve the following targets: 1. A 50% improvement in energy efficiency by 2030 2. A 51% reduction in energy-related Green House Gases by 2030 3. All HSE buildings to be Net Carbon Zero by 2050

PILOT PATHFINDER SITES DUBLIN NORTH EAST 1. 2.

Our Lady of Lourdes Hospital, Drogheda Lusk Community Nursing Unit, Dublin

DUBLIN MID-LEINSTER 3. 4.

Mullingar General Hospital Baltinglass Community Nursing Unit

SOUTH REGION 5. 6. 7.

Wexford General Hospital Clonakilty Community Nursing Unit, Cork Cork Head Quarters Office & Clinical Services

WEST REGION 8. 9. 10.

Sligo University Hospital Plunket Home Community Nursing Unit, Boyle, Co. Roscommon Nenagh Health Centre, Tipperary

These targets are absolute targets and performance will be assessed against baseline emissions for the years 2016-2018. Crucially, these targets do not take into account increased healthcare activity or increases in the building portfolio. To address this significant challenge HSE Capital & Estates Climate Action & Sustainability Office have identified 10 representative health facilities, four of of which are acute hospitals, four residential care Older Persons Units, one Primary Care and one office building, and have recently started a Pilot Pathfinder Programme with the objective of mapping a route to achieving these targets for these facilities. To do this, the HSE have engaged four Design Teams and a Technical Advisor Team (the HSE also intend to appoint an Energy Performance Specialist Advisor in the near future) and are pleased to announce that the programme, which is jointly funded by the Sustainable Energy Authority of Ireland (SEAI), has recently commenced. Initial Kick Off meetings for the programme have all taken place.

INTRODUCING THE HSE'S NEW REGIONAL WASTE AND SUSTAINABILITY OFFICERS

LOCATION OF 10 PILOT PATHFINDER PROGRAMME LOCATIONS

The Design Teams and Technical Advisors will assess and evaluate viable deep retrofit solutions that are suitable for healthcare environment, in order to achieve carbon and energy targets. This shall also include the detailed costs associated with progressing the building energy retrofit programme and to identify both technical and operational gaps or barriers that may exist. This Pathfinder programme is a pilot and learning programme and the sites selected form a representative sample of the HSE building portfolio. So the learnings from this programme will pave the way for, and inform, a much larger national programme for major energy retrofits across the wider Estate and Public Sector. Peter Smyth, Assistant National Director in the Climate Action & Sustainability Office, welcomed the start of the programme as “without effective mitigation and adaptation action, climate change will have profound implications for the health and well-being of Ireland’s population and the smooth delivery of our health and social care services”.

To broaden the approach to sustainability across the Health Sector and support the HSE to transition to a more sustainable organisation, four Regional Waste & Sustainability Officers have recently been appointed by the HSE Capital and Estates Climate Action & Sustainability Office. The four Regional Officers will advise and assist healthcare facilities in the reduction of waste and support more sustainable and environmentally friendly practices throughout the Health Service. The officers will work closely with the Clean Technology Centre (CTC) who run the HSE’s Green Healthcare Programme. This programme, which is fully funded by the HSE, aims to reduce

healthcare risk waste, reduce food waste, increase recycling and conserve water in healthcare facilities. The programmes recent focuses has been on implementing best practice and converting waste reduction and water conservation guidance onto an online training platform, with in-person and on-line training rolling out to larger healthcare facilities in 2022. The provision of waste reduction training is being coordinated by the Regional Waste & Sustainability Officers and will be provided to each local hospital waste, sustainability or catering manager and their team. The Sustainability Officers are also working with

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FOR FURTHER INFORMATION AND SUPPORT PLEASE CONTACT YOUR REGIONAL WASTE & SUSTAINABILITY OFFICER: Ken Hyland (DML) Robert Sweeney (DNE) Ruairi Keane (West) Aileen Fitzgerald (South West)

ken.hyland@hse.ie Robert.Sweeney1@hse.ie Ruairi.Keane@hse.ie Aileen.Fitzgerald3@hse.ie

Hospital Management Teams to support them in exploring opportunities to improve efficiencies in relation to sustainable waste handling (for both hazardous and nonhazardous waste) and improve Health Services’ recycling figures, if such opportunities exist. Current baseline for each hospital will be reviewed with a view to setting incremental improvements to reach our 2030 recycling targets. Another key focus of the officers will be to support the creation of Green Teams in Acute

Sustainability supports for small and medium healthcare facilities will also be provided by a new online Healthcare Sustainability Assessment tool which has been developed by CTC and the Climate Action & Sustainability Office. The interactive tool provides a score card for the facility and will advise on energy efficiency, waste prevention, water conservation and governance, with further support provided by CTC on successful completion of the assessment by an organisation. The tool will be piloted in CHO 4 in Q2 this year prior to being rolled out nationally. The tool is designed to initiate sustainable actions in each location by asking basic, and as non-technical as possible, questions in relation to a facilities operation. The responses to the questions will generate a follow up report with recommendations and a sustainability action plan.

FOR FURTHER SUPPORT PLEASE CONTACT: HSE Capital & Estates - Climate Action & Sustainability Office Phone: 01 795 5537 Email: climate.action@hse.ie www.hse.ie/sustainability www.greenhealthcare.ie

Hospitals and to provide assistance in Hospitals where Energy Teams exist to develop these teams into Green Teams. These teams, who will be supported by the Regional Waste & Sustainability Officers, will develop Registers of Opportunities for improved sustainability practises in their location in areas such as bio-diversity, waste prevention, water conservation, waste reduction, pollution prevention and the provision of facilities to support sustainable and healthy transport such as cycling and walking.

COLLABORATING TO PROFESSIONALISE PROCUREMENT IN THE PUBLIC HEALTH SERVICE A compelling vision for HSE Procurement is to build sustainable architecture for the professionalisation of procurement in the public health service. This is a most valuable vision considering that the HSE is the largest purchaser in the State with a spend of €3.7bn annually across a diverse range of goods and services to enable delivery of frontline patient care. In this context it is important that staff leading on procurement activity across the Health Sector are equipped with the skills and expertise required to deliver a best in class procurement service. This enables sustainable and innovative procurement while taking cognisance of the many geo political factors that are currently influencing the global supply chain. It presents the opportunity to create the required competencies to develop optimum portfolio and category strategies, while working across multi-disciplinary stakeholder groupings to enable effective procurement. This will continue to optimise efficient use of public funds while in parallel procuring products of the appropriate quality and standard. Through collaboration with the University of

Limerick (UL), HSE Procurement have developed and rolled out accredited training modules to support the continued professional development of HSE and health sector procurement. It has been a key focus to ensure that at all times the course content reflected the challenging environment that the procurement staff, in the public sector, have been faced with. This approach will ensure participants can continue to be in a position to procure according to best practice procurement in a professional manner in accordance with the European competency framework for public procurement. At the recent 2022 Education Awards, the collaboration between HSE and UL was formally recognised as the Certificate and Diploma in Public Procurement and Supply Chain Excellence Programme was one of the finalists shortlisted. The Education Awards recognise, encourage and celebrate excellence in the third level education sector on the island of Ireland from both State and privately funded institutions. This recognition not only signifies the success of the journey to date but demonstrates the power of collaboration in

pursuing a collective vision to professionalise procurement. John Swords, National Director of HSE Procurement, said, “Through working in collaboration with the University of Limerick we have created opportunities for our staff and indeed staff across the wider Health Sector to develop both public procurement and supply chain management expertise. I am delighted that the programme continues to grow and develop and very pleased to represent HSE Procurement at the 2022 Education Awards.” If you would like further information in respect of the public procurement and supply chain management programme, please contact: Neasa.ODonovan@ul.ie – Certificate/ Diploma in Public Procurement and Supply Chain Excellence Carole.Ryan@ul.ie – Micro Credentials (Supply Chain Management & CRM/ Introduction to Supply Chain Management/ Public Procurement Compliance and Support Systems)

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PATIENT SAFETY IS EVERYBODY’S BUSINESS National Quality and Patient Safety Directorate publishes first Prospectus of Education and Learning Programmes WHO ARE WE?

WHY DOES IT MATTER?

The National Quality and Patient Safety Directorate (NQPSD), led by Dr Orla Healy, works in partnership with HSE operations, patient representatives and other partners to improve patient safety and quality of care. Our mantra is “patient safety is everybody’s business.” Everything we do is anchored in the Patient Safety Strategy 20192024. A key commitment of this Strategy is to empower and engage staff to improve patient safety. We aim to honour this commitment by supporting a culture of continual learning through education programmes, resources and learning opportunities. To that extent, we are delighted to launch the first annual NQPSD Prospectus of education and learning programmes.

This resource will help staff identify learning programmes that will support them in their day to day work to improve quality and patient safety and it will also support them in planning their personal or continuous professional development. Many of our programmes are eligible for CPD points or credits from RCPI, NMBI and CORU.

WHAT IS THE NQPSD PROSPECTUS?

This prospectus provides information about the education and learning programmes available to staff through e-learning, virtual learning and face to face workshops. Our programmes cover key areas relating to quality and patient safety such as: • Quality Improvement • Incident Management • Open Disclosure • Clinical Audit Human Factors

BOOK OF ABSTRACTS highlights quality improvement capability in system

We hope you find it a useful resource to support you in your own development and we look forward to welcoming you onto our programmes in 2022. The Prospectus can be found on our website https://www. hse.ie/eng/about/who/ nqpsd/qps-education/ prospectus-of-educationand-learning-programmes. pdf and for further information please contact QPS.EDUCATION@hse.ie

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ach year, the National Quality and Patient Safety Directorate (NQPSD) partners with the RCPI to support the Quality Improvement Leadership Programme. This collaborative one-year diploma - fully funded by the NQPSD - aims to build quality improvement capacity and capability in the Irish healthcare system. The 2020-21 programme was the tenth year of this partnership and it was a particularly challenging time for our healthcare workers who responded to the COVID-19 pandemic with innovation, resilience and dedication. In the midst of the pandemic and cyberattack, the 2020-21 year students navigated the daunting task admirably. As part of the programme, students explored the use of quality improvement methodology in their own workplace to improve quality and patient safety. The ideas and solutions proposed are brought together into the Book of Abstracts. Speaking on the launch of this year’s Book of Abstracts, Dr Orla Healy, National Clinical Director, Quality and Patient Safety, said, “We are proud to collaborate with the RCPI in providing this Diploma programme and supporting the development of leaders in quality and

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HSE welcomes new National Centre for Clinical Audit (NCCA)

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he HSE has welcomed the establishment of the National Centre for Clinical Audit (NCCA). The NCCA was formed following on from the publication of the HSE National Review of Clinical Audit Report in 2019 and will be primarily responsible for implementing the report’s recommendations under five key pillars: National Governance for Clinical Audit; Local Governance for Clinical Audit; Education and Training for Clinical Audit; Education and Training Resources for Clinical Audit and Legislative Changes affecting Clinical Audit. This important step confirms the HSE’s commitment to developing clinical audit as an essential quality and patient safety tool in Ireland, promoting improved patient outcomes. The NCCA is part of the National Quality and Patient Safety Directorate. WHAT IS CLINICAL AUDIT? Clinical audit is a clinically-led quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and acting to improve care when standards are not met. The process involves the selection of aspects of the structure, processes and outcomes of care, which are then systematically evaluated against explicit criteria. If required, improvements should be implemented at an individual, team or organisation level and then the care re-evaluated to confirm improvements. Dr Colm Henry, HSE Chief Clinical Officer (CCO), who commissioned the HSE National Review of Clinical Audit and chairs the HSE National Steering Group for Clinical Audit, welcomed the development. “This will ensure an integrated approach to clinical audit. The HSE NCCA will implement the recommendations of the National Review of Clinical Audit Report 2019 which will strengthen the development of an end-to-end process for clinical audit and meet the needs of clinical audit service providers and multi-disciplinary stakeholders.”

safety across our health and social care system. In this Book of Abstracts, we can see how this partnership has led to many outstanding results over the past year. The importance of keeping the focus on improving quality and patient safety during these difficult times cannot be overstated.” Despite the challenges faced, you will see the breadth of the improvement projects, from quality improvement, patient safety, person-centred care, timeliness and effectiveness. The projects in the Book represent the HSE’s commitment to improving patient safety and quality of care, which creates great optimism for ongoing improvements within teams and services across the country. For example, Caitriona Heffernan, Senior Speech and Language Therapist at Cork University Hospital, created a standardised method for discharge documentation for children under 18 months admitted to a General Paediatric acute hospital setting. The objective of this project was to increase the percentage of children having a discharge report detailing their admission on the day of their discharge from 35% to 100%. This improves patient safety and gives more knowledge to the patient and their carers.

Dr Orla Healy, National Clinical Director, Quality and Patient Safety, added, “Clinical audit is an integral component of safety in all modern healthcare systems and the programme will ensure delivery of a standardised approach.” NATIONAL CLINICAL AUDITS A wide range of National clinical audits are commissioned and managed on behalf of the HSE by our clinical audit service providers: National Office of Clinical Audit (NOCA), Royal College of Physicians of Ireland (RCPI), National Perinatal Epidemiology Centre (NPEC, UCC), National Clinical Strategy and Programmes Division (NCSPD), Out of Hospital Cardiac Arrest Register (OHCAR, NUI, Galway) and Office of Nursing Midwifery Services Directorate (ONMSD). WANT TO LEARN MORE? The NCCA Training and Education programme for Clinical Audit will be available in early Q2.2022, and will cover a range of virtual and in person training options including ‘Fundamentals in Clinical Audit’ elearning programme, Foundation in Clinical Audit, Advanced Clinical Audit and Train the Trainer. Further information and booking details will be issued in due course.

MORE INFORMATION: The terminology around clinical audit can be confusing and at times, inconsistent. To help with this, we have put together a Nomenclature - a Glossary of Terms for clinical audit access www.hse.ie/eng/about/who/ nqpsd/ncca/nomenclature-a-glossary-of-termsfor-clinical-audit.pdf We invite you to follow us on our clinical audit journey through Twitter @hsencca and learn more on our website www.hse.ie/eng/about/who/ nqpsd/ncca/ncca.html For further information please email us at ncca@hse.ie

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Open Disclosure Sligo leads the way in a new Skills-Based Open Disclosure Training Programme

"THIS NEW PROGRAMME ALLOWS STAFF TO DEVELOP THEIR SKILLS FOR FACE TO FACE OPEN DISCLOSURE IN A SUPPORTIVE ENVIRONMENT." Dr John Kelly, Consultant orthopeadic surgeon, SUH

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he HSE operates a policy on Open Disclosure and it is mandatory for all staff to attend Open Disclosure training Open Disclosure is “an open, consistent, compassionate and timely approach to communicating with patients and, where appropriate, their relevant person following patient safety incidents. It includes expressing regret for what has happened, keeping the patient informed and providing reassurance in relation to on-going care and treatment, learning and the steps being taken by the health services provider to try to prevent a recurrence of the incident”. (HSE 2019)

FACE-TO-FACE TRAINING PILOT PROGRAMME In 2021, the HSE National Open Disclosure Team, in conjunction with a project team from Sligo University Hospital (SUH) and CHO1, commenced a pilot programme to develop and test a revised face to face skills based workshop which would support and compliment the on-line Open Disclosure modules which are available on HSeLanD.

The ultimate aim and objective of this working group was to develop a workshop that will support staff and increase their confidence in preparing for and managing open disclosure discussions to meet the needs of patients, their families and staff involved in patient safety incidents. This revised programme has been co-designed with consultants from across various directorates, QPS staff and managers in SUH and CHO1. The workshop, which was developed following a training needs analysis, is informed by evidence based practice and is aligned with the HSE Open Disclosure policy, current and pending Open Disclosure legislation and the HSE National Healthcare Communication Programme.

PROGRAMME CONTENT This three-hour, CPD accredited, face-to-face programme uses a case scenario approach and involves information sharing, discussion and the exploration and practice of the key communication skills involved in effective open disclosure through role play exercises and the application of various communication tools. The case scenarios used are relevant to the service in which

"PRACTICAL NATURE OF SESSION ALLOWS YOU TO PRACTICE REAL-LIFE SCENARIOS AS THEY HAVE OCCURRED." Prof Catherine McHugh, Consultant endocrinologist, SUH

For further information contact the National Open Disclosure Office on opendisclosure.office@hse.ie

the training is being delivered – these scenarios are developed with staff from the services involved. A revised Train the Trainer programme has also been developed to support the roll out of this programme across all health and social care services.

ACKNOWLEDGEMENTS The staff in the HSE Open Disclosure Office wish to thank the project team in Sligo University Hospital and CHO1 for their hard work, support and commitment to the development and roll out of this programme.

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HSE Occupational Health Service – Supporting Line Managers

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he Occupational Health Service (OHS) provides an independent, confidential advisory service to HSE employees and their line managers on matters relating to the effect of health on work and the effect of work on health. The OHS seeks to promote and maintain the health and wellbeing of employees with the aim of ensuring a positive relationship between an employee's work and health. Common reasons for referral to the service are: occupational blood exposures including needle stick injuries; mental health issues; musculoskeletal problems; work-related stress; and ill-health retirement. The Occupational Health Service provides advice and recommendations to managers on what they can do in these circumstances to improve, reduce, or remove any potential risks to their employees. The advice and recommendations may include: • Adjusting working arrangements, for example the employee's shift pattern and working hours • Removing something from the workplace, for example bright lights above the employee’s workstation • Providing advice or signposting regarding extra or specialised equipment • A phased return to work following a period of sickness absence • A referral for an appropriate course of therapy, for example physiotherapy or counselling

As a line manager, you can refer a member of staff to Occupational Health using the management referral form. Ensure to tick all relevant boxes under the ‘reason for referral’ section and feel free to add as much detail on the matter as possible. Before submitting the form, your employee must be given an opportunity to read over the form, and they must give consent before the referral is made. Line managers can expect a written report following assessment. This report will give a suite of medical recommendations and will include an opinion on the employee’s fitness for work, potential time frames for return to work, and recommendations to facilitate a member of staff remaining at work or efficiently returning to work. Upon receiving the report, the line manager may then make the decision around which recommendations they can reasonably and practicably support and implement within their own work environment. Further information on Occupational Health and the management referral form can be found on: https://healthservice.hse.ie/staff/benefits-services/ occupational-health/manager-referral-info-for-managers-.html

HANDING OVER NEW SKILLS IN MID WEST MASTERCLASS Mid West Community Healthcare Infection Prevention Control (IPC) Team recently held a Hand Hygiene Masterclass attended by over 50 key staff involved in delivering, monitoring and supporting hand hygiene practice across all services. Embracing the theme for WHO Hand Hygiene Day, this Mid West event engaged people at all levels of the service to promote a culture of working together to support people to clean hands at the right times and with the right products with the common goal of delivering safe quality care. Chief Officer, Maria Bridgeman, opened the Masterclass by recognising and celebrating our leaders in HSE Mid West

Community Healthcare who champion infection prevention and control in their daily roles: • Our Team of IPC Nurse Specialists • Frontline staff, in particular those who have trained as Hand Hygiene Trainers and IPC link practitioners • Our Service Managers The Masterclass had a packed schedule with presentations on local data by Ann Hammersley (ADON IPC) and Callum Ryan, Antimicrobial Pharmacist; the Public Health perspective by Siobhan Treacy, CNM2, Mid West Public Health; an update on AMRIC’s work by Dr Eimear Brannigan, in-coming Clinical Lead AMRIC; and the launch of the Community IPC Resource Manual

by Gwen Ryan, National DON IPC, Community Operations. The IPC Nurse Specialists kept everyone busy in their workshop on Hand Hygiene Moments. The Masterclass concluded with a session focussed on self-care with the Mid West Aries Team reminding us that hand hygiene moments are everyday moments for self-care.

Maria Bridgeman, Chief Officer Mid West Community Health Care; Ann Hammersley, ADON IPC; Gwen Ryan, National DON IPC, Community Operations.

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Into the woods New woodland park to be created on HSE land

Left to right: Marina Conway, CEO Western Forestry Co-operative; Pippa Hackett, Minister of State for Biodiversity and Land Use at the Department of Agriculture, Food and the Marine; Martin Beirne, Property Manager HSE; Brian McGarraghy, Coillte Forestry Manager; Colm Gilheaney Western Forestry Co-operative, Forestry Project Manager; and Denis O’Rourke, HSE, Maintenance Foreman, Cloonamahon Services. Top right: Pippa Hackett, Minister of State for Biodiversity and Land Use at the Department of Agriculture, Food and the Marine; Martin Beirne, Property Manager HSE; and Frank Feighan, Minister of State at the Department of Health with responsibility for Public Health, Well Being and National Drugs Strategy.

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he sod was turned and the first tree planted at the new Cloonamahon Native Woodland Park at a recent opening ceremony. The development, which is the largest such project in the country, is a collaboration between the HSE, Coillte, Western Forestry Co-op and Sligo County Council. This site is being 100% funded by the Department of Agriculture Food and the Marine under its Woodland Creation on Public Land scheme. The scheme was introduced by Minister of State Pippa Hackett in 2020 to encourage public bodies to use their lands for the creation of public lands. This project which will develop over the coming years will see over 100,000 native trees planted across a combined land area of almost 250 acres. Of this, 105 acres of HSE land will be converted to native woodland under the scheme. This will include 4.55km of tracks and trails as well as a picnic and fully accessible playground area. There are 15 acres of Coillte-owned woodland which are transitioning from commercial Stika spruce forest to native Irish Woodland, this will be integrated with the Cloonamahon Native

GO FISH

Woodland and provide a further 1km of tracks, trails and amenity areas. HSE CEO Paul Reid said the development represents great collaboration between agencies and showcases the HSE’s commitment to the environment. “From a HSE perspective it’s important for us to be invested in this project, we care for people and one way to do that is investing in preventive healthcare and people’s social, physical and mental wellbeing,” he said. HSE Acting Chief Officer for CHO1 Dermot Monaghan highlighted their focus on ‘universally designed accessible’ spaces where everyone is able to participate in the space. Many of the speakers praised HSE property manager Martin Beirne for his role in developing the project stating it was his determination that helped ensure this development became a reality. “I’ve been coming to Cloonamahon working for the HSE for the last 45 years and this is the nicest project I’ve worked on. Everybody supports it and sees how worthwhile it is. We’ve only started. We can do so much here that can be developed.”

The Ladywell Centre in Louth County Hospital is a community-based Adult Mental Health Team. The Social Work department started an angling group in conjunction with Rory Keating of Inland Fisheries Ireland. The group meet fortnightly in Lough Muckno, Co Monaghan and Rory and his angling colleagues instruct the team in lake fishing for carp and pike. “It is a very enjoyable and positive mental health activity to be undertaking in the great outdoors,” said Torin Fleming, Mental Health Senior Social Worker, Louth/ Meath Mental Health Services. The department are very grateful to Rory and his colleagues in IFI for the ongoing support of this worthwhile project.

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Love Run St Mary's stroke unit does 5km ‘Love Run’ for the Irish Heart Foundation

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he Irish Heart Foundation’s 2022 Love Run – a 5km run or walk – took place in February. The patients on Achill Stroke unit in St Mary’s Hospital, Phoenix Park, got involved by walking, cycling or self-propelling 5km over a one-week period. A staff member contacted the Irish Heart Foundation (IHF) to see if patients could get involved in the Love Run. The IHF provides support to all stroke survivors on discharge and link regularly with the Achill Stroke Unit. They provided some headbands and snoods for patients. An email was sent to all staff to explain the event and the plan for patients to complete the 5km over the week. Staff were also encouraged to register to participate to do the 5km themselves. The event was advertised on the ward. Each patient had a log and the various distances on the ward were measured out and displayed on a notice board on the ward. The challenge took place for seven days from February 7th – 14th. Staff encouraged patients to reach their targets daily and record them. At the end, the results were totted up and prizes were given. All patients completed 5km in the week with some patients reaching much greater distances on the bike and walking. The event helped raise awareness of the support the IHF provides. It was noted that there was an overall positive atmosphere on the ward and patient’s moods were enhanced by achieving their goals. The event also empowered patients to take the lead in their own recovery. The event also created an awareness of the importance of physical activity and the role the IHF plays in supporting stroke survivors. The involvement of staff and patients alike created a sense of teamwork and motivation. It also improved the atmosphere on the ward which increased patient’s mood.

POETS AND PLAYERS SOCIETY BRINGS CULTURE TO ST JAMES The Poets & Players Society at St James's Hospital exists as a social forum for the appreciation of all things literature: from poetry to prose, plays to powerful speeches. Founded by Dr Stephen Hatton, it is open to all hospital staff interested in exploring and discussing literature, public speaking, acting, and other creative expressions of language. “The society embraces the exploration of the human experience and condition in the unique setting of Irelands largest acute hospital,” explained Stephen. Since its founding, the P&PS have ventured off campus on field trips including to the Irish Museum of Modern Art (IMMA) to explore the Poetry Speaks outdoor exhibition, and to the Museum of Literature of Ireland at St Stephen’s Green. The P&PS organised the Words To Live By poetry recital in the Creative Life Hub courtyard. Staff members recited some of their original creative writing pieces alongside the works of St Vincent Millay, Heaney, and Blake. This was the first performative event of the P&PS on SJH campus and was warmly received by all in attendance. The bright sunshine and the soothing tones of the Irish harp opening and closing the event enhanced the atmosphere of calm reflection and respite during the hectic workday. “The P&PS has been hugely supported by the Creative Life Hub at MISA, and we are indebted to Roisin Nevin, director of CLH, for her encouragement, guidance, and continued support for this project,” he said. The society remains open to all staff interested in the written word in all its forms. Please contact hattons@tcd.ie for more information or expression of interest or join them at their weekly meetings held in the Creative Life Hub, MISA at 5.30pm onwards.

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THIRD TIME

Lucky

Environmentally-conscious CUH claims world-first with third Green Flag

C Top: Staff members planting the Catering Herb Garden at CUH Outdoor Staff Dining Area at CUH Above: At the flag-raising ceremony were (left to right): Dr Gerard O’Callaghan, CUH CEO; Ruaidhrí de Barra, Sustainability Officer, CUH; Marie J McCarthy, Services Manager, CUH; and Michael John O’Mahony, Director, An Taisce Environmental Education Unit.

ork University Hospital (CUH) became the first hospital worldwide to be awarded its third Green Flag from An Taisce, on behalf of the International Foundation for Environmental Education in March 2022. Green Flags are awarded to campuses that have demonstrated they have implemented a seven-step programme of environmental management across campus. The award follows an assessment of the hospital’s Green Flag programme in November 2021 by an external panel comprised of members of staff from the Environmental Education Unit in An Taisce. Dr Gerard O’Callaghan, CEO CUH, spoke of the hospital’s pride at the achievement. “This is in recognition of the excellent work being done on the hospital campus by our staff and students to maintain a clean and sustainable environment,” he said. The Green-Campus Programme aims to ensure that members of a campus community can engage in a meaningful way to enhance sustainability on campus. The programme focuses on environmental education, sustainable development on campus, and beyond. Led by staff and students and supported by Senior Management, CUH’s Green Campus programme has evolved to manage an array of environmental themes, from waste, water, energy, transport and biodiversity. As part of the latest Green Flag submission, CUH expanded the remit of the programme to cover green procurement and health and wellbeing initiatives. As part of the programme, CUH developed wildflower zones, a catering herb garden and provided outdoor seating areas (made from recycled plastic) for staff to use when taking a break from the clinical areas. CUH has plans in place to roll-out different initiatives including the installation of outdoor exercise equipment, staff exercise programmes and a Slí na Sláinte route. The success of the programme is also credited to the work of a network of green teams across the hospital championing sustainability in their areas. CUH recently organised a Green Campus week in partnership with An Taisce, HSE Estates and the HSE National Health Sustainability Office to highlight the Green Campus initiatives being rolled out across the campus. Events rolled out over the week included waste and energy awareness stands, Green Campus presentations and initiatives including the collection of old mobile phones and glasses which were sent forward for upcycling. The Green Flag raising ceremony also formed part of the week to celebrate the environmental achievements CUH have realised throughout the COVID-19 pandemic.

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GARDENERS WIN

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Donegal gardeners win Outstanding Community Disability Service Award at Active Disability Services Awards

our avid gardeners had a double cause to celebrate recently after winning a national prize in addition to coming out in top spot in a county-wide competition. The quartet from Clarke’s Place, Moville, a HSE-run Community Group Home for people with Disabilities - Matthew McLaughlin, Kevin McLaughlin, James Ruddy and Patrick Ruddy - were involved in making planters for the flowers, sowing seeds, making bird feeding tables, upkeep of the gardens and growing their own vegetables. David James presented the achievement awards and was joined by senior management, relatives and staff in celebrating and acknowledging the hard work the four residents put into making their home a pleasant and colourful place. The competition ran across Disability Services in CHO1 and there was one winner selected for each of the following areas: Donegal, Sligo/Leitrim and Cavan/ Monaghan. Following on from that win, there was even more exciting news. After receiving a huge number of entries from services all over Ireland, Clarke’s Place Community Group Home was a nominated finalist in two of the categories in the national Cara Active Disability Awards: People Make Places Category and Outstanding Community Disability Service Category, and won in the latter category. The win was announced at the National Active Disability Services Awards ceremony hosted by TV presenter Matt Cooper at Farmleigh House, in Phoenix Park, Dublin. Anita Gallagher, Disability Service Manager, said the Disability Senior Management in Donegal were extremely proud of the

residents and staff in Clarkes Place, Moville Community Group Home, in winning the Cara Active Disability Service Award. “This award reflects the positive team working between the staff and residents with staff encouraging and supporting the residents to participate in physical activity and lead a healthy and active lifestyle,” she said. Head of Service for Disability Services in Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo, Edel Quinn, said, “The Cara Active Disability Service Awards were developed to recognise and reward Disability Services throughout Ireland who have shown leadership and commitment to helping people with disabilities to stay active and healthy. The awards highlight the commitment of management, staff and individuals with disabilities to participating in physical activity programmes and adopting healthy practices as part of their lifestyle choices. The promotion of health and wellbeing is a key component of Slaintecare and to have this recognised nationally within our local services is very positive.” Martin McNamee, Clinical Nurse Manager 2, added, “This is a wonderful example of where both residents and staff met the challenge of COVID-19 restrictions head on and developed their own direction in order to maintain and grow both their physical and mental health. The outcomes as a result of this were new education and skill development as well as creating a number of produce lines both for use in the community group home and for sale.” This W their recent win in the Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo Gardening Competition.

Front: James Ruddy and Patrick Ruddy (holding trophy); middle: Kevin McLaughlin and Matthew McLaughlin; back: Matt Cooper and Martin McNamee.

There were also nominations from other areas of Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo, which included: • Health and Wellbeing – HSE Sligo / Leitrim Disability Service who were nominated for Best Physical Activity Programme • Chair aerobics and healthy lifestyle programme - RSW Day Services, North West Parents and Friends, Sligo who were nominated in the Best Health Education Programme • PhysioFit Programme – Donegal Community Inclusion Training Services, Donegal who were nominated in the Best Community Engagement Programme

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FOLLOW THE 5 S’S TO KEEP SAFE IN THE SUN: • Slip on clothing that covers your skin, such as long sleeves, collared t-shirts • Slop on sunscreen on exposed areas, using factor 30+ for adults and 50+ for children • Slap on a wide-brimmed hat • Seek shade - especially if outdoors between 11am and 3pm - and always use a sunshade on a child’s buggy • Slide on sunglasses to protect your eyes

Sun care

Enjoy the summer weather safely – Be SunSmart

A

s part of the SunSmart campaign, the HSE’s National Cancer Control Programme (NCCP), in collaboration with Healthy Ireland and cross-sectoral partners, are working together to help raise awareness of ways to prevent skin cancer. The campaign runs from April to September and outlines the steps you, your family, friends and colleagues can take to protect your skin from the sun and reduce your risk of skin cancer. Skin cancer is the most common type of cancer in Ireland accounting for almost 13,000 cases annually. The number of people being diagnosed with skin cancer in Ireland is rising rapidly. Yet, in most cases, it is also one of the most preventable forms of cancer. You can reduce your risk by avoiding overexposure to ultraviolet radiation (UV) from sunlight or artificial sources such as sunbeds. Protecting your skin from the sun whether at home or abroad can reduce your risk of skin cancer. Research in Ireland has found that among the Irish population the most commonly used forms of sun protection is sunscreen. However, people in Ireland are less likely to use other forms of sun protection such as clothing and shade. Sunscreen is an important sun protection measure, but should not be used as the first or only line of defence. It should be used in conjunction with other sun protection measures such as shade, protective clothing, hats and sunglasses and limiting time outdoors in the mid-day sun.

AS WELL AS THE 5 S'S IT IS IMPORTANT TO REMEMBER: • In Ireland, the UV radiation levels are high from April to September, even when it is cloudy. Stay safe by limiting time in the sun when UV is strongest, typically between the hours of 11am - 3pm • Do not deliberately try to get a suntan. Remember tanned skin is damaged skin • Avoid getting a sunburn • Never use a sunbed

The UV index is an international standard measurement used by the World Health Organization to quantify the level of UV from the sun. It measures the strength of the sun’s UV rays so that you know how and when to protect your skin when outdoors. The higher the UV index, the higher the risk of skin and eye damage. When the UV index is 3 or above, you need to protect your skin and eyes by following the Healthy Ireland SunSmart 5 Ss. You can check the UV index forecast at Met Éireann https://www.met.ie/uv-index. For more information visit www.hse.ie/sunsmart, contact prevention@cancercontrol.ie or #SunSmart on social media.

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PASSENGER CAPACITY 125 UPPER DECK SEATED 55 LOWER DECK SEATED 36 STANDING ROOM 34 AT RISK UNKNOWN

We don’t always know who’s at risk from COVID-19 and other viruses. But we do know how to protect them.

HANDS

FACE

AIR

VACCINATE

STAY HOME IF UNWELL

#ForUsAll

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