HSE Health Matters Winter 2021

S TA F F M AG A Z I N E O F T H E I R I S H H E A LT H S E R V I C E

STRIKING A FESTIVE NOTE FRONTLINE CHOIR LIFTS NATION’S SPIRITS

CONTENTS 1 2 4 6 9 10

A M E SSAG E F RO M O U R ED I TO R Welcome to the latest edition of Health Matters.

As we reflect on another year of the COVID pandemic and another tough winter ahead of us, we again pay tribute to the tireless work and innovation that is going on throughout the health service.

In the midst of the darkening winter evenings, there was a ray of sunshine for everyone as David Brophy’s Frontline Choir hit the RTÉ airways. It was nearly impossible not to get a boost from watching the healthcare workers turn into singing superstars before our eyes. As well as sharing their wonderful voices, they also shared their own stories of the pandemic.

As an intensive care nurse at the Mater Hospital in Dublin, Vanessa MacNamara has certainly seen the worst that the pandemic has given us. Despite the relentless onslaught from the COVID waves, she said the choir has given her joy during a very difficult time.

We chat to Kelly Ann McCabe who shared her amazing story of going from a wedding guest to a life-saver in seconds as she saved the life of a fellow guest who went into cardiac arrest. Kelly Ann was lucky enough to be a trained nurse but she highlighted how important it could be for members of the public to recognise the signs of cardiac arrest and the need for a defibrillator.

We also find out about the winners in this year’s Health Service Excellence Awards, which received a record number of entries. The innovation and dedication across the health service is incredible, especially considering the unprecedented challenges of the last two 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.

Happy Christmas and a prosperous new year to all our readers. We can only hope that 2022 brings us brighter days.

Joanne Weston Editor

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CEO message Frontline choir Off-duty nurse saves wedding guest Health Service Excellence Awards Steps to Health Challenge Minister for Health praises healthcare staff Rathdrum Centre opens Eating Disorder Clinic welcomes minister Farewell to Defence Forces Patient Council makes appeal Tallaght outpatient unit heralds new milestone Waterford Residential Centre opens to public VTE awards Electronic vital signs for patients New volunteers booth in Mayo COVID – telling our stories Get up, get dressed, get moving Flu vaccine awards Vaccines protect mum and baby Labour of love at the Coombe Community Intervention Team Tablet loan scheme for service users Quitters feel fantastic after lockdown Day care resumes for older people COVID memorial in Tallaght Final flight for Pat 20 new single rooms in Sligo Charity cycle to commemorate COVID victims NAS retirement Memory Resource Technology Rooms Dementia survey Song and dance a boost for dementia patients Virtual tour for young patients GP access to diagnostics extended Diabetic treatment for Donegal Project cuts wait times Nenagh Heart Failure Support Unit Physiotherapy boost for premature babies Series of concerts for hospital residents Rheum to Recover initiative Make Every Contact Count Children First HSE aid for overseas Infection prevention and control training

48 Continence care and training 49 Innovations in renal dietetic practice 50 Is blended care the new normal?

52 Breastfeeding week celebrated 53 Marketing of breast milk substitutes 54 Cervical screening – Ruth’s story 56 BreastCheck campaign 57 Adolescent young adult cancer care 58 First call for proposals on changes to screening 59 Traveller mental health report 59 Age Action repairs for older people 60 Community Healthcare Networks progress 62 National Clinical Programme for Early Intervention Teams in Psychosis 63 HSE award for chronic disease management 64 Methadone COVID study 65 New NMH website for parents 65 If you go, go slow 66 Severe weather planning 68 World Patient Safety Day 69 Sexual health update 70 CPD Certificate Programme in Organisation Development and Change 71 National Framework for Governance, Management and Support of Research 72 NiSRP updates 74 NEIS in 2021 75 Woodlands for Health 76 Healthy Communities 78 Obesity – breaking the stigma 79 New nutrition standards for staff and visitors 80 START to cut back the treats

MEET THE TEAM

HSE Head of Internal Communications Emma Finn Internal Communications Team Yvonne Costello

A M E SSAG E F R O M O U R C EO PAU L R E I D

Ann McLoone Jennifer Carrie Amy O'Neill Frances Plunkett Shane Larkin Paddy Crosse

Ashv il l e Medi a Gro up 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 2018.

As we near the end of another demanding year, I would like to take this opportunity to give my heartfelt thanks, to all those working across the health and social care services, for their efforts and dedication over the past 12 months, and to wish you all a very happy and safe holiday season.

We are facing another uncertain festive season, with the COVID-19 virus hitting us hard with a fourth surge ongoing, resulting in unrelenting and increasing demands on staff, who continue to meet these challenges, day in and day out, across all of our services. Every one of you, in all areas of our health service has and have done, all that has been asked of them, in managing this virus time and time again.

The vaccination programme has shown how we can and do work together to deliver a historic programme of work, with our society placing trust and confidence in our health system, by delivering over 7.8m doses of this vaccine to date!

Thousands of HSE teams in conjunction with staff, GPs, officials, volunteers, the National Ambulance Service (NAS), Public Health, the Defence Forces, pharmacists, volunteers, and many others, across organisations in the public and private sector, have all played a significant role in the smooth and ongoing running of this programme. We express our sincere thanks to everyone involved. Your contribution has ensured that it has proceeded, in a safe and speedy manner, whilst achieving one of the world’s highest vaccination uptake rates.

One of our current focus’ is on the third dose and booster programme, to strengthen and ensure that our staff and the public, have the greatest protection from COVID-19 as we move through what will likely be our most challenging winter to date.

It may not be the Christmas that we hoped for or originally planned but we will come through this and hopefully have many great Christmases ahead.

Again, thank you for all that you do every day, your support for your colleagues, teams and the health service in general.

Have a safe, healthy and happy Christmas and best wishes for 2022, for you and your families.

HEALTH MATTERS WINTER 2021 | 1

FRONTLINE CHOIR 71 healthcare workers became singing superstars before our eyes as RTE documentary charted the progress of conductor David Brophy's newest choir, made up entirely of frontline staff. The heartwarming series gave the nation an insight into the realities of life on the frontline during the pandemic.

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n March 2021, after possibly the toughest 12 months in living memory, RTE conductor David Brophy began recruiting for a new choir, made up of entirely of healthcare workers. The progress of the choir was charted in a heartwarming three-part RTÉ series, from the initial rehearsals on Zoom during lockdown to a special one-off concert in Dublin Castle where they were joined by Aslan, Paul Brady and Sibéal Ní Chasaide.

Based across the country, some 71 people are members of this choir. They hail from a wide range of medical professions and disciplines – there are neurophysiologists, staff nurses, clinical scientists, consultant paediatricians, hospital porters, finance managers, receptionists, therapists and directors of nursing in the choir – over 50 professions in all.

Over 40 healthcare institutions are represented. Staff from St Vincent’s University Hospital, Dublin, the Mater Hospital; Children’s Health Ireland at Temple Street; Tallaght University Hospital; St Luke’s Hospital Kilkenny; Midlands University Hospital Mullingar; University Hospital Kerry, Caherciveen Community Hospital, and many more are involved, including nursing homes, care and community services and Mental Health Services.

With the help of Assistant Choir Director Róisín Savage, the group also created a hugely emotive and powerful music video.

The music video sees the choir sing an arrangement of the U2 song ‘Sometimes You Can’t Make it on Your Own’ and was fittingly filmed on the campus of St Vincent’s University Hospital, projected onto the external wall of a building that served as a COVID-19 ward.

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It was a particularly poignant moment for Nice Marie Tarugo, a healthcare assistance at the hospital.

She lost her mum Mariter, a fellow healthcare assistant there, to COVID-19 on Christmas Eve. She had contracted the virus a week earlier. Nice Marie said the choir helped her to get through the horrible time she had following her mum’s passing.

“It was awful, it really was. Those months were tough. I had to think about my dad and family, but the choir acted as an escape for me. It was inspiring because you heard the stories of others and how they learned to be resilient. It helped me,” she said.

“We didn’t know what to expect from that first Zoom meeting to our outdoor rehearsals. We couldn’t imagine how it would all come together in the end, but it did, and it was so entertaining.”

Within the choir, a number of members have lost family members to COVID-19. Nice Marie was one of two members who lost family members who were fellow healthcare workers and so the choir and David decided to dedicate this music video to the choirs’ colleagues and fellow healthcare workers in Ireland who lost their lives fighting against the virus.

He said the series showcases the choir’s power in creating community and connection and the joy of singing.

“I wanted people to recognise the ordinary extraordinary people that are our healthcare workers. It was the nurses, the doctors, the porters and assistants who had to step up and make the hard decisions and choices in the worst of times. They need to be celebrated because they are the real heroes,” said David Brophy.

“What we have done here is utterly

David Brophy

ICU nurse Vanessa MacNamara

unique. This group has bonded from the very beginning. The comraderie they share and the friendships they have made are fantastic. I have huge admiration for this incredibly talented, great bunch of people.”

Vanessa MacNamara is an intensive care nurse at the Mater Hospital in Dublin. She said the choir has given her joy during a very difficult time.

“The first two waves of COVID were

CHOIR

The video of ‘Sometimes You Can’t Make It On Your Own’ by David Brophy’s Frontline Choir LEFT: TUH members of the choir: Fiona Liu, Clare Dowling, Sheeja Mathew, David Brophy, Ali Baker Kerrigan, Seamus Connolly, Aoileann Ni Chonchubhair and Fiona Ashe. Colleagues missing from the image are Donnell Rivera and Amritha Roy. BELOW: The Frontline Choir before festive practice at St Patrick's Cathedral. Photo: Paul Connor David Brophy conducts the Frontline Choir in an emotional finale concert at Dublin Castle

manageable, but the third was truly horrific.

We have families outside of work. I have a husband and two small children at home, so it was terrifying at times. But those were the risks, and we went in every day because it was our job,” she said.

“The choir was a distraction. It was a gift to me. I got the hour all to myself to be present and perform. I didn’t worry about work or what tomorrow would bring; I just sang. We could fully express ourselves.

From the moment we first met online, we immediately knew it was going to be fun. I think we forgot what it was like to enjoy ourselves,” she said.

The call for frontline choir singers was initially put out on the Ryan Tubridy Show.

One of the healthcare workers who answered the call was Mary Walshe.

Mary retired as Chief Officer, CHO Dublin North City and County, after 36 years of service in March 2019. She returned to

help with the COVID-19 efforts, helping to set up the HSE self-isolation and step-down facility at Citywest Hotel.

She said the choir has brought a lot of fun and support to her life. She made the decision to take early retirement following the death of her beloved husband Greg of cancer in 2016. She says she still misses him every day.

“Greg was only 49 when he died. He was a big 6’4” Mayo man who played football with Mayo for 10 years. It really stops you in your tracks. I’m fortunate to have great family but I miss him every day,” said Mary.

“Singing for me is about the fun. It is about being able to empathise with each other. I find singing very emotional. You can make it on your own, that’s important, but there are times that you need people and you need to open up and say you need support or help.”

John Doyle, the famous Temple Street

Hospital porter who appeared on last year’s Late Late Toy Show with Adam King, is also a member of the choir.

On singing with Aslan at Dublin Castle, he said, “If you had said to me eighteen months ago when Covid started that I would be in Dublin Castle with the most amazing group of people you would ever meet in your lifetime, I would have laughed at you.

I’ve never sung with anyone before. I’ve never even sang in the bathroom before.”

See the choir perform their version of U2’s ‘Sometimes You Can’t Make it On Your Own’ https://bit.ly/3oH45fp

HEALTH MATTERS WINTER 2021 | 3

OFF-DUTY NURSE SAVES WEDDING GUEST WITH CPR By recognising agonal breathing and immediately administering CPR, nurse Kelly Ann saved the life of her fellow guest at a recent wedding

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urse Kelly Ann McCabe went from wedding guest to hero when she saved the bride’s uncle from near certain death as he went into cardiac arrest.

And she highlighted the importance of ordinary members of the public being trained in CPR and recognising the signs of a cardiac arrest so they too might become a life-saver one day.

The 30-year-old staff nurse in St Luke’s General Hospital had travelled to Ennis from Kilkenny on October 2nd, looking forward to a day of relaxation and celebration for her neighbour’s wedding.

During the pre-reception drinks at the hotel in Ennis, Kelly Ann and her partner Mark noticed a man stumbling and falling. Soon after, there was noticeable panic and

somebody shouted if there was a medic in the room.

“Mark told me to go over and see if I could help. I ran to the man but it is so difficult to assess somebody without any patient history.

It is like being put into a situation blindfolded. But I could tell from him that he wasn’t looking great,” explained Kelly Ann, pictured above.

She got him down on the floor and knew instinctively to put him on his back.

“Another person, a volunteer medic, came to assist me. After a few seconds, he said that we didn’t need to perform CPR because the man was breathing but I knew something wasn’t right. I recognised that he was doing what is known as agonal breathing. It sounds almost like a snore and is a sure sign that a person is struggling to get oxygen in. So I

went with my gut and said I needed to start chest compressions,” she said.

An ambulance was called but was some time away so a community responder was dispatched to the scene. The duty manager in the hotel ran to get a defibrillator in the centre of the town.

“It felt like an eternity doing the compressions.

When the AED (defibrillator) arrived, I gave the patient three shocks and then he became alert. I can’t explain the relief I felt when the AED was attached and it gave the message to shock the patient," she said.

"I am a trained nurse but you start to question your own judgement in situation like this. I had no access to any monitoring so it was all done on instinct."

The ambulance arrived and the paramedics took over the care of the man, who was by now alert and doing a lot better.

“The emotion of it all just got the better of me. I was in a total state of shock and was trembling. The family were so grateful and kept saying how thankful they were that I was there. But I was so uncomfortable with the praise and was still so uncertain if I had done everything I should have done,” said Kelly Ann. A few days later, the man was still on her mind. She contacted the bride to see if there was any news.

“She told me that her uncle was feeling much better and he was getting an ICD (Implantable Cardioverter Defibrillator) fitted to prevent another cardiac arrest. I was so relieved to hear that,” she said.

“He himself sent me a lovely message and the family have sent me a lovely card thanking me.

"He said he is not a religious person but something about a guardian angel stood out to him during the wedding ceremony and he insists that I was his on the day.”

Kelly Ann, who only qualified as a nurse two years ago, said that anyone with CPR training could find themselves saving someone’s life.

“It just takes one person with the right training to be in the right place to make a real difference. It is so important that people know what to do in these situations and how to recognise when someone needs CPR," she said.

"If my story can teach just a few people about agonal breathing and when to recognise it, then I will be just delighted.”

Kelly Ann hopes to visit the patient soon as he continues on his road to recovery and he is looking forward to properly meeting his ‘guardian angel’.

Putting survival at the heart of the community

Alan Coughlan, NAS Paramedic; Dr Martin Holohan; Martin Walley, Cork Lions Club; and Jonathan Lynch, NAS Community Engagement Officer; pictured recently at an AED location, St Luke’s Cross, Cork city.

When an individual suffers a cardiac arrest in the community, minutes matter in order to try and save that person’s life. The public has a vital role to play in responding to these emergencies and so too do HSE staff (both when on and off duty). So how can we save more lives among those who experience an Out of Hospital Cardiac Arrest? International evidence shows that the following four simple steps known as the’ Chain of Survival’ are key to saving lives after an Out of Hospital Cardiac Arrest.

The four steps are simple and can be implemented by any member of the public, supported over the phone by the National Ambulance Service (NAS) 112/999 team.

• Early recognition of a cardiac arrest, calling 112/999 immediately for support throughout the resuscitation • Start immediate CPR (supported by NAS staff over the phone) • Early AED use (over the phone NAS staff will point to the closest location for an AED) • Effective advanced Emergency Medical Service support and post resuscitation care How are we doing in Ireland?

“We are fortunate in Ireland to have one of the best bystander CPR rates worldwide.

The Irish public are great at responding when a life is at stake particularly in phoning 112/999 and starting CPR. This public response is due to trojan work by many committed organisations over the last decade,” said Jonathan Lynch NAS Community Engagement Officer (South) and Bridget Clarke, NAS Lead, Out of Hospital Cardiac Arrest Strategy & Specialist Programmes. “Actions like the introduction of community first responder groups, public training, awareness campaigns and changes in how the NAS call-take, dispatch and respond to calls has resulted in big improvements in CPR rates and as a result - enhanced patient survival.”

We can still do better and we can save more lives – how?

Improving access to and the availability of AEDs to the general community and training the public to become comfortable in carrying out CPR and using AED’s. In 2019 an AED was used in only 7% of cardiac arrests before an ambulance arrived.

This is a figure we can vastly improve on as a nation.

If you want to help right now The National Ambulance Service is encouraging all HSE staff to access CPR training, keep yourself updated and check how to make AEDs, both in your workplace and your own community, more widely available for public use, 24/7.

If you would like further advice or if you would like to register an AED – please get in touch now - email cfr@hse.ie or click on the link to the NAS website.

Out of Hospital Cardiac Arrest (OHCA) Strategy for Ireland, Putting Survival at the Heart of the Community

The HSE commissioned the implementation of this national strategy in 2019 and NAS is currently leading a multi stakeholder Steering Group of health, statutory and voluntary agencies to implement it. The goal is to save approximately 80 lives a year of people who experience an Out of Hospital Cardiac Arrest.

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HEALTH SERVICE EXCELLENCE AWARDS SHOWCASE INCREDIBLE STAFF INNOVATION

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he annual HSE Health Service Excellence Awards represent an opportunity for staff to share and showcase their innovative and exceptional work. They promote team work, facilitate staff to establish their service as an exemplar and help demonstrate how staff are valued for the work that they do. A record number of entries – totalling almost 700 – were received this year with 80 staff members nominated for their outstanding contribution. Entries featured both COVID and non-COVID related services and all winners in the eight categories were worthy recipients. Congratulating award recipients and entrants, HSE CEO Paul Reid noted how staff had showcased their “impressive skills and their can do attitude in every aspect of their work.” Commenting on the quality of the entries, the CEO said

that patients and the public were “already reaping the efforts of staff to prioritise and improve patient care. This is what the health service is all about.” Describing it as a privilege to add his congratulations, An Taoiseach Micheal Martin noted how the country was now “slowly emerging from one of the toughest years our health service has experienced. I want to express how grateful I am and how grateful the entire country is for the leadership, commitment, resilience and adaptability demonstrated by health service staff – you have my admiration and respect and the admiration and respect of the Government.” Commenting specifically on the awards, the Taoiseach said the “innovation and ambition demonstrated by all the projects submitted is emblematic of the quality of service you provide.”

SERVICE DEVELOPMENT AND INNOVATION IN RESPONDING TO COVID

CONTACT TRACING ‘SAVED THOUSANDS OF LIVES’

The national contact management programme was responsible for saving thousands of lives during the COVID-19 pandemic. Dr Sarah Doyle, a specialist in public health medicine, was Clinical Lead of the HSE Contact Management Programme from March 2020 to March 2021, said the lives were saved ‘by breaking individual chains of transmission through advice to cases and close contacts and also through enabling departments of public health to manage large and complex outbreaks and also do contact tracing in complex and highly vulnerable settings’. The establishment of the contact management programme was the winning project in the award for Service Development and Innovation in Responding to COVID-19.

“We established the Contact Management Programme in response to the COVID-19 pandemic in the knowledge of the very large numbers of cases and close contacts that would soon be coming our way in Ireland,” she said. “The idea was to provide contact tracing of high volume but low complexity cases and contacts so the Departments of Public Health could use their expertise to manage high complex settings and outbreaks. The impact of our contact management programme, I believe, was in the saving of thousands of lives.” “A secondary impact was the impact it had on those of us who worked in the contact management programme.

It showed us how we, working as a team, could respond so effectively and efficiently to a crisis of this magnitude.”

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Dr John Coulter

EXCELLENCE IN QUALITY CARE

100% SUCCESS RATE FOR NATIONAL GESTATIONAL TROPHOBLASTIC DISEASE CENTRE The winner in the Excellence in Quality Care category was the National Gestational Trophoblastic Disease Centre in Cork University Hospital. Explaining the background and thanking those involved, Dr John Coulter, Consultant Gynaecologist and Clinical Lead, explained, “In this disease a malignancy can occur in the placenta which requires multiple courses of chemotherapy for cure in many women. Over many years in Ireland the management of gestational trophoblastic disease and molar pregnancy has been quite inconsistent and many patients have had to travel to the UK for treatment. “But with the help of the National Cancer Control Programme and the HSE we set up a National Gestational Trophoblastic Disease Centre here in Ireland to provide excellence in care for all women diagnosed with molar pregnancy in Ireland. “Since going live in 2017 we have managed over 500 women in Ireland with gestational trophoblastic disease and molar pregnancy with 100% success rate. Many of these women have required multiple courses of chemotherapy but all have been cured thankfully. Most patients give us feedback telling us that as well as receiving professional and expert medical care, they also feel minded by our nurse specialists. To me, this peace of mind that the patients have, while being medically managed on this dangerous journey, means that the establishment of our national centre has been a success.”

SUPPORTING A HEALTHY COMMUNITY

COCOONING PROJECT HAS REAL AND POSITIVE INFLUENCE ON THE HEALTH OF THE COMMUNITY A project to help older people remain strong and steady on their feet was the winner in the Supporting a Healthy Community category. Turners Cross Day Care Centre’s initiative supporting older adults to stay physically active during COVID-19 cocooning and beyond had a massive impact on local older people, and continues to see results.

Michelle McNamara is the senior physiotherapy behind the programme.

“The aim of this project was to assist a role for adults to remain strong and steady on their feet and so reduce their falls risk. We created an evidence-based exercise resource which we also supported with an exercise video," explained Michelle. "Once cocooning was finished we put in place a walking programme in the local community hall. We reached out to the older adults and agencies in our community to empower this project

EXCEEDING EXPECTIONS WINNERS

Chief Officer, Cork Kerry Community Healthcare, Michael Fitzgerald presents the team at Turners Cross Day Care Centre in Cork with their award.

so that it would reach as many older adults as possible as quickly as we could. Our community partners were integral in the fast response and in its success. The impact of this project is still ongoing but what we do

know is that 200,000 copies of the exercise programme were distributed, 420,000 people were able to access this through national TV, 500,000 were also able to access it through YouTube."

There were an unprecedented number of entries for the Exceeding Expectations – Outstanding Employee Award. The selection panel chose 10 winners from across the health service, individuals nominated by their peers for their exception work and dedication. The winners were: Anne Clerkin, Radiology Services Manager South Infirmary - Victoria University Hospital; Dr Avril Beirne, Consultant Geriatrician, Connolly Hospital Blanchardstown; Dr John Connaughton, Clinical Director, Midland Regional Hospital Portlaoise; Lorraine Kelly, Project Manager Housing Co-ordinator, Adult Mental Health Services, CHO 2; Majella O’Donnell, CNS - Dementia, ICTOP Sligo; Terry Boyle, surgeon, and breast care team, St James Hospital; Vania Ndoma-Egba, Paediatric Physiotherapist, Primary Care Centre, Balbriggan; Yvonne Doheny, Clinical Nurse Manager, Kilkenny Mental Health Service; Maria Lynch, Clinical Nurse Manager, Rheumatology Department, Our Lady’s Hospital, Manorhamilton, Co Leitrim; Maurice Moloney, Clinical Nurse Manager, CAMHS, CHO 2.

OPERATIONAL SERVICES INTEGRATION

HSE, NAS AND DEFENCE FORCES TEAM UP TO DELIVER EXCELLENCE IN COMMUNITY TESTING The project that won the Operational Services Integration in a COVID-19 Environment award was the COVID-19 community testing integration with the National Ambulance Service (NAS) and Defence Forces. Kenneth Stanley explained the national COVID Community Testing Team comprises nine CHO Community Testing Leads, the NAS and our partners from the Defence Forces. “The project was set up to monitor COVID testing demand across the country. Meeting three times a week, our team evaluates the data and makes decisions in a timely manner with regard to where we will deploy additional resources to support our testing across the country,” he said.

“Overall this team supports the national COVID-19 effort by ensuring that we have the maximum capacity available and ensuring the tests are taken in a minimum amount of time.” The frontline staff of the NAS have been co-ordinating home testing, helping set up pop-up test sites and drive through testing facilities, and testing at residential care facilities with their swab teams. The defence forces have supported in numerous ways, from the construction of test centres and transportation of PPE, medical supplies and tests, to carrying out COVID-19 tests and manning contact tracing roles.

D COM JTF Col O’Luasa and JTF BSM A/BSM Burke collecting the Operational Services Integration award on behalf of the Defence Forces.

HEALTH MATTERS WINTER 2021 | 7

INNOVATION IN SERVICE DELIVERY

18-MONTH WAITING LIST ELIMINATED

BY COMMUNITY PROGRAMME

An initiative that eliminated a waiting list for care that had stretched up to 18 months was the winner of the Innovation in Service Delivery award. The Community Paediatric Ophthalmology waiting list initiative at the Grangegorman Primary Care Centre in CHO9 saw over 2,700 children on the list screened in just three weeks. Dr Duncan Rogers, Consultant Lead for the Grangegorman Community Ophthalmologist Service, explained the reason behind the programme. “Over the last five years, the Grangegorman Service had a waiting list of between 2,500 and 3,500 children waiting an average of 18 months. This was a real issue as within the context of children’s vision we have around a two-year period where we can intervene and stop blindness. So an 18-month average wait was something that we couldn’t continue with,” he said. “The initiative itself was, in essence, a secondary rescreen of the entire waiting list and was only made possible by previous work done by the team I had come into, integration with the directors of public health nursing and the full support of management within CHO9.” He said that the team saw 2,782 children over a three-week period. “I am delighted to say that one year on, we still do not have a waiting list. And this means that referrals are seen within six weeks if they are urgent and 12 weeks if they are routine. The amount of clinical time that has been released has allowed us to now run, to my knowledge, the only additional needs children’s ophthalmology clinic in the community in Ireland,” said Dr Rogers.

Dr Duncan Rogers accepts the Innovation in Service Delivery award on behalf of the Grangegorman Community Ophthalmologist Service.

The Traveller Health Working Group are presented with their Improving Patient Experience award

IMPROVING PATIENT EXPERIENCE

TRAVELLER HEALTH PROJECT ‘BREAKING DOWN BARRIERS’

The pioneering work of the Traveller Health Working Group in St Luke’s General Hospital, Carlow-Kilkenny earned the team the Improving Patient Experience award. Established almost seven years ago, the Traveller Health Working Group was the first of its kind in an acute hospital in the country and it was established as a partnership approach between hospital management and staff, members of the Travelling community, local Traveller health projects and the HSE South East Traveller Health Unit. Paula Power is the project lead and Director of Midwifery at the hospital. She explained that the group was set up based on staff feedback and patient feedback on the need to improve the patient experience for the Travelling community. Zoe Doheny, regional coordinator for Traveller Health and Traveller Mental Health Liaison Nurse, said, “The aim of the group is to improve the patient experience of members of the Travelling Community who use the hospital services and to provide the necessary training to staff to encourage them to work in a way that respects the cultural diversity of all service users.” She said that the hospital management and staff have ‘really listened to the voice of the Travelling community’. “They listened and acted on their voice and their opinion about what would make them feel more welcome in the hospital,” said Zoe.

INNOVATION IN DIGITAL EXCELLENCE

MEDICAL DEVICE TRANSFORMS CARE FOR PATIENTS WITH BALANCE ISSUES A simple medical device has transformed rehabilitation for patients with dizziness and balance problems, earning a physiotherapy team at Beaumont Hospital the Innovation in Digital Excellence. Deirdre Murray, Clinical Specialist Phyisotherapist in Beaumont Hospital, explained how Vertigenius has been revolutionary for her treatment of these patients, particulary during COVID-19. “I see patients who had dizziness and balance problems for vestibular rehabilitation. During COVID-19 we weren’t able to see our patients for the regular review and for progression of exercises that they normally require. And so we collaborated with Dr Dara Meldrum from Trinity College Dublin who had been working on Vertigenius,” she said. “We hope we will be able to use this technology going forward to improve the efficiency of the care that we provide for these patients with the vestibular issues.” Vertigenius is a medical device that uses smart technology to assess balance, dynamic visual acuity and gait speed to rehabilitate patients with balance disorders more effectively.

“When you have a vestibular problem, you don’t like moving your head because it makes you feel dizzy, anxious and fearful. What we do is we try to get patients moving their heads again. So we’ve developed a sensor that can track the head movement during exercise and we can also track symptoms. The sensor talks to an app which a patient downloads from the app store,” said Dr Meldrum. “In the app, they get their exercise programme. They can see how to do it, and it also tracks what they’re doing through the head sensor. All this information gets fed back into Beaumont Hospital into a clinician portal which is GDPR compliant and very secure. And the therapist can then see how the patient is doing and remotely prescribe a changed exercise programme if necessary. It’s really cutting down the amount of time that a patient has to come to hospital, which is really valuable during COVID times, but it also saves the therapist time.

They can just press a button and see how the patient is doing and send the patient exercises.”

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STEPS TO HEALTH CHALLENGE

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ur annual Steps to Health challenge remained undefeatable in the face of further obstacles posed this year by the cyberattack on our IT systems.

Hats off to all those who took part despite the many hurdles. 1,200 courageous team co-ordinators signed up with 8,800 employees.

The Pandemic Pros from the Self Isolation Facility at the CityWest Hotel pounded the pavements solidly for the five weeks of the challenge and their team of 45 notched nearly 21 million steps between them!

“We calculated that we have walked all the way to Melbourne. The enthusiasm and effort from everyone were phenomenal. We officially had a team of 10 for the challenge but we were joined by lots of the hotel staff here who were eager to take part,” explained team leader Helen Stokes, General Manager of the Self Isolation Facility.

“We have a huge campus here so there’s always plenty of walking to be done. It was as simple as making small changes like taking the stairs instead of the lift or walking to work instead of taking the bus.

We also arranged lunchtime walks down to Saggart and around the local area to keep the team going and getting those steps in.”

Team member Eoin Hill put in an amazing 933,000 steps by himself.

“We had loads of people who never really walked before and they had amazing results. To keep everyone motivated, we had a weekly update and we made a gallery wall of photos taken by people on their walks. We’ve also given out prizes for the top steppers and that kept the effort going,” said Helen.

She said they had great support from hotel management and staff at the CityWest.

“Everyone really got behind the efforts.

The chefs at the hotel even put on a healthy food option each day. They said there was nearly no point in doing any other food because everyone was going for the healthy option,” said Helen.

The facility remains busy with

.... continues to assist our wellbeing

You can view the participation numbers from around the country in the table below.

Community Health Organisations

Teams CHO 1 85 CHO 2 35 CHO 3 50 CHO 4 62 CHO 5 53 CHO 6 29 CHO 7 90 CHO 8 71 CHO 9 87

Hospital Groups

Teams Children’s 6 Dublin Mid Leinster 68 Ireland East 69 RCSI 30 Saolta 77 South SW 50 Limerick University 53

National and Other

Teams National HSE 83 TULSA 18 Other 126

Participants 677 272 380 501 419 236 732 566 686

Participants 51 519 516 242 590 393 429

Participants 595 126 859

The Pandemic Pros from the Self Isolation Facility at CityWest.

healthcare workers who are unable to isolate at home, returning travellers who are COVID positive and can’t stay in an ordinary hospital, as well as COVID patients stepping down from care in acute hospitals.

“Our residents have their own recreational areas so we have been encouraging them to go for walks and stay active while they are isolating. There are lots of children here so we have been providing football goals and other equipment to get them out and keep moving,” said Helen.

The Steps to Health project team, which comprises Clodagh Armitage, Health Promotion and Improvement; Norma Deasy Programmes and Campaigns; Noreen Turley, Health and Wellbeing; Aine O’Connell, Digital; Jennifer Carrie, Internal Communications; and Aine Lyng National Cancer Control Programme; wishes to thank everyone who took up the challenge to make a difference to their physical and mental wellbeing. Equally we would like to send gratitude to all the team coordinators for inspiring and motivating their members. We are already in planning for our sixth initiative - next spring.

HEALTH MATTERS WINTER 2021 | 9

‘INNOVATION, EXCELLENCE AND KINDNESS: THE BACKBONE OF OUR HEALTHCARE SYSTEM’

I

Minister for Health Stephen Donnelly praises healthcare staff for their ‘extraordinary dedication’

t is a privilege to be able to speak to you in this Christmas edition of Health Matters. Since my appointment as Minister for Health in July 2020, I have had the honour of seeing first-hand the extraordinary dedication, commitment and expertise of all of you, Ireland’s healthcare workers.

When our professional lives are most difficult, we rely heavily on our friends and family for support, and yet, in the last 20 months due to the COVID-19 pandemic, you haven’t been able to meet friends, you haven’t been able to go out for dinners or even hug some of your own family members.

While coping with this upheaval in your personal lives, you’ve been front and centre in Ireland’s response to COVID-19. You’ve worked long hours, in difficult circumstances to do what’s necessary to keep people safe.

You’ve dealt with incredibly stressful situations and you’ve done it with professionalism, and you’ve done it with pragmatism. You’ve always put the most vulnerable first, even if it meant personal suffering for you. You’ve done all this while also coping with your own personal responsibilities and trying to keep yourselves and your loved ones healthy and happy.

Some of you are grieving after losing loved ones and colleagues to COVID-19, and I would like to take this opportunity to offer my sincere sympathies. Many of you are worried about those who are close to you that are vulnerable to COVID-19, and some of you are worried about your own health.

To all of you for everything you’ve done, I want to say a heartfelt thank you.

In the last few months, it has been a pleasure to be able to meet with many of you in different locations, getting a front row view of the innovation, excellence and kindness that is the backbone of our health care system day in and day out. I have visited hospices, maternity units, trauma centres, community care settings and many more.

On these visits, it is clear that the key principles of Sláintecare are being embraced and delivered - I see a healthcare service

10 | HEALTH MATTERS WINTER 2021

Minister for Health Stephen Donnelly during a recent visit to the Midwifery-Led Unit at Our Lady of Lourdes Hospital in Drogheda.

which is providing timely and accessible care to everyone in our community.

In September on a visit to Our Lady of Lourdes Hospital in Drogheda, I saw their impressive Midwifery-led maternity unit and was fortunate to meet a number of their highly skilled Advance Nursing Practitioners. It was inspiring to hear about how their advanced training is assisting in the treatment of people in their own homes, and also leading to more efficient diagnoses

and shorter waiting times.

In Roscommon, I officially opened the Roscommon Palliative Care Support Unit and walked through the fantastic services in Roscommon University Hospital. It was wonderful to meet so many teams delivering high quality care including the impressive Endoscopy Unit team and Urology team.

The innovation at work in Roscommon and the commitment to patient care is brilliant to see.

In Galway I was pleased to see that strides are being taken in terms of improvements in service and waiting times at UHG. While there I visited the recently operational Ambulatory Gynae clinic at the hospital which provides timely healthcare for women in the region. It was encouraging to learn of a new advancement in healthcare that provides heart failure diagnostics and care in the community, meaning patients can avoid a trip to Galway University Hospital. This has meant a reduction in waiting times from six months to six weeks.

In Dublin’s Mater hospital I got to see some of the robotics at work in the hospital’s theatres and meet the fantastic multidisciplinary oncology team. The Mater Hospital has been designated as the National Trauma Centre for Ireland and I look forward to continuing to support the teams there to implement this.

My visit to Cavan gave me a real sense of the work done by compassionate and caring disabilities teams all over our country, providing top quality holistic care. I also had a chance to visit the vaccination centre there, where the public health team have worked tirelessly to ensure information is accessible to all members of the community by making translators available and providing for special transport to the centre.

I’m truly impressed by the work of our

vaccination teams across Ireland - we cannot thank them enough.

Women’s healthcare is a top health priority for me and this Government.

Through the continued implementation of the National Maternity Strategy, the Ambulatory Gynaecology Model of Care, and the establishment of specialist clinics in women’s health, we are seeing significant and tangible improvements that enhance the safety and experience of our services for women, babies and families.

This year in Budget ’22 I secured €31 million to fully fund the Women’s Health Action programme. I cannot overstate how important it is for us to take action on what women have told us about their experiences in healthcare. In doing so, we enable you, our healthcare workers to provide the best healthcare for women. These improvements will also impact your own health and wellbeing, because so many of our valued healthcare workers are women. 2022 will see contraception freely available to women aged 17-25 and increased investment in a new approach to menopause care, to name just two things. This is only the beginning – this is the revolution in women’s health that has been long overdue.

I am committed to cutting waiting lists and have established a dedicated taskforce between the HSE and the Department of

Health. I know that as front-line health care workers, the delay in delivering care is as much a source a frustration to you as it is to me and the many patients who are waiting for the care that they need. We are making incremental improvements across our service through investing in technology, staff, and infrastructure, and our aim is to continue to do this and to continue to build our world-class health service for the nation.

As we move through this winter period, it is important that we all take the steps available to us to continue to protect ourselves from COVID-19. This includes receiving a booster dose of COVID-19 vaccine once it is available to you. We know if you work in healthcare you are 10 times more likely to get the flu so please do ensure you receive your winter flu vaccine It is a great privilege to be Minister for Health and to represent you, our front-line healthcare workers, who’ve worked tirelessly on behalf of the people of Ireland throughout this pandemic.

I hope that you all manage to take a break in the coming weeks. It’s important that we all get a chance to unwind, to reflect and to enjoy time with our friends and family. I wish you and yours a safe and happy Christmas and look forward to better times in 2022.

HEALTH MATTERS WINTER 2021 | 11

NEW CENTRE

MINISTER MEETS WITH YOUNG PEOPLE ATTENDING EATING DISORDER SERVICE

RATHDRUM PRIMARY CARE CENTRE OPENS TO THE PUBLIC The new state-of-the-art Rathdrum Primary Care Centre has opened to the public and will initially offer a range of Primary Care services all under one roof including a GP practice, public health nursing, paediatric occupational therapy, physiotherapy, speech and language therapy, psychology, mental health and social work services. Services will also expand to include dietetics and podiatry in the future. The new centre will also deliver a Sláintecare-funded Pulmonary Rehabilitation Service and Chronic Disease Programme. Minister for Health Stephen Donnelly acknowledged the dedication of HSE staff at the official opening.“I would like to acknowledge the work and dedication of HSE staff in continuing to work towards a better health care system for all during what has been a challenging time for health care professionals due to the COVID-19 pandemic. I would also like to extend a thank you to everyone involved in this project for working together to provide this service for the Wicklow community. The establishment of Primary Care Centres, like this one, puts service users at the centre of healthcare policy in Ireland. They are pivotal in the realisation of Sláintecare’s vision to shift health and social care services left and take pressure off the acute care system in hospitals.”Speaking at the opening, Martina Queally, Chief Officer, HSE Community Healthcare East, said the centre will ensure easier access to health and social care services for the local people.“I would like to recognise the efforts and dedication of HSE staff in bringing this new facility to fruition. We look forward to helping to assist and enrich the continued health and wellbeing of residents in this community through services offered at this centre,” she said.

Dublin South, Kildare & West Wicklow Community Healthcare Linn Dara Child and Adolescent Mental Health Services (CAMHS) were delighted to welcome a visit by Minister of State for Mental Health & Older People, Mary Butler, recently. Minister Butler met with Linn Dara Community Eating Disorder Service (LDCEDS), which is a regional specialist multidisciplinary community eating disorder team providing evidence based care for children and young people with eating disorders in Dublin South, Kildare & West Wicklow Community Healthcare. She met with families and young people attending the service to hear their experiences and also with Jacinta Hastings CEO Bodywhys and Harriet Parsons Training & Development Manager Bodywhys. In January 2018 the HSE published a National Model of Care for Eating Disorders (MOC) in partnership with College of Psychiatrists’ of Ireland and Bodywhys. The MOC is the blueprint for the HSE to roll out specialist eating disorder services in Ireland to address the current unmet need for specialist eating disorder service within HSE. While in Linn Dara, the Minister also visited the Linn Dara Approved Centre which provides specialist inpatient treatment for children and young people with eating disorders through a dedicated eating disorder programme, and met with some of the team there.

A FAREWELL SALUTE AS DEFENCE FORCES STEP DOWN FROM VACCINATION PROGRAMME

Lt Col Pat Murnane, Officer Commanding, 12th Infantry Battalion, and Colette Cowan, CEO, UL Hospitals Group, thanking Defence Forces personnel for their support in the vaccination programme. Photo: Brian Arthur

12 | HEALTH MATTERS WINTER 2021

Healthcare staff at UL Hospitals Group have saluted members of the Defence Forces on their last day supporting the rollout of the Mid-West COVID-19 vaccination programme on September 24th. At an event to mark the occasion at Limerick Racecourse attended by members of the 12th Infantry Battalion and HSE staff, Colette Cowan, CEO, UL Hospitals Group, said the vaccination teams would be ‘eternally grateful to the Defence Forces for their support in the vaccination programme at our three centres in Limerick, Ennis and

PATIENT COUNCIL PATIENT COUNCIL APPEALS FOR VOLUNTEERS TO HELP STRENGTHEN PATIENT VOICE AT UL HOSPITAL GROUP UL Hospital Group Patient Council is currently seeking new volunteers to help in its campaign to improve services across the Group.

The Patient Council was established in 2016 and provides an independent voice for patients, service users and their families. It gives patients and members of the public the opportunity to become involved as active partners in UL Hospital Group and advise hospital management on improving patient experience.

The Council is composed of volunteers from the general public as well as members of the hospital management team. It is currently looking to increase the number of public and expressions of interest are sought from people who have had experience of University

John Hannafin, Chairman, Patient Council, UL Hospitals Group

Nenagh’.“One of the things that members of the public remarked upon most often was the mere presence of the Defence Forces at the centres, which brought sharply to mind how we were all involved in an emergency response and a great national effort,” she said. Since the opening of the vaccination centres in the region, Defence Forces personnel have provided logistical support, managed stores and

Members of the ULHG Patient Council (l to r) Elizabeth O’Leary, Declan McNamara (vice-chairman), John O’Neill, Michael Ryan, John Hannafin (chairman), Judy Ryan, Anne Fitzgibbon, Melody Buckley, Marie Killowry, Catherine English, Virginia O’Dowd, Janice Cahill, Niamh O’Grady, Prof Brian Lenehan, Colette Cowan, CEO, Niamh Hogan. Missing from the photo: Kay Caball, Jill Franz, Tammy Meaney, Bernadette Moore and Mike Dwane.

Hospital Limerick, Ennis Hospital, Nenagh Hospital, Croom Orthopaedic Hospital or University Maternity Hospital Limerick. John Hannafin, Chairman of the Patient Council, said that in the course of its ordinary work and through its engagement on a wide range of hospital committees- including Nutrition and Hydration, the National Inpatient Experience Survey, End-of-Life Care, Patient Flow, and many others – the Patient Council was having a positive impact in improving services across the Group. “The pandemic has greatly disrupted the work of the Council as it has affected the entirety of the health service and society as a whole. As we look to exit the emergency phase of the pandemic, we are looking for new public members to assist the Council in meeting the new challenges and the

supported pharmacy services. Lt Col Pat Murnane, Officer Commanding, 12th Infantry Battalion, said, “It is very gratifying that the Defence Forces was able to assist the HSE in the nation’s hour of need and the level of co-operation we have had with HSE staff and the relationships we have built during the pandemic will stand to us in good stead in the future should we ever need to do something like this again. The

new opportunities that have become apparent over the past 18 months,” said John. Niamh Hogan, Patient Advocacy and Liaison Services (PALS) Manager, UL Hospitals Group, said the Council was an essential element in promoting a culture of patient partnership across the six hospitals. “We have various ways of gathering patient feedback, through surveys, through research and quality improvement projects, through the complaints process and by other means.

In the shape of the Patient Council, we also have a formal structure that meets regularly and through which the voice of our service users and their loved ones is articulated and acted upon. Only by having truly meaningful engagement of this kind can we build the trust and confidence needed to improve our services,” she said.

fact that all of our personnel volunteered to put themselves in harm’s way with HSE staff across a wide variety of tasks from patient transfer to assistance in nursing homes to assistance in both the inoculation and testing centres, it was very gratifying to be able to assist with a 100% volunteer response.” Over 360,000 vaccinations have been delivered by UL Hospitals Group vaccination teams to date.

HEALTH MATTERS WINTER 2021 | 13

CHILDREN'S HOSPITAL

ANOTHER MAJOR MILESTONE FOR THE NEW CHILDREN’S HOSPITAL PROJECT AS TALLAGHT OUTPATIENT AND EMERGENCY CARE UNIT OPENS The substantial completion of the new 4,600m² Tallaght Paediatric Outpatient & Emergency Care Unit by the National Paediatric Development Board (NPHDB) and handover to Children’s Health Ireland (CHI), announced in September, marks another significant milestone in the children’s hospital project. When fully operational, it is expected to provide 17,000 additional outpatient appointments (General Paediatrics, Specialist and Orthopaedic clinics) and will see more than 25,000 Emergency care attendances annually. Eilísh Hardiman, Chief Executive, Children’s Health Ireland, “This new facility, together with our existing services at Tallaght, Crumlin, Temple Street and Connolly and when we move into the new children’s hospital, will transform how acute paediatric healthcare is delivered to sick children in Ireland and how local secondary paediatric care

is delivered in the greater Dublin area – delivering better healthcare outcomes as well as better experiences for children, families and staff in a modern fit for purpose facility that they all deserve now and for future generations to come.”This expansion of services CHI at Tallaght will facilitate the delivery of a new model of care in paediatric services in south county Dublin and its environs, delivering the right care, at the right time, in the right facility, as close to the child’s home as is possible, as outlined in Sláintecare.Specially commissioned artwork and installations will pay a prominent part in welcoming children and families to CHI at Tallaght. This includes artwork by renowned glass artist Róisín de Buitléar which was conceived with a view to creating a healthy, uplifting and child-friendly environment throughout the facility. Entitled The Balloon Tree and funded by NCH Foundation Tallaght, it is part of a programme of public art hosted

by Children's Health Ireland.

LEFT: David Gunning, Chief Officer, NPHDB; Eilish Hardiman, Chief Executive, Children's Health Ireland; and Theo Cullinane, CEO of BAM Ireland at the opening of the new facility in Tallaght.

ABOVE: Staff gather to celebrate the opening of the new Paediatric Outpatient and Emergency Care Unit.

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WATERFORD RESIDENTIAL CARE CENTRE OFFICIALLY OPENED The Waterford Residential Care Centre has officially opened. Construction of the €25.4m project began in early 2018 on a site adjacent to St Patrick’s Hospital and was completed last year.

It features 100 single en-suite rooms, spread across four households. The 30bed Farronshoneen, 20-bed Farrandale and the 20-bed Grange units in the Waterford Residential Care Centre now house residents of older persons services previously accommodated in St Patrick’s.

The 20-bed Aidan’s unit at the new centre replaces a shared model for Psychiatry of Later Life residents previously provided at a building located on the grounds of the nearby St Otteran’s Hospital. Speaking at the official opening of the care centre, Kate Killeen White, Chief Officer, HSE/ South East Community Healthcare, said, “We are delighted for the residents and families involved that have relocated to the Unit. Our staff teams have worked incredibly hard to turn this vision into reality and to meet the regulations set by HIQA and the Mental Health Commission.

This facility enables us to deliver an enhanced service in line with infection, prevention and control requirements – which is particularly important as we continue to operate in a COVID-19 environment. I cannot thank everyone enough in delivering on this significant achievement."

AWARDS SHOWCASE EXCEPTIONAL ACHIEVEMENTS TO REDUCE BLOOD CLOTS On World Thrombosis Day, the patient charity Thrombosis Ireland launched the VTE Exemplar Awards, showcasing and celebrating exceptional healthcare achievements to reduce harm with VTE. The winners were: • Scientific Advancement in Maternity Hospitals: Prof Brian Cleary and Dr Jennifer Donnelly, Rotunda Hospital - Electronic VTE risk assessment tool (Thrombocalc).

• Quality Improvement in Maternity

TUH LAUNCHES ELECTRONIC VITAL SIGNS FOR PATIENTS Tallaght University Hospital (TUH) is rolling out exciting new Irish technology which will benefit patients during their healthcare journey. The Vital Signs Automation project has started as a pilot on Osborne Ward, a combined medical and renal ward. The project is being undertaken in partnership with the HSE digital transformation team. TUH was awarded an ‘Our Public Service’ innovation award to assist the delivery of this project. Taking the vital signs, ie temperature, oxygen saturation, heart rate/pulse and blood pressure of patients, is a vitally important part of their care. Hospitals use the National Early Warning Score (NEWS) which is a guide that determines the degree of illness of a patient and determines how often their vital signs need to be checked. A change in the NEWS can indicate early detection of infection or sepsis, and an increase of the score prompts medical review. Previous studies have shown that staff can make errors when manually calculating the EWS, this can lead to delayed or inappropriate escalation of patient care. Elsamma Philip, Clinical Nurse Manager on Osborne Ward where the technology has been launched in the hospital, said that, from a nursing perspective, it is ‘really helpful technology’. "It gives us valuable time back to spend time with patients,” she said.

New volunteers’ booth at Mayo Hospital Mayo University Hospital (MUH) launched its new volunteers’ booth donated by Baxter Healthcare in recognition of the hard work and dedication of the hospital staff throughout the COVID-19 pandemic.

The MUH Volunteer Service has had over 50 members of the community participating in the scheme since March 2012, with volunteers ensuring patients and visitors have a warm, friendly welcome and are assisted with directions and any information needed. Hospital manager Catherine Donohoe said, “We are very pleased to be able to welcome back our volunteers who could not be on site due to social distancing and infection. Our volunteers bring the energy and enthusiasm of members of the community who want to give something back, into the hospital."

ABOVE: Dr Catherine Wall, Martin Curley, Mary Hickey, Elsamma Philip and Lucy Nugent launch the Vital Signs Automation project in TUH. RIGHT: Winners of the Exemplar Awards VTE National Champions 2021, Dr Su Maung & VTE working group, Our Lady’s Hospital, Navan

Hospitals: Sile Gill, Dr Samah Hassan and the Maternity Team, Mayo University Hospital - QI program to monitor hospital practice regarding VTE prophylaxis in mothers.

• Scientific Advancement in Acute Hospitals: IEHG VTE Service Review Work Group (special acknowledgement to Mick Fitzpatrick) -VTE incidence data dashboard showing VTE incidents and burden of HAT. • Quality Improvement in Acute Hospitals: St Vincent’s Private Hospital Clinical Pharmacy Team -Developed an app (with VTE Ireland) to efficiently audit VTE Prophylaxis • Best Hospital 2021: UHL- Including nurse-led DVT service and virtual clinic.

• Best Hospital Group 2021: Ireland East HG For commitment to VTE excellence.

The VTE Warriors 2021 show daily commitment

to ensuring optimal safe care and education in a compassionate and holistic way: Jacinta Byrne, National Maternity Hospital (Maternity) - Prophylaxis protocols for anteand post-natal women; Catriona O’Leary, Cork University Hospital - Anticoagulation review and thrombosis clinics; Sarah Garvey, Beaumont Hospital - Driving VTE service evolution; Ciara Kirke, National Medication Safety Programme, HSE - Led the national VTE Improvement Collaborative Project and worked with Thrombosis Ireland to create and distribute VTE Alert Cards to all

acute hospitals; Niamh O’Hanlon, St Vincent University Hospital - QI in thromboprophylaxis and dedication to patient safety; Prof Fionnuala Ni Áinle and Dr Barry Kevane, Mater Hospital (Team) - Improving the care of VTE patients based on evolving scientific research.

VTE National Champions 2021: Dr Su Maung & VTE working group, Our Lady’s Hospital Navan - Implemented VTE risk assessment & appropriate prophylaxis for all patients, prospective data collection and incidence reporting for hospital-associated thrombosis & guidelines for managing thrombophlebitis.

HEALTH MATTERS WINTER 2021 | 15

ON THE ANXIETIES OF STAFF AND SUPPORTING EACH OTHER “Everyone was absolutely consumed with COVID and talking about how bad it was, what was the next shift going to bring.”

“It was really important to be able to sort of show humility and admit to when I wasn’t feeling okay or when I felt overwhelmed… looking out for each other has become much more embedded in what we do on a day-to-day basis.”

COVID TELLING OUR STORIES

Research tries to make sense and learn from staff experience of the pandemic

A

s the gravity and enormity of the pandemic experience on health staff was emerging, a group of staff from the HSE and an academic researcher from UCD came together to try and make sense of and learn from staff experience of the pandemic.

It all started in March 2020 with a call from Dr John Fitzsimons, Paediatrician and Clinical Director for Quality and Patient Safety, for staff to share ideas to help inspire, replenish, and care for each other in the face of the challenges ahead.

Early examples of local adaptations and changes in ways of working, and stories of staff putting their values into action, demonstrated how staff were already responding, adapting, and leading with compassion, trust, and bravery to ensure the continued safe delivery of care during the pandemic. The opportunity was identified to capture and understand these examples of excellence and learn from them.

HSE staff from Quality & Patient Safety, Values in Action, Staff Engagement and Communications partnered with researchers from University College Dublin to understand the experiences of healthcare staff during this time.

“Everything was so uncertain. I picked up my phone and headed down to the beach, I wanted to record a message to my colleagues in the health care worker community. I wanted to ask them to tell their stories to each other and connect because this virus had forced us to interact and deliver care in different ways,” explained Dr Fitzsimons.

“I hoped that by seeing each other through our stories, examples and successes, it would give us the strength we would need to persevere, continue to deliver excellent care for the public, show compassion to each other and learn from each other’s extraordinary efforts.”

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ON COLLECTIVE WAYS OF WORKING AS A TEAM: “What it certainly showed for our team was the absolute adaptability and flexibility of the team members. As I said, we had to learn new ways of doing things.”

With the aim of representing the hard realities of healthcare delivery in Ireland throughout the pandemic, we wanted to hear stories of change and adaptation, capturing the real human experiences and anxieties of healthcare staff, as well as their many achievements.

By doing this, we aim to support the future proofing of health services, and to help inform how we can support staff to drive change that will improve patient and staff experience and quality of care.

Through social media and submissions to Health Matters, we reached out to ask people to share their stories of excellence, care, compassion, kindness, trust, leadership, bravery and learning in their work and in their teams. Zuneera Khurshid, a PhD scholar working across the HSE and the UCD team, conducted interviews to gather further information. Based on this work, a number of key findings

ON COVID-19 FORCING RAPID CHANGE IN THE SYSTEM: “I felt like it accelerated my vision of the service.

I didn’t think it would happen so quickly but COVID kind of made us do it very fast.”

emerged, highlighting how staff supported each other and used coping mechanisms to deal with the stress and anxiety of the pandemic. Working collaboratively in teams, staff were empowered to implement co-designed, innovative ideas which accelerated the implementation of change and improved staff confidence. Reflecting on their experiences, staff appreciated this new and collective way of working and were keen to explore how best to preserve the learning.

Staff employed a person-centred, values-based approach to deliver care in an environment safe for patients and staff. Not only did the pandemic accelerate the pace of change, it helped to facilitate it by introducing staff to a new, flexible, and less hierarchical way of working, removing many of the barriers traditionally faced by healthcare teams.

“I felt like it accelerated my vision of the service. I didn’t think it would happen so quickly but COVID kind of made us do it very fast.”

“Nobody had done this before, so we were all starting out together.

So, it kind of got rid of that hierarchy and the traditional levels within the organisation.”

We found that this storytelling approach was a valuable way to unpack the complex experiences of healthcare staff during this period. This allowed us to explore the anxieties, stresses and challenges experienced, and to examine how staff leveraged the support and expertise of their peers to deliver high quality, safe patient care.

“It was really important to be able to sort of show humility and admit to when I wasn’t feeling okay or when I felt overwhelmed… looking out for each other has become much more embedded in what we do on a day-to-day basis.”

Although these stories are just some of the many examples of the extraordinary response of the Irish healthcare system, they demonstrate the importance of hearing staff voices, and highlight storytelling and narrative research as key tools for healthcare leaders and organisations to learn from staff experiences during the pandemic.

“The original staff are gone back to their teams so they’ve taken the learning stuff back you know from the testing service back, to their own teams and said look because this is the way we did it before why can’t we try this and we found this really helpful.”

“We will look back at this, regardless of what stage of your career, you are and really see that - oh my goodness, it was such a time of challenge, opportunity, and learning.”

What’s next?

We would like to thank those staff who shared their stories with us. We are hoping to continue to collect stories of experiences and are particularly interested in stories relevant to sustained improvements and staff resilience when implementing change. Please email aoife.debrun@ucd.ie if you are interested in taking part in a brief interview.

A more detailed discussion of our findings is available via a HSE QPS TalkTime webinar: https://www.hse.ie/eng/about/who/qid/ resourcespublications/qi-talktime/ Further information on this research is available here: https://tinyurl.com/StaffExperiencesOfChange

HEALTH MATTERS WINTER 2021 | 17

GET UP, GET DRESSED, GET MOVING First national 60-day challenge in acute hospitals in Ireland

ABOVE: Staff of Kavanagh Ward in St James’ Hospital in their pyjamas to highlight the vulnerability of patients when they are in their pyjamas.

Photo: Brid Ryan, Senior Clinical Photographer, St James’s Hospital.

T

he Get up Get dressed Get moving (GuGdGm) challenge is an initiative that will be taking place in a number of hospitals throughout Ireland between October 4th and December 3rd 2021. Each of the participating hospitals has nominated a ward/wards that will be involved in encouraging older people to get up, dressed and to get moving during their hospital stay.

Each hospital has also identified a control ward, where no GuGdGm intervention will be introduced to facilitate comparison of data.

Insert logo here

Get up Get dressed Get moving

Why are we doing it?

During a hospital stay older adults can spend 97% of their day lying or sitting down.

These reduced activity levels can have a serious impact on the quality of life of the older person. Each day spent immobile is associated with loss of muscle strength, which in a vulnerable person can be the difference between being able to climb the stairs or being able to get up off the toilet independently. It can actually make the 18 | HEALTH MATTERS WINTER 2021

FOR MORE INFORMATION ON THE CHALLENGE, search Get up Get dressed Get moving, on hse.ie and #GUGDGM2021 on Twitter.

difference in their ability to be discharged back home or in having to go to long term care facilities.

What are the benefits?

During the 60-day challenge all members of the multi-disciplinary team will be supporting the older person to increase their levels of functional activity. And the benefits of simply becoming more active include less risk of: • Getting an infection.

• Losing mobility and agility.

• Losing fitness and strength.

• Developing pressure sores.

• Having a fall.

One of the significant risk factors for falls is inappropriate footwear, which can include slippers. Therefore if the older person is encouraged to bring in appropriate clothing and footwear they will be at less risk of falls while mobilising. Also we know when people are dressed healthcare professionals are more likely to notice their ability, rather than see them in the ‘sick role’ and so plan for their discharge.

What is involved?

Staff of the Slieve Bloom ward in Midland Regional Hospital Portlaoise.

SLIGO WARD DELIGHTED TO PARTICIPATE IN CAMPAIGN The Get up Get Dressed Get Moving challenge is being implemented in Sligo University Hospital at ward level on Medical 5 by the entire MDT with support from local and national senior management. Medical 5 specialises in the care of patients with neurological conditions where the focus on mobility is so important to ensure that patients do not become deconditioned during their hospital stay. Every effort is made to maximise patients physical functioning when they have a neurological diagnosis and this initiative fits in very well to this ethos. This challenge requires the input of all staff to work with each patient who wishes to and is able to participate – health care assistants, catering staff, household staff, doctors and nurses, physiotherapists, occupational therapists, dieticians, speech and language therapists, podiatrists, clinical students, family members, carers and visitors. Data is collected on a daily basis on the number of patients who are up and dressed by 12 midday but data is also collected to measure the impact of the challenge on metrics such as number of falls, pressure ulcers, lengths of stay, readmission rates, and discharge destinations. We are hopeful that this challenge will result in a permanent change of mindset and daily routine on Medical 5 which will ultimately result in improved outcomes for our patients. Medical 5 is delighted to participate in this new campaign, staff have seen an area of care that can easily improve the inpatient experience of our patients and have embraced it. The tagline was cleverly thought up by Staff Nurse Davinia Paul. As ward managers, both Smitha Nair CNM1 and Dean Flanagan CNM2 hope that small changes in the daily routine of all staff on the ward nurtures a new outlook on bedside attire. Both CNMs took part in handover in their pyjamas and showed staff and themselves just how vulnerable you can become. #GUGDGM2021

Get up Get dressed Get moving teams are collecting data on the participating wards over the 60 days on the numbers of patients up, dressed and moving at midday each day.

At the end of the challenge the Health Pricing Office will compare lengths of stay, discharge destinations, 30-day readmission rates and falls on the intervention wards and compare this with the same data on the control ward in an effort to ascertain the cost of functional decline.

The National Ambulance Service and Dublin Fire Brigade are also supporting the challenge by encouraging older adults, where appropriate, to pack their day clothes and footwear, for their hospital stay.

This is a collaborative of the Office of the Nursing & Midwifery Services Director and the Health & Social Care Professions Office.

Staff working collaboratively is integral to embedding the culture change of the Get up Get dressed Get moving campaign.

Mairéad O’Sullivan, Clinical Placement Co-Ordinator, Midland Regional Hospital, Portlaoise, said, “When doing a little education on the ward and giving out information leaflets, one lady asked me if I could give her one of the posters to put up at home to remind her of why it is of benefit to her to get dressed and moving even when at home as she lives alone and often just stays in her PJs for the day. It made me think again about how this initiative really does start in the community and filters into the hospital and back out home again.”

ABOVE: The team from Medical 5 ward in Sligo University Hospital in the pyjamas in support of the Get up Get dressed Get moving challenge.

HEALTH MATTERS WINTER 2021 | 19

LOURDES STAFF WIN TOP FLU VACCINE AWARD FOR FOURTH SUCCESSIVE YEAR

BELOW: Staff at Our Lady of Lourdes Hospital celebrate their award win during a

I

t was four in a row for the staff of Our Lady of Lourdes Hospital at this year’s Seasonal Influenza Vaccination Awards as they took the top prize once again. The ceremony, organised by the National Immunisation Office, was held virtually this year.

A massive 89.2% of staff at the Drogheda hospital received the flu vaccine during the winter period 2020-21, the highest in the country. Their colleagues in Beaumont Hospital took second spot with an uptake of 87.1%.

Third place in the acute category went to Wexford General Hospital where 84.9% of staff got the flu jab.

Lourdes flu champion Martin Smith has been the person responsible for leading the campaign and heading the team of peer vaccinators over the last number of years and has just retired, passing the baton on to his former colleagues.

“It was a pleasure to lead this wonderful team with Adrian [Cleary, Director of Nursing] to first place for the last four years.

Best of luck everyone with this year’s campaign,” he said.

In the best improver category, maternity hospitals took the top two spots. University Maternity Hospital Limerick saw a seasonal uptake of 69.9%, which represented an

20 | HEALTH MATTERS WINTER 2021

recent flu vaccination clinic. ABOVE: Eileen Ronan, Director of Midwifery, University Maternity Hospital Limerick, presents the hospital’s award to some of the staff who helped ensure they took the best improvers prize.

incredible increase of 41.4% on the previous year. Cork University Maternity Hospital had an uptake of 73.2% of staff, a jump of 35.1% year on year.

Kilcreene Orthopaedic Hospital in Kilkenny saw their staff uptake rise by a third to 59.5% to land them third place in the category.

Eileen Ronan, Director of Midwifery, UMHL, was delighted with the award win.

“On behalf of multidisciplinary team of UMHL, I am delighted to receive the award

of best improvement for influenza vaccination amongst healthcare workers for 2020/2021 influenza season. The uptake in 2020/2021 demonstrates the awareness among our teams of the importance in protecting themselves, their families and services users in our care,” she said.

In the long-term care facilities, all the top three in the under 100 beds category reached almost full uptake by staff. Brymore House Nursing Home in Howth had a 100% uptake, followed by Carlingford Nursing

Home in Carlingford, Co Louth with 98.1%, and Howth Hill Lodge Nursing Home, Howth at 97.8%.

Best improvers in the under 100 beds category were Re Nua in Cashel, Co Tipperary whose uptake of 86.4% was a jump of over 60%. In second and third place were Tralee Community Nursing Unit at 81.5% (up 55.5%) and Kenmare Community Hospital in Co Kerry at 92.1%, up by 53.4%.

In the over 100 bed long-term care facilities, the winners were Our Lady’s Manor, Dalkey in Dublin with a 95.9% staff vaccine uptake. Killarney Community Hospitals (Fuschia, Hawthorn and Heather wards) followed in second place with 88.6% uptake. Peamount Healthcare ID Community-based Service came third with 85.5%.

Killarney Community Hospitals also took home the best improver award. Their 88.6% uptake was 39.1% higher than last year.

The Royal Hospital Donnybrook was second with 55.5%, up 11.7%, and third was Chery Orchard Hospital in Dublin 10 with 58.9%, up 5.7%.

HSE CEO Paul Reid told the awards ceremony that the phenomenal uptake in the COVID-19 vaccine in Ireland was thanks largely to the strong confidence built up through the flu vaccine campaigns.

“A huge thank you to all the staff who have served as ambassadors for the flu vaccine campaign and have inspired and driven confidence in the vaccine among their fellow workers and congratulations to all the winners today,” he said.

“As we head into winter, we still have a great deal of apprehension over the challenges that are ahead for our acute services and they could be very significant.

We are faced with having to manage the twin challenges of flu and COVID and that is why it is so important that flu vaccine levels among healthcare workers continue to remain high.

He noted that the last 18 months of COVID have seen trust and confidence in the HSE soar thanks to consistent and coherent advice from NPHET, GPs, consultants, and other healthcare workers.

“We have taken great learnings from how that trust of the public has risen through COVID and with the vaccine uptake, and how we can use that to see high levels of the flu vaccine through the community this winter,” added the HSE CEO.

PROTECT YOURSELF AND OTHERS:

GET THE FLU VACCINE Dr Catherine Lynch, Specialist in Public Health Medicine with the HSE’s Public Health Department in the South East, received her flu vaccine recently and urged everyone to make sure they do the same “Flu is unpredictable. As high an uptake as can be achieved generally, in addition to cutting the risks of infection, will help the health services to better manage any demands on the system from COVID-19 cases. We also want to avoid scenarios whereby people might become co-infected with flu and the coronavirus and the severe illness that may be involved,” said Dr Lynch. “Flu is a serious illness. Although the severity of the flu season can vary, we know that people aged 65 and over are most likely to be impacted and have an increased likelihood of severe illness, being admitted into hospital or dying from flu when compared to the general population. The flu vaccine is the best protection against flu this winter. A flu vaccine will protect those aged over 65 from the very worst effects of flu.”

ABOVE: Dr. Catherine Lynch (Specialist in Public Health Medicine, HSE Public Health Department/South East), who received her flu vaccine at a clinic in the HSE’s offices in Lacken, Kilkenny. BELOW: Maria Long and Róisín Burke of the Primary Care Unit, South East Community Healthcare, who received their flu vaccine at a clinic in the HSE’s offices in Lacken, Kilkenny.

This year the free flu vaccine is recommended for you if you are in one of these groups:

• • • •

Aged 65 and over A health care worker A child aged 2 – 17 At any stage of pregnancy

• People with certain medical conditions which put them at increased risk from the complications of flu.

FOR A FULL LIST OF RECOMMENDED GROUPS visit hse.ie/flu

HEALTH MATTERS WINTER 2021 | 21

PROTECTING MOTHER AND BABY: VACCINES DURING PREGNANCY As we head into winter, it continues to be important that pregnant women get the recommended vaccines to be protected against vaccine preventable diseases, says Dr Aparna Keegan, Specialist in Public Health Medicine, at the HSE National Immunisation Office.

Flu vaccine “Pregnancy causes changes to your body – it can change how your heart, lungs and immune system work. Because of these changes, flu can be serious for mothers and their babies. Getting the flu vaccine is the best way to protect you and your baby from flu this winter,” said Dr Keegan. While anyone can catch flu, pregnant women are at an increased risk of serious complications from flu. Pregnant women are more likely to need treatment in hospital or the Intensive Care Unit because of flu. Catching the flu while pregnant can significantly increase the risk of premature birth and stillbirth. “The flu vaccine protects mother and baby. If you get the flu vaccine while pregnant, your baby will

also be protected during their first six months.

women in Ireland and can be given from 16

This is when babies are most likely to be

weeks of pregnancy (up to 36 weeks of

admitted to hospital with flu. Flu vaccines

pregnancy). The whooping cough vaccine is

have been given to millions of pregnant

recommended for pregnant women in every

women all over the world for over 50 years.

pregnancy. Getting the vaccine in pregnancy

All the information available shows us that

protects your baby during the first few

the vaccine is safe for both you and your

months of life.

baby.”

COVID-19 vaccine Pertussis (Whooping Cough) vaccine

“It is also important that pregnant women

Babies under six months are most at risk from

get the COVID-19 vaccine. The COVID-19

whooping cough. The Pertussis (whooping

vaccine can be given at any stage of

cough) vaccine is recommended for pregnant

pregnancy, but the sooner you get it, the sooner you can be protected,” said Dr Keegan.

Vaccination protects mothers and babies Flu, pertussis and COVID-19 are caused by different organisms and can be serious for pregnant women or their babies. “The vaccines recommended in pregnancy work to stimulate your own immune system to make antibodies to protect against these diseases. Vaccination is the best way you can protect you and your baby from diseases like flu, whooping cough and COVID-19 while pregnant. The vaccines can be given at the same time or at any interval.”

Talk to your obstetrician, midwife or GP about the risks and benefits of getting the flu, whooping cough and COVID-19 vaccines. Visit www.immunisation.ie and join the conversation on social media using the hashtag #Vaccines4Pregnancy

22 | HEALTH MATTERS WINTER 2021

LABOUR OF LOVE AT THE COOMBE

Three babies born within 12 hours of each other have been reuniting, along with their mothers, almost every year for the past 30 years.

Helen Conlan, Eoin Conlan, Caroline O'Leary, Caoimhe Whelan, Patrick Quinlan and Kathleen Burke.

C

aroline O’Leary, Helen Conlan and Kathleen Burke all met at the Coombe Women & Infants University Hospital in August 1991 and gave birth to three children Caoimhe, Eoin and Patrick.

Caroline recalled, “Caoimhe was born at 10.55pm on August 14th and I think by next morning the other two boys had arrived so their birthday is August 15th. For Kathleen and I, it was our first baby and for Helen it was her fourth and last baby” The ladies were all on the same postnatal ward and their beds were side by side in the six bedroom ward for the five day stay, which was the norm in those days. The three mothers formed a strong friendship and by the time they were leaving the hospital they had agreed to meet the following year when the babies had their first birthday.

“Helen is a midwife and she was a great support to Kathleen and myself as first time Mums. However, Eoin (her baby) was in the Baby Unit for a while so we didn’t get to meet him on the ward. We were all having lunch and dinner together and supporting each other, so we said why don’t we just meet up next year and we could get to meet Eoin then?”

And they did have that first birthday meeting which was so successful it has become a pretty much annual event. Get togethers have included places in Wicklow and Wexford, barbeques at their homes or meet-ups in Dublin. Caoimhe, Patrick and Eoin’s 30th birthday celebration took place

this year on Portmarnock Strand because of COVID-19.

Eoin and Patrick have been particularly close as they went to the same secondary school in North Dublin. And in a strange twist of fate, Eoin and Caoimhe both emigrated to Canada three years ago although Eoin has since returned to Ireland.

What has remained constant is the annual birthday get-together no matter where they are. Whilst there has been the odd gap over the years, conversation never runs dry. As the mothers swap all kinds of stories, they find they just take up where they left off at their last meeting.

“As the children got older, we thought they wouldn’t want to do this but they did want to do it. They liked it.” said Caroline.

Caoimhe even timed her trip home from Canada this year so that she could attend the Portmarnock Strand birthday gathering.

“They are like cousins – family – they are significant people in our lives. Kathleen and Helen are witnesses to me having my first baby. They can tell Caoimhe things I can’t remember.

“It really stands out as a lovely thing to keep going,” she added.

HEALTH MATTERS WINTER 2021 | 23

Kerry CIT team outside Rathass Community Services Building: Mary Ann Kelly, Admin Support; Mary Kavanagh, CNM1; Breda Lyons, RGN; Claire Kiely, RGN; Claire O’Connor RGN; Antoinette Boyd, CNM1; Mary Harty, Assistant Director of Nursing. Missing from photo are: Trisha Tangney, RGN and Kate Dunne, RGN.

Service user Michael O’Brien greeting Antoinette Boyd outside his home in Castlegregory, Co Kerry

24 | HEALTH MATTERS WINTER 2021

Kerry CIT team outside Rathass Community Services Building: Breda Lyons, RGN; Kate Dunne, RGN; Mary Ann Kelly, Admin Support; Mary Kavanagh, CNM1; Claire O’Connor, RGN; and Antoinette Boyd; CNM1.

Ursula McCarthy, service user, pictured with Antoinette Boyd, CIT CNM1.

NURSE-LED SERVICE A ‘GODSEND’ FOR PATIENTS Almost 1,000 hospital bed nights saved by Community Intervention Team

D Patrick O’Connor, service user, pictured in Glenbeigh Health Centre with CIT CNM1 Mary Kavanagh.

escribed as a “godsend” by the people who benefit from the service, the Community Intervention Team (CIT) in Kerry is a specialist nurse-led service which can allow people to avoid a hospital stay or leave hospital earlier than would have otherwise been possible.

The team are proud that they continued to provide an uninterrupted service during COVID-19, and in fact saw an 88% increase in referrals during 2020, saving close to 1,000 hospital bed nights.

The team, which began in 2012 and has grown constantly since then, holds daily clinics in Tralee, and provides home visits within 45kms of Tralee. Establishing satellite clinics in Dingle, Glenbeigh, Listowel and most recently Killarney has allowed the team to treat patients from an even wider area.

Portmagee resident Patrick O’Sullivan is among the many Kerry people who have benefitted from the CIT service, and says that the team’s intervention (providing IV antimicrobial treatment at a clinic) meant he avoided six weeks in hospital. “I’m from Portmagee and I came up to the health centre in Glenbeigh for my treatment. The service was wonderful in Glenbeigh,” he said.

Another grateful user of the service is Ursula McCarthy from Tralee, who developed septic arthritis and faced a sixweek stay in hospital in Dublin for intravenous antibiotics between surgeries.

However, she was referred to CIT Kerry through the national OPAT programme to complete the final four weeks of treatment at home.

“I think it is an excellent service. I wouldn’t have been able to complete

treatment at home if the service wasn’t there,” she said.

There are seven nurses working on the team - Antoinette Boyd, CNM1; Mary Kavanagh, CNM1; Breda Lyons, RGN; Claire Kiely, RGN; Claire O’Connor, RGN; Trisha Tangney, RGN; and Kate Dunne, RGN, along with clerical officer Mary Ann Kelly and line-manager Mary Harty, Assistant Director, Public Health Nursing.

The service provides a rapid and integrated response to patients with acute episodes of illness who require enhanced services for a defined short period of time – often in a patient’s own home, residential care setting or at a clinic in the community.

While CIT is primarily clinic-based, the team will always provide home visits where necessary depending on clinical need and on compassionate grounds.

Community oncology is a substantial part of the team’s work, including supporting the CUH satellite oncology unit which runs out of UHK. The team can facilitate pre-chemotherapy blood tests and assessments, disconnection of chemotherapy pumps and administering post-chemotherapy injections – all saving patients time in a hospital setting, and reducing the number of hospital visits they need to make.

Michael O’Brien was diagnosed with colon cancer in 2012 and has been a client of the CIT service for the past three years and says his referral to Kerry CIT was a ‘godsend’.

“If I have any concerns, you know, if something’s bothering me or whatever, I can bounce it off them and they can give me advice or tell me who to see or what to do,” he said.

HEALTH MATTERS WINTER 2021 | 25

TABLET LOAN SCHEME A VIRTUAL LIFELINE TO COMMUNITY Technology enables service users get to stay connected to their service, their friends and their community from home

L

ike so many parts of the health service, new ways of working during the pandemic required a reimagining of adult day services programmes and the ways in which they can be offered. The introduction of a Digital Tablet Loan Scheme across EVE’s 20 mental health and disability services proved to be a lifeline for many service users keen to stay connected to their service, their friends and community from home.

EVE is a HSE programme whose primary ethos is to provide community-based recovery-orientated programmes for adults who experience mental health difficulties, intellectual difficulties, Asperger’s Syndrome, and physical and sensory disabilities. It operates through a network of Vocational, HUB and Clubhouse services in 20 locations across the HSE Community Healthcare Organisations in Dun Laoghaire and Dublin South East (CHO6), Dublin South, Kildare and West Wicklow (CHO7) and Dublin North City and County and Wicklow (CHO9).

Through their dedicated tablet scheme, tablets were purchased by EVE and offered to those who did not have access to technology or could not afford to buy their own devices.

Services like EVE’s Suaimhneas Clubhouse in Raheny were quick to see the advantages of offering their members this online connection to both their programmes and opportunities in the wider community.

Suaimhneas is one of EVE’s seven Clubhouses that supports members with mental health difficulties in their recovery journey to live full and productive lives in the community.

Eddie, a member, explained,“I have been a member of Suaimhneas for many years and they have always done what they can to help me, but I couldn’t believe it when Suaimhneas were able to lend me a Samsung Tablet. My luck was in. Because of COVID-19, many of the club’s activities are

26 | HEALTH MATTERS WINTER 2021

LEFT: Eddie, EVE club member, with his tablet. RIGHT: Catherine, EVE club member, with her tablet.

now remote, and my college is on Zoom.

“With the tablet, I can link in with the members and staff of Suaimhneas over WebEx, and I can also Zoom into my college course. On my course, the tutor talks about computers. My world is now fantastic with the tablet. In the evenings, when Suaimhneas is closed and my college is finished, I can log on to YouTube and listen to music and watch videos. Happy days!” he said.

Whilst adapting to using virtual technology was a challenge for both staff and members demanding a lot of training and support, feedback suggests that the benefits justify the effort. As another member, Catherine, describes it, “The loan of the tables from Suaimhneas Clubhouse was a lifesaver for me during the pandemic and continues to be a tremendous help. It is such a marvellous link with Clubhouse staff and members. Communication is the lifeline for me and my mental health.”

Claire Brennan, Suaimhneas Manager, identified that with virtual access to House Meetings, scheduled morning coffee n’ chat sessions and online courses, Catherine has been able to ‘contribute to the work ordered day of the Clubhouse, continuing to be an

active, valued member’. “Online social activities on bank holidays and in the evenings like quizzes and bingo also emerged as a popular new feature of services over the past months which we hope will continue,” she said.

According to Margaret Webb, General Manager, EVE, “As restrictions lift and members of Suaimhneas Clubhouse enjoy attending onsite again, virtual programmes and services continue. By offering services in a more flexible way, people now have greater access to social, educational and employment opportunities and addressed concerns over social isolation.

“In time, we plan to expand our online offering by creating an online community HUB for those who enjoy and value the online experience. Building confidence, skills and capacity in digital technology takes time but for EVE services, this could emerge as one of the very positive service bonus from the pandemic.”

Margaret added, “We would like to say thanks also to all those in CHOs Dublin South, Kildare, West Wicklow and Dublin North City and County (Day Opportunities) for their financial support for this initiative.”

QUIT SMOKING

QUITTING

QUIT TRIO EMERGE OUT OF LOCKDOWNS AS NON-SMOKERS

and feel fantastic

The HSE QUIT programme helps thousands of people give up smoking every year, but research shows that many smokers choose to go it alone when they quit. With support from the Quit programme, friends, family or even other quitters, you have a much better chance of success. So, in March 2021, the QUIT campaign and the Irish Mirror recruited 10 would-be ex-smokers to join a team of QUIT leaders and share their stories.

Leaders were recruited from all over Ireland and they were determined to QUIT for good. Each leader followed their own personalised QUIT Plan but all had the goal to stop smoking for 28 days because in doing so, you are 5 times more likely to QUIT for good.

Here are some reasons why our leaders wanted to quit when we met them earlier this year.

CONOR HINEY, Co Laois: “In October, myself and my partner had a baby girl. I don’t want her growing up in an environment where there’s smoking going on.”

SHARON BROPHY, Co Dublin: “The last straw was my wheezing in the evening time.”

RITA CONWAY, Co Dublin: “It’s a hard time to give up as we’re all deprived of so many things, but I keep telling myself this is not a deprivation.”

2021 QUIT leaders Conor Hiney, Sharon Brophy and Rita Conway.

After an eventful six months with lockdowns, vaccines and Ireland reopening, we caught up with our QUIT leaders once again in October to find out what impact quitting smoking had on them.

RITA CONWAY: “All my health issues come from smoking. I had to stop.

Since quitting my breathing has improved, I am definitely sleeping better and I don’t feel as anxious.”

CONOR HINEY: “When I gave them up first, I started to taste food better...

I was asking was there something different in the dinner, but there wasn’t, it was my sense of taste getting better!”

SHARON BROPHY: “After the first week, I had more energy, I was sleeping

better... I was seeing all these things and physically experiencing benefits, so it made it easier when a craving did come along. I might have wanted a cigarette, but I wasn’t going to have one.”

Q U I T RESO U RC ES Watch all of the interviews with the Leaders on youtube.com/HSEIreland.

You can start your own 28 days no smoking challenge and Quit journey by going to QUIT.ie, calling Freephone 1800 201 203 or free text QUIT to 50100.

FOR MORE INFORMATION : If you are a HSE staff member, you can avail of free stop smoking medication (nicotine replacement therapies and/or a prescription drug called Champix) to help you stop smoking. To find out about availing of free nicotine replacement therapy/champix in your area visit www.hse.ie/eng/about/who/tobaccocontrol/news/

HEALTH MATTERS WINTER 2021 | 27

BRINGING BACK THE JOY

Shann Morris, CNM3, Older Persons Services, Dublin South, Kildare & West Wicklow Community Healthcare explains the uplifting effect of the resumption of day care for older persons

D

ay Care for Older Persons closed down on-site services when the COVID-19 pandemic was declared in March 2020.

We told service users that we’d probably see them in a few weeks. That was not to be.

During the next 18 months, Day Care staff were responsive and creative in supporting their service users. Meals on Wheels increased, regular phone contact was maintained with service users and / or their family carers and multiple other creative supports were put in place by Day Care staff.

Fast forward to the end of June 2021 when we got the go ahead to resume on-site Day Care for Older Persons. The excitement was like Christmas morning, phones were hopping, clients wanted to come back ASAP. However, after everything our older population had gone through, it had to be done safely.

No two day centres are the same. Some are run by nurses, some by social care managers, and some by volunteers. Some offer a dine-in service only while some run a full day of activities, provide personal care, as well as breakfast and dinner. However, they all have the same aim - to support older persons to live in their homes and participate in their communities where they are known, loved and want to be.

Day Care Centres are Sláintecare in action.

They are preventing both physical and mental decline for older persons by reducing social isolation and loneliness. They provide care on people's doorsteps. Older persons are more at risk of loneliness and isolation due to life transitions. Some service users and their families reported a decline in their loved one's cognition and mobility. Carer stress went through the roof in the time centres have been closed.

Barbara McDonough, Manager of Older Persons Services in Dublin South, Kildare & West Wicklow, and her team were tasked with supporting the 39 Day Care Centres in the CHO to resume on-site services safely.

A project team was established.

28 | HEALTH MATTERS WINTER 2021

Pictured during a project team meeting were: top left - Jeason Kanagaraj, Quality and Patient Safety Advisor; Top right - Catherine Croke, Health & Safety Officer. Bottom left to right - Shann Morris, CNM3 Older Persons; Danielle Malone, Clerical Officer Older Persons Ssrvices; Sharon Maher, Assistant Director of Nursing, Infection Prevention & Control; Barbara McDonough, Manager for Older Persons Services.

Collaboration with Infection Prevention & Control team Sharon Maher and Jacinta Grace Parker, Quality & Patient Safety advisor Jeason Kanagaraj, Health & Safety Officer Catherine Croke, our admin team Danielle Malone and Martina Foley, and myself, an ex-nurse manager of a Day Care Centre, meant a good robust plan was put in place.

Due to the strong team-focused approach fostered by Barbara, everyone was only a phone call away and the fact that we had a hotline to our IPC team was worth its weight in gold. Issues could be dealt with in real time and queries from Day Care staff were answered. This has also strengthened the relationships between Day Centres and this has developed a network for Day Care Managers to share experiences, knowledge and ideas.

Throughout this whole process the collaboration between Day Care service staff and HSE Older Persons Services has been amazing, with everyone sharing the one common goal – to give older people the opportunity to reengage with their

communities.

Service users are delighted to be back. A lot of them were nervous and frail at the start but staff report improvements in people’s moods and mobility very quickly over time. I have met so many lovely people on my visits to the centres and one thing that strikes me is that they do not say anything negative about the lockdown but tell me how they watched more sport or talked to their families.

The joy I feel when meeting service users in the Day Care Centres has been immense.

One man I met is known as daddy long legs - he is tall and thin with real long legs, he is the first to get up to dance and can’t wait for the dancing to be back. He is the main carer to his wife and he brings her home her dinner every day. The support he gets in the centre keeps him going. He has a twinkle in his eye and doesn’t complain.

We are all looking forward to restrictions easing further and updated guidelines for our Day Care Centres. Hopefully this will be in time for the waltzing at tea dances and the Christmas party season.

COVID MEMORIAL

‘A PLACE TO HONOUR, TO RESPECT, AND A PLACE OF HEALING’ Permanent memorial for those who died of COVID-19 erected at Tallaght Hospital

ABOVE LEFT TO RIGHT with medical staff from Tallaght University Hospital were John Kelly, Director of Pastoral Care; Niamh Gavin, Chief Executive of the Adelaide Health Foundation; Lucy Nugent, Chief Executive of TUH; and Ann Hickey, Assistant Director of Nursing. BELOW RIGHT: The Heart Memorial unveiled at Tallaght University Hospital.

A

permanent memorial honouring those that died during the COVID-19 pandemic has been unveiled at Tallaght University Hospital (TUH). The sculpture by artist Mark Ryan and sponsored by the Adelaide Health Foundation will be known as the ‘Heart Memorial’. The memorial is located in the garden adjacent to the hospital chapel and contemplation room. The ‘Heart Memorial’ is in honour of those who died during the COVID-19 pandemic, the grieving families, the hospital staff and the community who provided so much support during the pandemic. The piece is based on identical hearts, an initiative by the Pastoral Care team. Throughout the COVID-19 pandemic and continuously since then, healthcare chaplains in TUH incorporated into their end-of-life care the practice of placing a handcrafted heart in the hand of a dying or deceased patient while an identical heart is given to the next of kin/family member (when present) or if not forwarded to them by post. These identical hearts are handcrafted by hospital staff and also sent in by members of the public. The message to the bereaved families reads: “Your loved one was not alone, we cared for them, we stayed with them “life has to end, love doesn’t - a pair of identical hearts, one is with them and this heart is for you made with love”. The identical hearts are deeply appreciated by family members as a meaningful keepsake of the time of their loved one’s death. Commenting on the unveiling, John Kelly, Director of Pastoral Care at TUH, said, “The image of the identical hearts incorporated into a permanent memorial commemorates this tragic time of COVID-19. It serves as an everlasting tribute to beautiful lives well lived and worth remembering. The heart of those we remember returning to the loving heart of the source of their being and a reminder of the love they shared in the world. It stands here least we forget, as a place of remembrance, a place to honour, to respect and a place of healing.” Lucy Nugent, Chief Executive of TUH, said, “This memorial provides us all with a space to honour those that have died in our hospital but also for those of us that have lost loved ones during this pandemic. It also recognises the dedicated care provided by staff throughout this pandemic

who have and continue to contribute to the care of end-of-life patients with courage, selflessness and dedication. It ensures that there is a special location where family members and hospital staff can pause and remember, a reminder that loved ones lost to us are forever in our hearts.”

HEALTH MATTERS WINTER 2021 | 29

FINAL FLIGHT

HOSPICE FULFILS PATIENT’S WISH TO RETURN TO HIS BELOVED DONEGAL Donegal Hospice, the National Ambulance Service (NAS) and the Defence Forces were able to grant a Donegal man his last wish of returning home to spend his last days in his beloved Donegal

Pat Diver on his final journey home to Donegal before he passed away.

P

atrick (Pat) Diver from Donegal, who had rarely left the county and had never been on an airplane, was referred to Palliative Care in Galway University Hospital. Unfortunately, Pat became very unwell and his family were called and advised that his condition had significantly deteriorated.

Pat’s wish was to return to Donegal so Donegal Hospice were contacted and were able gave him an urgent bed. His condition was weak, so travel from Galway to Donegal by Ambulance was not an option. NAS was contacted and their National Paramedical Co-Ordinator contacted the Defence Forces Helicopter Service and the Defence Forces agreed to air-lift the patient home on humanitarian grounds. Pat’s family said the relief that he was getting home was palpable and visible, he brightened up and spent those final days before he passed away with his family around him in his beloved Donegal. Pat was delighted to get his photo taken as he was being brought home and could not have happened without teamwork between services. Donegal Hospice Palliative care services have been in operation since 2003. Palliative Care is care given to improve the quality of life of patients who have serious or life-limiting conditions. This means a condition, illness or disease which is progressive and cannot be cured. The team, made up of consultants in palliative medicine, doctors, a Director of Nursing, an Assistant Director of Nursing, nurses, a Social worker, an Occupational therapist, physiotherapists, pharmacists, care assistants, household staff, administration staff and volunteers, aims to provide a seamless link in the flow of care between the hospital, the Hospice in patient unit, and community palliative care. This service compromises of a dedicated eight-bedded in patient unit based in Knocknamona, Letterkenny, Co Donegal.

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NEW BEDS

20 NEW SINGLE ROOMS OPENED IN SLIGO

Twenty newly constructed single rooms have been opened at St John’s Community Hospital in Sligo. The new rooms are part of ongoing construction works in the community hospital in Ballytivnan which includes the upgrading of two wings. It’s hoped works on both wings, which include the construction of two new buildings, will be complete by the end of February 2022. Director of Nursing at St John’s, Melissa Kelly said, “Due to COVID-19 the four existing units were to be upgraded first but with COVID-19 it was felt that the building of the new 20 single rooms would be a better schedule of works as the builders could work outside the hospital and thus reducing the risk to residents. “Thankfully this worked well and the 20 single rooms were built and these are now operational.

These single rooms are state-of-the-art ensuite rooms.

The residents have remarked that they feel like they are in the Ritz Carlton!” Frank Morrison, HSE Head of Service Older Persons, said, “The new rooms mark the first in a three part series of building works at St John’s. Once all works are completed early next year, St John’s will not only offer residents the best of care, but also the most comfortable and modern of surroundings in which to receive it. We are delighted to see how the works have progressed with little or no impact on the residents.”

FRONTLINE STAFF GET ON THEIR BIKES Dr Catherine Motherway heads UHL team’s 200km charity cycle to Dublin

Pictured at University Hospital Limerick preparing for the ICU4U Memorial Charity Cycle were Eileen Greaney O’Neill, Staff Nurse, ICU; Dr Catherine Motherway, ICU consultant; Anne Calitz, CNM2, ICU and Vera Leahy, CNM2, ICU.

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CU consultant Dr Catherine Motherway was joined by frontline colleagues from University Hospital Limerick in late August in the local effort of a national fundraising cycle to commemorate those who have lost their lives to COVID-19.

Dr Motherway was grateful to the people of Limerick, Clare and Tipperary for their support for the ICU4U Memorial Charity Cycle, which set out to raise €150,000 for charity partners working with people

impacted by the secondary challenges of the pandemic.

The UHL team of frontline healthcare workers, some accompanied with family and partners, included Eileen and Paddy O'Neill, Anne Calitz, Mary Sexton, Vera Leahy, Hanin Hamza, David Murphy, Debbie and DJ Hayes, and Donal Ryan, as well as Catherine Motherway and Christy Curley.

The four charity partners of this year’s ICU4U Memorial Charity Cycle were

ALONE (supporting older people); Aware (mental health supports); Aware NI (depression supports in Northern Ireland); and Breakthrough Cancer Research (new treatments for poor prognosis and difficult to treat cancers).

Ahead of the two-day event, Dr Motherway, said, “This year’s event is an important commemoration of all those who have lost their lives to COVID-19. And we are grateful to the public for supporting our participation by contributing funds for the four excellent charities whose work helps many people who have been adversely affected by the pandemic.”

The ICU4U event saw small teams of ICU doctors, nurses, paramedics, ambulance drivers, other healthcare staff and gardai depart from each of the six nationwide University Hospitals in Cork, Belfast, Galway, Limerick, Sligo and Waterford, with midway points in Dundalk, Athlone, Portlaoise and Kilkenny. The cyclists passed through as many community hospitals as possible en route to Dublin, collecting white roses along the way to represent lives lost to the virus.

At the conclusion of the cycle, a brief commemoration ceremony was held (in line with public health restrictions) at the Memorial Gardens, Islandbridge, to remember the victims of COVID-19 in front of more than 7,000 white roses, which were displayed at the gardens for the weekend.

RETIREMENT Staff, colleagues and management at Edenderry Ambulance Station, Co Offaly gathered to say farewell to Tommy McGuire who retired recently after 19 years of service.

Pictured left to right: Brian Ó Rourke, Charlie Rice, Niamh Daly, Adrian Schneider, Stuart Fraser, Carol Kearney, Noel Lynch, Tommy Maguire, Noreen Wright, Greg Hoey, Philip Campbell, Pat Mooney, Lisa Leogue and Jerry Sheehan.

HEALTH MATTERS WINTER 2021 | 31

MEMORY TECHNOLOGY RESOURCE ROOMS EMPOWERING PEOPLE WITH MEMORY DIFFICULTIES

HSE/Cork Kerry Community Healthcare in collaboration with Baile Mhuire Older Persons services launches Kerry Memory Technology Resource Rooms “It’s about empowering people to engage in meaningful activities, therefore enhancing your quality of life, to enable independence and safety in everyday activities.” Senior Occupational Therapist Catherine Murphy, who runs the Kerry Memory Resource Room, was explaining what people can expect when they visit.

Minister for Mental Health and Older People Mary Butler recently officially opened the Kerry Memory Technology Resource Room (MTRR) in Tralee, Co Kerry.

The MTRR is a collaboration between the HSE/Cork Kerry Community Healthcare and Baile Mhuire Day Services. It showcases assistive technologies and supports that can help people with memory difficulties such as dementia, and their families.

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One of 30 such memory technology resource rooms around the country, the Kerry MTRR supports people with memory difficulties to continue engaging in daily tasks and has a hugely positive impact on maintaining their independence and improves quality of life.

“Each person is different, so each visit will be tailored to your needs. We wanted to create an environment that is homely and welcoming so visitors can feel at ease when they come into us,” said Catherine.

“During your visit we will discuss practical tips to help your memory, by looking at your memory and strengthen areas that you may be experiencing difficulty. Common challenges can include; remembering appointments or events, misplacing the keys

or mobile phone. Many people feel overwhelmed by digital technology like phones and tablets and in the memory technology room we explore all different technology, it may be a light that turns on when you walk past it or simply a reminder checklist at the front door to bring your phone with you.

“We will recommend and provide a demonstration of simple equipment that can enable you to keep doing the everyday tasks that are important to you. We also offer emotional support and recommend other services available in the community for you and your family.”

The Kerry MTRR is the first purpose- built one in the country and is also an excellent example of how a collaboration between a

LEFT: Aidan Kelly Baile Mhuire Tralee; Dolores McElligott; Eibhlis Cahalane HSE; Catherine Murphy, Senior Occupational Therapist who runs the Kerry Memory Resource Room; Minister Mary Butler; Mike Fitzgerald, HES; Etna McAuliffe, HSE; and Paddy Garvey,cChairman Baile Mhuire. BELOW: Catherine Murphy, Senior Occupational Therapist.

BOTTOM: Catherine Murphy, Senior Occupational Therapist; Paddy Garvey, Chairman Baile Mhuire; Mike Fitzgerald HES; and Minister for Education Norma Foley.

voluntary agency and the HSE can support such an important community service.

The Baile Mhuire campus which already houses an older person’s day centre, a dementia-specific Day centre and the Kerry Integrated care team is an ideal home to the Kerry Memory Technology Resource Room as many of the clients accessing it may be attending some of the services on site.

It can be much easier to be independent and safe within your own home when you have the right supports and equipment.

Memory Technology Resource Rooms are a welcoming and safe environment for clients and their families to discuss any challenges they are encountering in their day to day lives. The service is free of charge.

Following their visit, families may then

decide to purchase any equipment they feel might be helpful. With guidance from the occupational therapist about the most appropriate and useful equipment specific to their needs, costs are kept to a minimum.

There is also a loan facility in operation for people to borrow equipment and try it out at home to make sure it works for them before they purchase it.

Minister for Mental Health and Older Persons Mary Butler said she was delighted to officially open the Kerry Memory Technology Resource Room, which she said provides a hugely valuable service to people with dementia and memory difficulties.

“Significant progress has been made this year to develop community-based dementia services, and I'm delighted to have secured additional funding in Budget 2022 to continue to enhance such supports, including Memory Technology Resource Rooms,” she said. “I would really urge families who have any concerns about memory difficulties to make an appointment to visit their local Memory Room, which is free of charge. It’s the little things like the support available in these Memory Rooms that can make such a big difference to daily life.”

Michael Fitzgerald, Chief Officer for Cork Kerry Community Healthcare, also welcomed this initiative. “The Kerry Memory Technology Resource Room is an integral component in supporting the safety and independence of people with memory difficulties living in our community. The MTRRs, in conjunction with other HSE and voluntary services, aim to maximise the potential of Assistive Technology and support people living with memory difficulties and their carers to benefit from this technology.”

Paddy Garvey, chairperson of Baile Mhuire Day Services said the MTRR has been a great addition to the Baile Mhuire campus.

“The additional support and practical advice provided by Catherine has benefitted both the clients attending the MTRR and also the clients attending the day service particularly during COVID when the ability to provide virtual support became so important. Baile Mhuire is proud to be a partner in such an important collaboration with the HSE in providing the MTRR service,” he said.

The official opening of the Kerry Memory Technology Resource Room in Tralee was attended by Minister for Mental Health and Older People, Mary Butler, Baile Mhuire staff, health service staff, staff who run the service in Tralee and individuals and families who have previously visited the Memory Resource Room.

WHAT IS ASSISTIVE TECHNOLOGY (AT)?

Assistive Technology (AT) refers to equipment that enables someone to complete a task to maintain their independence, help manage risks at home and reduce stress for carers.

Assistive Technology includes safety equipment, prompts and reminders, sensory technology, communication and orientation devices.

Typical equipment on display in the Memory Technology Resource Room includes push button reminders, easy to use remote controls, radios and phones, prompts to take medication, speaking clocks and watches, orientating devices and lots more. In most cases, very simple and inexpensive solutions enable people with memory difficulties to do things by themselves for as long as possible. Quality of life ideas such as a life history book, talking photo album or a personalised memory box can also make a difference to people living with dementia and memory difficulties. The Memory Technology Resource Rooms have examples of these and advice on how to put them together.

People with memory difficulties, including dementia, and their family members can arrange to visit their local Memory Technology Resource Room free of charge. You can speak to your GP or Public Health Nurse, or make an appointment directly with your local MTRR.

MORE DETAILS CAN BE FOUND AT www.understandtogether.ie.

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PERCEPTIONS OF PEOPLE WITH DEMENTIA CHANGING FOR THE BETTER Survey reveals half of us know a person with dementia

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new survey by the Dementia: Understand Together campaign has found improving public perceptions and attitudes towards people with dementia since the last time similar questions were asked. The nationally representative survey of over 1,200 people undertaken by Behaviour & Attitudes in July of this year found: Welcoming society

When asked about the attitudes of others, 67% of respondents believe most people would accept a person with dementia as a close friend and a similar number (68%) would treat a person with dementia as they would anyone. Both of these results are up from 56% in 2016, showing a significant positive shift in public inclusivity and empathy towards people with dementia Good company

there are things businesses and service providers can do to make their services accessible to people with dementia.

Circle of friends

Demonstrating how dementia touches the lives of so many people, almost half of those surveyed (48%) said that they know at least one person with dementia, up from 44% in 2018.

Understanding

Seven in 10 (71%) people are happy to spend time with a person with dementia, up from 66% in 2018, and a similar number (72%) are happy to be in a social group in the company of a person with dementia, up from 68% in 2018. When asked if they wouldn’t bother to visit a person with dementia because ‘they won’t remember’, three in four people (76%) rejected this, up from 73% in 2018.

A third of adults (33%) feel that they have a reasonable understanding of dementia while almost nine in 10 adults (88%) know something about dementia – just 12% say they know nothing at all. These figures have remained consistent with those reported in the previous survey in 2018, notwithstanding the public discourse being understandably dominated by information on COVID-19 over the past 18 months.

Active citizens

Early diagnosis

In a new survey question asked in 2021, more than nine in ten who responded (92%) believe that people with dementia have the right to be active citizens in their communities.

Businesses

In another question not previously asked, more than eight in ten (81%) believe that

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More than nine in 10 (91%) agreed that getting diagnosed at an early stage is good because it allows the person more of an opportunity to make decisions about their care – up from 78% in 2018 Seeking attention

A further additional question for 2021 found that almost six in 10 (58%) would react

immediately if they felt they were becoming forgetful and were concerned that it might be a sign of early dementia.

Three in ten (31%) would delay a couple of months and “keep checking myself”.

One in ten (9%) say they would be anxious about such a diagnosis and would probably try and cover it up for a while.

Reflecting on some of the survey’s outcomes, Dr Emer Begley, National Dementia Office, said, “It is perhaps not surprising that with almost half of the population knowing a person with dementia, more and more people are seeing the person and not the disease.

The Dementia: Understand Together campaign works with partners and community champions in communities across the country, so that more of us have an awareness and understanding of dementia.

“More people are seeing the importance of social connections for people living with dementia, that this can enhance not just how they feel and their experience of life, but they understand that they too have something to gain from greater inclusion. What is also reassuring is that respondents want people with dementia to live their lives to the full and see that an inclusive community enables them to do that, from joining a local club to visiting a shop.”

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ee the person, not the dementia” is a guiding principle when supporting someone who is living with a diagnosis of dementia. It focuses on the truth that despite having dementia, people have many of the same abilities, life-long skills and needs as before.

Dementia is usually far more than memory loss. The sensory challenges can be more difficult to cope with in day-today living. Alongside difficulties with language and expression, there can be issues around auditory and visual perception.

Music and dance can transcend these difficulties as they don’t rely on good language skills. They are non-verbal communication channels that can tap into deep memories and promote movement, balance and confidence.

Dancing isn’t just about music and steps.

It’s a perfect combination of physical activity, social interaction and mental and emotional stimulation. It can move us, bring us joy, and help us to connect with others.

Specialist dance companies offer online music and movement sessions inclusive of people with dementia, their partners and carers. Music is specially selected to connect creativity with exercise, whether seated or standing, and people have the freedom to move as they are able, with musicality, imagination and selfexpression. Most importantly, everyone has fun.

Speaking of her experience of dance, a spouse, who had become her husband’s carer, told me, “This is the first time I have felt that we were a couple for so long. It feels so good and so normal.”

Choirs offer a weekly routine with familiar songs and faces. They’re often an opportunity for a choir member who can play an instrument to showcase their talents. They provide a sense of belonging and lift spirits. Many community groups also hold tea dances which are another wonderful opportunity for people to relax, enjoy and connect.

One woman whose husband had been diagnosed with Alzheimer’s said to me, “Joining the choir was one of the best things we ever did. Seeing him close his eyes and tap along with the singing was great. I could see his mood lift and his smile broaden. It lasted all day.”

Another woman joined with her mum which enabled both to enjoy social time together. “My experience in the choir was

MAKING A SONG AND DANCE

Joan Fitzpatrick, HSE Senior Occupational Therapist, Living Well with Dementia programme, explains the value of music and dance for people living with dementia.

INTRODUCING MUSIC

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Tailor the experience. Think about how the person with dementia has engaged with music previously. What music did they listen to? Did they like singing?

Would they join a choir?

Think about your environment.

For some, being in a room with lots of movement and activity is great. For others, it can be distressing and a small gathering is best.

Bring music into the home. This can be as simple as playing Lyric FM or downloading favourite music onto a USB stick so that it’s always available. Why not dust down the record player and some old vinyl, or find some oldies on YouTube?

Strike up the band. Did the person play an instrument that has been lying idle in the attic all these years? Would a musical family member or friend play a few of the person’s favourite songs?

Look around you. A little research about what is happening in your locality can be revealing. A lunchtime recital or an evening concert can be a lovely way to spend some time.

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transformational. It enabled my mother and I to participate as equals in a highly enjoyable social activity. She adored singing. It was an activity that she knew she could do well despite the challenges she faced in other areas.”

Challenging the brain by remembering or carrying out skills that might otherwise lay dormant is important in maintaining a sense of self and living a full life. Singing, hearing or playing a favourite piece of music can lessen anxiety and bring real pleasure to the person with dementia.

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The Dementia: Understand Together campaign is led by the HSE in partnership with The Alzheimer Society of Ireland, Age Friendly Ireland, Age and Opportunity and the Dementia Services Information and Development Centre. For information on choirs that are inclusive of people with dementia, use the service-finder at www. understandtogether.ie or contact The Alzheimer Society of Ireland Helpline for support on Freefone 1800 341 341 (Monday to Friday 10am to 5pm, Saturday 10am to 4pm).

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ONLINE & ANXIETY-FREE Virtual tour video helps reduce pre-surgery worries for children

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virtual tour video has been made to give children and parents/guardians a realistic idea of what they can expect when a child has to attend University Hospital Limerick for surgery.

The video is a three-minute, step-by-step guide, from arrival at the Children’s Ark paediatric unit, through surgery preparations and what happens in theatre, and concluding with the return to the Ark after surgery.

Deirdre Twohig, a Clinical Nurse Manager (CNM-1) at the Children’s Ark, is the friendly virtual tour guide who introduces each of the steps, describing the various healthcare workers the young patients and their parents/guardians will meet along the way.

The virtual tour video, which can be viewed on YouTube at https://youtu.be/67Zh7DVSJs, is a project that arose from COVID restrictions in the hospital, and the limits they have placed on opportunities for staff to show children around the hospital to prepare them for surgery.

A collaboration between the Maternal & Child Health and Perioperative Directorates at UL Hospitals Group, the video aims to help children, primarily, and their parents/ guardians, understand what will happen on the day of their surgery, and to put their

36 | HEALTH MATTERS WINTER 2021

minds to rest at what can be an anxious time.

The video enables children to familiarise themselves with the hospital ahead of time.

They will see the areas in the Children’s Ark where they will make their final preparations, including checks for weight, blood pressure, breathing and temperature; they will also see the operating theatre, the waiting bay, and the theatre staff. They will also learn about the facilities in the Children’s Ark, including the playground, school and playroom, which they will get a chance to use when they have recovered.

Deirdre Twohig, Clinical Nurse Manager (CNM1), Children’s Ark, said, “The Children’s Ark provides pre- and post-operative family-centred care within a multicultural environment. We work in partnership with family/child needs to deliver personalized care, and have created this video in collaboration with the Operating Theatre Department as we recognise the need to alleviate a child’s anxiety before having a surgical procedure.

“Our hope is that children can watch the video at home with a parent/guardian prior to an elective procedure, or indeed on the ward if going for unplanned surgery. The video aims to help the child become familiar with the ward/theatre environment and the

staff members they will meet along their theatre journey. Preparing children will also give them the opportunity to raise any queries or fears they may have, enabling them to feel more confident and in control of their surgery experience.”

Katie Tierney, Clinical Educator, Operating Theatre Department, UHL, added, “Not many people look forward to having an operation. However, anxieties can be reduced if a person knows what to expect.

With this video, and its age-appropriate glimpses into the hospital environment and our healthcare staff, we aim to reduce those concerns for children, and their parents/ guardians. Helping the parent or guardian to adequately prepare the child will lessen any anxiety the young patient might be feeling and contribute to a smoother recovery. Studies show significant differences in post-surgery anxiety between those children who have been prepared for surgery, and those who are not.”

A total of 243 children had elective operations in UHL this year up to the end of August. “That is a lot of children,” Katie added, “and if we can help in any way to make their journey as pleasant as possible, through initiatives such as this video, then we will be happy that we have made a difference.”

DIRECT ACCESS TO SCANS HELPS GPS KEEP PATIENTS OUT OF HOSPITAL Over 100,000 scans have been performed in the first 10 months of 2021 under a new scheme which increased GP access to radiology diagnostics for patients.

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uilding on the work already under way in the community to increase GP and patient access to ultrasound and X-ray, this further rollout of the service increases GP direct access to additional scans for X-ray, CT, MRI and DEXA. Initially, the service was open to people aged 16 years and over with a medical card or GP visit card. However, since May 21st 2021, it has been available to the full adult (16 years and over) population and remains so.

Professor Ray Walley, GP and Associate Clinical Professor of General Practice, UCD, welcomed the benefits the direct access has brought.

“We have access to diagnostics in community that are provided at the same place as a private or insured patient goes to. The quicker access to diagnostics allows us diagnose quicker issues that may otherwise wait on a long waiting list or allows us exclude something that otherwise waits a long time to be told the same answer,” said Prof Walley, noting that the main cohort benefitting are predominantly medical card patients and often these people are ‘the most vulnerable and elderly’.

He said it was great to be able to deliver a better service to his patients during a particularly stressful and busy couple of years.

“It gives one more enjoyment in a GP’s life as you are saying something positive rather than repeatedly apologising that you are on a long waiting time. Apologising repeatedly is stressful and exhausting. It allows you do the job you are trained to do,” he said.

Professor Moira O’Brien, founder of the Irish Osteoporosis Society (IOS), said the earlier access to scans can have a massive

impact on patients with osteoporosis, as well as saving the health service millions.

“Osteoporotic fractures are one of the most common causes of disability and a major contributor to medical care costs in many regions of the world.. Earlier diagnosis of this silent disease will help to prevent potentially life changing injuries/deformities and costs to healthcare bodies,” she said.

“It will help to decrease the number of senior citizens losing their independence.

It will assist to reduce hospital services from being overloaded with patients blocking beds, due to poor fracture healing, as those not treated for osteoporosis will take longer to heal, have reduced mobility and more difficulty with daily life.

“The secondary effects of the fractures then cause the patients to be a higher financial burden on the health system.”

She highlighted the fact that Ireland has the sixth highest rate of hip fragility fractures in the world and 90% of hip fractures are due to osteoporosis. Hip fractures continue to be one of the most serious and costly injuries suffered by older people globally.

One hip fracture cost in total is €55,000 and there were 3,666 in 2020, costing approximately €201.63m, of which 69% were females.

“Preventing fractures and further fractures by earlier access to DEXA would be much more cost-effective and can help to prevent many of these fractures occurring in the first place,” she said.

Prof O’Brien said that before the scheme was put in place, elderly patients faced long waiting lists to be seen for a scan or a costly bill for a private one.

“The public waiting lists for DEXA scans were very long (up to several years in some places) which left those on medical cards

and GP access cards undiagnosed, and at high risk to fracture or refracture, which we believe contributed to the diagnosis rate being only 19%,” said Prof O’Brien.

She insisted that it was never too late to take action to prevent fractures.

“Instead of following what other countries do, it would be wonderful if Ireland could become the poster country to show that prevention of bone loss is much cheaper and less painful, than treating fractures. Also showing other countries how they can save billions of euro long term, by initiating a similar program, combined with screening for fragility fractures in all hospitals,” said Prof O’Brien.

“I have 90+ year olds who have improved their bone health, it is rarely ever too late, but much cheaper to prevent fractures.

“The direct access for GPs initiative will help to contribute to the majority of our senior citizens keeping their dignity, maintaining a positive mental health and independent in their own homes, which as we age, we can all benefit from.”

Speaking about the scheme,Pat Healy, National Director, Clinical Programme Implementation and Professional Development, said, “The increased direct access to radiology diagnostics is currently available via five private providers or hospitals. It provided GPs and patients with access to over 100,000 additional radiology scans up to October 2021. This consisted of over 23,000 x-rays, 7,500 CT scans, 64,000 MRIs and close to 6,000 DEXA scans.

“This service was designed so that GPs and patients could access radiology diagnostics; particularly in the COVID environment. By increasing access to scans in this way, people can undergo scans in the community, thereby avoiding a hospital visit.”

HEALTH MATTERS WINTER 2021 | 37

NEW DIABETIC RETINOPATHY TREATMENT SERVICE A MASSIVE BOOST FOR DONEGAL Sláintecare project delivers care closer to home for many

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anny O’Donnell used to have to travel for over three hours for his appointment to treat his diabetic retinopathy. He is just one of the many patients that will benefit from the new state-of-the-art Specialist Medical Retina and Intravitreal Injection Therapy service in Donegal.

Community Health Organisation Area 1, Letterkenny University Hospital and Sligo University Hospitals in partnership with Sláintecare and the National Diabetic Retina Screening Service announced the establishment of the service in Donegal for patients with a diagnosis of diabetic retinopathy.

“It would take me over three hours to travel to Sligo for my appointment. Coming back was worse for me with being uncomfortable after the procedure. My son had to take off work to take me. Having the service in Letterkenny is a big advantage for me and people like me who and I think it’s great to have this facility on the doorstep,” explained Danny.

“I can’t fault the service I got in Sligo and they were very good. It was just the travel.

This facility that’s now on our doorstep in Letterkenny is state-of-the-art. The team here treat me like royalty when I come in and I want to thank all the team here. It couldn’t be better.”

Another user of the service, Declan Kearney, was also thrilled to hear of the new location.

“Before the service was available in Letterkenny I had to take a day off work to attend my appointment in Sligo. A round trip of over six hours. As I needed a driver with me, my father also had to take time off. Now that the service is in Letterkenny it’s an unbelievable difference, it’s less than an hour

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ABOVE: Pic 1 L-R Helen Kavanagh, Diabetic Retina Screening Programme; Joe Travers, Deputy General Manager LUH; Dr Darren McAteer Consultant Ophthalmic Physician; Danny McCahill, NCBI; and Colette Murphy, Diabetic Retina Screening Programme management. BELOW: Danny O'Donnell, service user

from where I live and I only need to take a half day’s leave.”

Diabetic retinopathy is the most common cause of blindness in working age individuals' in Ireland, at the present time. It is estimated that there are approximately 190,000 people in Ireland with diabetes and 10 per cent of them are at risk of sight threatening retinopathy.

As a result of successfully securing Sláintecare Integrated funding, it is now possible to offer this treatment locally across the Eye Clinic St Conal’s Hospital and Letterkenny University Hospital.

The Specialist Medical Retina and Intravitreal Injection Therapy service was

previously offered only in locations with dedicated Ophthalmic Units. This is a very welcome development for the people of Donegal and means that service users will be able to avail of this treatment closer to home instead of having to travel to Sligo University Hospital.

Patients with a diagnosis of diabetic retinopathy may be offered this as a treatment option following a medical assessment by a Consultant Ophthalmologist.

An intravitreal injection is an injection into the vitreous, which is the jelly like substance inside the eye. Intravitreal injections are used to deliver drugs to the retina and other structures in the back of the eye, thus avoiding effects on the rest of the body.

Consultant Ophthalmic Surgeon Shauna Quinn from the regional ophthalmology unit for the north west of Ireland at Sligo University Hospital welcomed this pilot project to delivery intravitreal therapy for patients with diabetic retinopathy closer to patients’ homes.

“We are very aware that we have patients travelling long distances to appointments and are very pleased that this initiative has been established to provide intravitreal injections to some of our Donegal patients,” she said.

“There is a huge benefit in providing local care to patients having regular treatments; we would be very interested in establishing a permanent intravitreal therapy unit in Letterkenny for our patients with retinal conditions in addition to solely diabetic retinopathy, such as age related macular degeneration (AMD) and vein occlusions, but this will clearly require considerable investment in staff (clinical, nursing and admin) and building a dedicated eye injection room. Hopefully this pilot project is the first step in establishing this valuable outreach service in a location convenient for our patients.”

ABOVE LEFT: Nurse Sinead Cunningham, nurse Coirle Kerranem; Dr Darren McAteer, Consultant Ophthalmic Physician; Fidelma Kerins, Nurse Manager; nurse Anne Crawford. ABOVE RIGHT: Emma Ball, CHO1 Primary Care General Manager Sligo/Leitrim; Mary McGroarty, Business Manager, Community Ophthalmic Service, Donegal, Sligo & Leitrim.

Consultant Ophthalmic Physician Dr Darren McAteer, the consultant lead for the Sláintecare injection for Diabetic Retinopathy project in Donegal, said, “I am delighted to see the positive impact that having the service much closer to home has had on our patients and their family and friends. The increased capacity for intravitreal injection has also the simultaneous benefit of easing pressure on the very busy intravitreal injection service in Sligo.

"This new service could not have come about without the excellent work done by our colleagues here in Letterkenny University Hospital and also in Sligo University Hospital."

He added, "This integration of staff from radiology, pharmacy, IT, administration, management and clinical care is an example of how, with a dedicated team in place we can develop new services for our patients in more convenient locations while still upholding the highest of professional standards.”

IF YOU WOULD LIKE ANY FURTHER INFORMATION about the Diabetic Retina Screening Service - www.diabeticretinascreen.ie Freephone 1800 45 45 55 (choose option 4).

WAIT TIMES SLÁINTECARE PROJECT REDUCES WAIT TIMES FROM SIX MONTHS TO SIX WEEKS A new Sláintecare-funded project in Co Wexford providing geriatric assessments for older people in the community has reduced waiting times from six months to six weeks in the area. Wexford General Hospital and South East Community Healthcare have been working to integrate acute and community services for older people. The resultant Age Related Care (ARC) Team project has been successful in securing long term funding through the Enhanced Community Care fund, meaning that patients will be able to access these comprehensive services on a long term basis. Welcoming the progress made, Barbara Murphy, Head of Service/Older Person Services, South East Community Healthcare, said, “The aim of the ARC team is to expand its services to primary care centres in Wexford, New Ross, Enniscorthy and Gorey, so that patients can have their appointments locally and be able to provide home visits. The ongoing co-operation between South East Community Healthcare and Wexford General Hospital in this respect is a demonstration of Sláintecare’s principle of ‘Right Care, Right Place, Right Time’, which is seeing a focus on shifting more care into the communities, closer to patients’ homes.” The ARC service provides comprehensive geriatric assessments for older people, with a team currently based in Wexford General Hospital that includes an Advanced Nurse Practitioner, a Senior Dietician, a Medical Social Worker, a Senior Occupational Therapist and a Senior Physiotherapist. Patients are referred to the service by the hospital, as well as through community healthcare services and they can access a range of supports in one visit. Results from the service show that the team in Wexford had a target of 1,200 patients visiting the clinic and actually achieved 2,389. The non-attendance rate at appointments reduced from 10% to 3%. Applications for long term care from the acute setting have reduced by 12%, with a potential saving of €440,000. Delayed discharges have been reduced by 14%.

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NENAGH HEART FAILURE SUPPORT UNIT WELCOMES

FIRST PATIENTS TO NEW DESIGNATED CLINIC SPACE Staff at Nenagh Hospital started to welcome the first patients through its new Heart Failure Support Unit in August

Pictured at the official opening of the new Heart Failure Support Unit at Nenagh Hospital were patient Timothy Ryan and his wife Mary surrounded by staff of Nenagh Hospital and UL Hospitals Group and members of the Friends of Nenagh Hospital, who generously supported the project. Photo: Brian Arthur.

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mong them were local resident Timothy Ryan, who formally cut the ribbon on the refurbished facility. Timothy was one of the very first people to avail of the service when it first opened in the hospital back in 2012.

Since then, the team behind this important service in Nenagh has been providing specialist care and a chronic disease management programme to people with a diagnosis of heart failure. Thanks to significant financial support from the Friends of Nenagh Hospital and the HSE, the service now has a designated space in

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the outpatients department following a refurbishment and equipping project.

There are over 90,000 people in Ireland who suffer from heart failure. Heart failure accounts for more than 7% of all hospital admissions; affects about 20% of those over 80 years of age and causes very debilitating symptoms, such as breathlessness, fatigue and fluid retention.

The Heart Failure Support Unit in Nenagh Hospital currently sees approximately 230 patients from north Tipperary, east Clare and east Limerick. The service is led by Consultant Cardiologist Dr Syed F Abbas, and two specialist heart failure nurses,

Jacinta Glasgow and Kathryn O’Brien.

Clerical support is provided by Agnes Carroll, while two onsite cardiac physiologists ensure timely access to diagnostics, and the cardiac rehabilitation coordinator provides phase III exercise programs for patients attending the service.

“It is very important to retain and develop cardiology services locally in Nenagh and while we have been developing the service since its setup in 2012, we did not have a permanent base from where to operate. Our clinic location until now had moved from day to day, and week to week, reducing efficient use of resources and impacting the

growth of the service. In addition elderly frail patients with multiple health issues, or limited mobility and those with worsening heart failure symptoms (increased breathlessness, fatigue, leg swelling) often need unscheduled visits which we can now better accommodate with the new space,” said Jacinta.

“Our new designated space has two consulting rooms, a reception area, an office, a bathroom and is all fully wheelchair accessible. The team are delighted to be welcoming our first patients through our new unit this week. It provides patients with

this is a vote of confidence in the service and the dedicated staff providing it.”

Among the first patients through the new unit this week were Michael Flynn, Killaloe, Patrick Ryan, Borrisoleigh, as well as Timothy Ryan, from Tyone, Nenagh, who cut the ribbon on the facility.

“It’s a great honour for me to have been asked by the team at the Heart Failure Support Unit to formally open their refurbished facilities. I was one of the first people to be referred to this team in Nenagh Hospital back in 2012, and the service has been second to none. I attend for review

BELOW LEFT: Service user Michael Flynn, Killaloe (right), pictured in the Heart Failure Support Unit at Nenagh Hospital with his nephew Christopher McLoughlin. BELOW RIGHT: Service user Pat Ryan, Borrisoleigh, pictured in the Heart Failure Support Unit, with Kathryn O’Brien, CNS Heart Failure; and Jacinta Glasgow, CNM2, HFSU.

twice a year, and it is great to see the team get the space and the facilities they deserve.

The Heart Failure Support Unit team have provided me with an invaluable service, and I’m very glad to have been invited to this special day for them,” Timothy said.

Timothy’s wife Mary described the Heart Failure Support Unit team as a “lifeline” for her husband. “They have provided Timothy with an absolutely invaluable service. The expertise of the team gives great peace of mind, and to have this service more or less on our doorstep, very close to our home here in Nenagh, and not have to worry about accessing or parking, is a great bonus. It’s a very stress-free service, and Timothy could not be in better hands.”

Aside from the dedicated Heart Failure Support Clinic, a range of cardiology services are provided in Nenagh. These include cardiology outpatient clinics, cardiology diagnostic services and cardiac rehabilitation services.

Cardiology outpatient clinics are held weekly by Dr Abbas and his team. A range of cardiac diagnostic investigations are conducted including, exercise stress tests, echocardiograms, 24-hour ambulatory blood pressure monitoring and 24-48 hour holter monitor testing.

BELOW: Timothy Ryan from Nenagh, centre, with, from left, Dr Syed Abbas, Consultant Cardiologist; Jacinta Glasgow, CNM2 Heart Failure Support Unit; Agnes Carroll, Clerical Officer; and Kathryn O’Brien, CNS Heart Failure, Heart Failure Support Unit. Photo: Brian Arthur.

greater comfort, a more pleasant and safer environment, and additional physical space, which is more important in the current climate. From a staffing perspective it will allow us to be more efficient and to continue to develop the service all under one roof.”

The Heart Failure Support Unit has, since the outset of the Covid-19 pandemic, continued to provide a service through a combination of face-to-face urgent care and virtual clinics, in addition to the heart failure nurse specialist helpline. During 2020, there were a total of 699 clinic attendances, compared to 920 in 2019.

However the new virtual clinic reviewed 103 patients while 1,690 calls were dealt with on the helpline.

Cathrina Ryan, Operational Director of Nursing, Nenagh Hospital, added, “We are very grateful to the Friends of Nenagh Hospital for their continued support in developing services and improving patient experience in Nenagh. We are also grateful for the support of the HSE nationally and HEALTH MATTERS WINTER 2021 | 41

PHYSIOTHERAPIST ACCESS IMPROVING OUTCOMES FOR PREMATURE BABIES

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here have been huge advances was developed in 2015 and outlined that a in both neonatal and level 2 NICU, such as the unit in UHW, obstetric care over the should have access to a senior past 20 years, with an physiotherapist. increasing survival rate Deirdre’s six-month pilot project demonstrated a 90% increase in of extremely premature infants admitted to the Neonatal referrals. All infants born at or under Intensive Care Units. These 34 weeks gestation were assessed and highly vulnerable infants are at given individualised handling and risk of developmental sequelae positioning programme. The service and there are increasing requests allowed for in-depth assessment, multiple treatment sessions, parent for neonatal physiotherapists to education, nursing staff education, identify and assess infants at risk of discharge planning and liaison with morbidity and begin early intervention. community services ensuring smooth In May 2020, senior physiotherapist Deirdre Purcell spearheaded a service transition from acute to community services. development project to establish a Introduction of a weekly MDT ward round has led to formalisation of inneurodevelopmental physiotherapy service Senior neonatal physiotherapist Deirdre Purcell in the University Hospital Waterford holding a gel cushion in her left hand which staff in patient referral criteria, generation of (UHW) Neonatal Unit. This unit has 17 cot- the Neonatal Unit use to help prevent head shape referrals and community discharge spaces between Neonatal ICU and the malformations in preterm infants. In her right hand pathways. stepdown Special Care Baby Unit.

Deirdre submitted the results of her sixshe is holding a ‘prone plus’ positioning aid which is used to position babies on their tummies.

“The role of the physiotherapist in the month pilot project and developed a Neonatal Unit is to assess the infants and business case which was submitted to the provide advice on positioning and handling as appropriate.

General Manager. She was successful in securing a permanent With early and timely physiotherapy assessment and treatment, physiotherapy position in NNU. By building a rapport with these babies can start preventative therapeutic interventions colleagues in Level 2 and Level 3 centres across the country she immediately to address the problems associated with an set up a peer mentoring programme. She has also researched positioning aids and has implemented new aids for improving immature nervous system,” explained Deirdre. alignment for example when lying on their tummies and a gel “Any specific neuro-developmental problems highlighted cushion to help prevent head shape malformations. can then be addressed to optimise the potential for recovery Feedback from parents and staff on the unit was very positive which has been demonstrated in young babies, in order to improve their functional outcomes in later childhood.” with 100% satisfaction. Parents felt more empowered to take Previous benchmarking results found 91% of neonatal units ownership and staff felt more confident with the guidance of in the UK had a full-time senior physiotherapist which reflects an individualised positioning programme. All participants in the the complexity and highly sub specialised skills that this work feedback questionnaire reported the new physiotherapy service entails. The Model of Care for Neonatal Services in Ireland ‘to be invaluable in improving outcomes for those born too soon’.

HOSPITAL RESIDENTS ENJOY SERIES OF CONCERTS

The residents of Sacred Heart Hospital, Carlow enjoyed three concerts performed by the magical ‘Mobile Music Machine’ team recently. The Mobile Music Machine is a group of musicians who have been negatively affected by the COVID pandemic when all live concerts were cancelled indefinitely. Fortunately for the residents and staff of the Sacred Heart Hospital, Sinead Dowling, the local Arts Officer with Carlow County Council, intervened and enabled the residents to benefit in these strange times. Deirdre McGovern, CNM2 of the Social Care Programme at the Sacred Heart Hospital, explained, “The concert brought so much joy and delight to our residents and facilitated us to sample their incredible musical skills and better still to have front row seats to savour it all.” The Sacred Heart Hospital is currently in the midst of refurbishment, so the musical crew engaged in a lot of moving from one area to another to enable all residents to participate in the concerts. They provided their own equipment and awning for the unpredictable Irish weather and were self-sufficient in every respect in line with current infection control guidelines and recommendations. All three concerts showed a range of musical talents and music genres and had a variety to please all which definitely exceeded all expectations. So a big thank you to all involved in organising and participating in these concerts and hopefully the project will be maintained and we will savour more fantastic Irish talent into the future.

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ARTHRITIS

RHEUM TO RECOVER

Supporting patients living with inflammatory arthritis post COVID-19

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estrictions imposed by COVID-19 have brought significant challenges to patients with a chronic illness like arthritis, affecting both patients’ physical and mental health. Using a self-management technique known as Bridges self-management in face-to-face consultations, the Rheumatology Nursing team at University Hospital Waterford (UHW), through their Rheum to Recover programme, are helping patients identify difficulties with their health as a consequence of COVID-19 that are potentially affecting their arthritis.

“Now that patients are returning to our service, we want to encourage patients to adapt a ‘living life well with arthritis’ post-COVID approach,” explained Advanced Nurse Practitioner Una Martin. “The rheumatology nursing team observed that patients returning to the service had a number of challenges with their general health. We noticed increases in weight, rise in cholesterol levels, a return to smoking and alcohol consumption. We also noted some changes in patients’ psychological health with many reporting anxiety, depression and lack of motivation to maintain a regular routine. This prompted us to look how the nursing team could approach this in a positive but supportive way for our patient cohort.”

Una explained that using the language of Bridges self-management, the team put together a patient leaflet that supports them in making the necessary changes to their lifestyle in small steps. “In consultation with the patient, we will help them identify some of the challenges that they have encountered in the last number of months and work towards making a change in their health going forward and the benefits this can bring in managing their arthritis,” she said.

“Using the Bridges technique is so relevant in the current climate when patients need a helpful and supportive relationship with their healthcare team in an uncertain time. The language of Bridges helps patients feel they are listened to and supported to work on things that are important to them.”

The ANP stressed that recognition that management of chronic illness is changing and managing lifestylerelated diseases particularly post-COVID is vital as it can influence patients’ outcomes in the long-term.

ABOVE: The Rheumatology Nursing team at UHW: Staff Nurse Sajitha Pushpangadhan; Una Martin, Advanced Nurse Practitioner; Sreeja Nair, Staff Nurse; and Paula Dreelan, Clinical Nurse Specialist.

“Understandably, most of the healthcare focus has been on prevention and treatment of COVID-19 since February 2020.

However, the restrictions and implications of the pandemic are now being seen in patients living with a long-term illness like arthritis. The consequences and the persistent unfamiliar pathway for both patients and healthcare staff makes it all the more imperative that we address these challenges for patients now as we continue to grapple with the ever changing situation of COVID-19. Lifestyle-related diseases will have long-term negative outcomes for patients living with inflammatory arthritis,” added Una.

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MAKE EVERY CONTACT COUNT SUPPORTS PREVENTION AND MANAGEMENT OF CHRONIC DISEASE

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aking Every Contact Count (MECC) is an approach to behaviour change that supports the prevention and management of chronic diseases. It is about enabling healthcare professionals to recognise the role and opportunities that they have through their daily interactions with patients in supporting them to make health behaviour changes.

The MECC training programme is an essential component of the MECC programme and is a key first step in implementing MECC into our health services. It consists of a blended training of six 30-minute eLearning modules followed by an Enhancing your Brief Interventions Skills (EYS) workshop, delivered face to face or virtually. This autumn, 17 staff attended the Making Every Contact Count (MECC) Train the Trainers programme to become MECC trainers. They will join the current MECC trainer pool to deliver the Enhancing your Brief Interventions Skills (EYS) workshop across all CHO areas and Hospital

17 staff who recently completed the MECC Training for Trainers Programme.

Groups as part of the MECC Training Programme. The MECC EYS workshop delivery is co-ordinated and delivered largely through the Health and Wellbeing, Health Promotion and Improvement services. By providing the T4T, MECC trainer capacity is increased and it ensures that there is a sufficient trainer cohort in each area to deliver the MECC workshop.

The workshop is aimed at all frontline healthcare professionals working in the health service. The aim of the workshop is to equip the learner with the knowledge and skills to conduct a brief intervention with their patients as part of routine care.

The workshop focuses on the further development and practising of the key skills required to conduct a brief intervention.

By Making Every Contact Count health professionals can encourage patients to make healthier lifestyle choices during routine contacts to help prevent and manage chronic diseases.

FOR MORE The training programme can be accessed at www.learning. makingeverycontactcount.ie

CHILDREN FIRST AWARENESS WEEK: EVERYONE HAS A RESPONSIBILITY TO KEEP CHILDREN SAFE Children First promotes the protection of children from abuse and neglect, by setting out what individuals and organisations need to do to keep children safe, and how to deal with concerns about a child’s safety or welfare. It is HSE Policy that all staff irrespective of role, grade or position must promote the welfare of children and protect them from harm. It is not okay to do nothing if you have any information that a child has been, is being or is at risk of being abused or neglected. These responsibilities are especially relevant for health and social care professionals, even if you work in an adult based service. Services working with children and classed as relevant services under the Children First Act 2015 must have a risk assessment completed and have a Child Safeguarding Statement in place. The COVID-19 pandemic has highlighted the importance of communities and organisations working together to keep children and young people as safe as possible. Dean Sullivan, Chief Strategy Officer, HSE welcomed Children First Awareness Week. He said: “As the largest organisation in the State, the HSE serves children, young people and their families within primary care, community and acute hospital services. Raising awareness of our individual and collective responsibilities to children and young people is an on-going priority for the HSE, which will be greatly assisted by the focus provided during this awareness week.”

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At the launch of Children First Awareness Week were Dean Sullivan, Chief Strategy Officer, HSE; Jonathan O’Reilly, social worker, Tusla; Cathriona Comaskey, nurse, HSE; Bernard Gloster, Chief Executive, Tusla; Minister for Children, Equality, Disability, Integration and Youth, Roderic O’Gorman; John O’Driscoll, Assistant Commissioner, Organised & Serious Crime, An Garda Síochána; and Grainne O’Reilly, social worker, Tusla.

‘WE’RE ALL IN THIS TOGETHER’

HSE donations assist in COVID crises in Asia, Africa and South America PPE from Ireland arriving at a health post in Nepal.

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owards the end of April, Irish TV screens revealed the unfolding crisis in India as health facilities ran out of oxygen desperately needed to treat thousands of sick people with COVID-19 infection. Late on Friday evening on April 23rd, Dr David Weakliam, HSE Global Health Programme Director, received a call from Dr Vida Hamilton, HSE Clinical Adviser, to say that the HSE was in a position to donate oxygen concentrators – but how could we get them to India?

He immediately contacted the Department of Foreign Affairs (DFA) to seek support for transportation. What followed was a rapid, co-ordinated response involving many people across the HSE, DFA, Department of Housing, Department of Health, and Indian Authorities in Dublin and Delhi.

By Sunday afternoon, HSE staff had 700 oxygen concentrators ready for shipping, the customs documentation was completed, and funding was secured from DFA and the EU under the EU Civil Protection Mechanism. On Tuesday, a plane arrived at Dublin Airport and departed that night for Delhi. A second, larger donation followed the next week with 548 oxygen concentrators, 425 ventilators and 2 oxygen generators. This huge consignment filled a Boeing 747. This arrived in Delhi on 4th May and remarkably, just two days later on May 6th, the HSE received an email from the Indian Ambassador in Dublin with details of the distribution of every piece of equipment to various hospitals across India.

BELOW: Minister of State Colm Brophy; Marcel Biato, Brazilian Ambassador; Dr David Weakliam, HSE Global Health Programme; Helen Byrne, HSE Acute Hospitals; and Paul Rock, NDFEM.

The HSE made further donations over the following weeks. Nepal, a poorer country than its neighbour India, requested international assistance and again the HSE promptly responded. Despite the disruptions to communications following the HSE cyber-attack, clinical engineers and other staff worked flat out to organise a donation of 1800 items of respiratory equipment and more than two million items of PPE. The Irish Red Cross and other non-governmental organisations contributed additional oxygen concentrators and Respicare supplied non-invasive ventilators. This consignment was despatched in June.

The HSE further responded to an emergency request from Brazil for Atracurium, an essential muscle-relaxing drug for COVID-19 patients requiring ventilation. This was a more challenging process due to complex customs processes and the requirement for refrigeration. 47,250 vials of Atracurium were successful donated in June.

The HSE continues to support other countries as it is able. In response to the

Loading equipment for India at Dublin Airport

challenge of global vaccine equity, the HSE collaborated with the Departments of Health and Foreign Affairs to send 335,500 doses of the Astra Zeneca vaccine to Uganda in September. In October, the HSE sent two containers of PPE to Zambia and was preparing to respond to further requests for PPE from several other countries in Africa.

These are examples of how the HSE has played a significant role in sharing resources as part of Ireland’s global solidarity with less well-resourced countries during the COVID-19 pandemic.

David Weakliam summed up the response of the HSE and its staff. “In saying ‘we are all in this together’ we demonstrated our commitment to people everywhere and not just in Ireland. This is true solidarity, not just doing something because it is in Ireland’s interest (‘no one’s safe until we’re all safe’), but because we genuinely care what is happening in other countries and we believe that everyone has a right to the health care they need, wherever they are in the world,” he said.

BELOW Loading equipment for India at HSE warehouse

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BREAKING NEW GROUND

INFECTION PREVENTION AND CONTROL ONLINE LEARNING

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Online education module accessed nearly 190,000 times

he HSE Antimicrobial Resistance and Infection Control (AMRIC) team launched a new infection prevention and control online education programme in December 2020. From December 2020 to August 2021, the online education modules were accessed 189,011 times by 75,870 individual learners who went on to complete their modules and print their certificates.

This figure was achieved despite the cyber-attack when the programme was inaccessible for a number of weeks. You can read some feedback from two staff members who completed some of the courses and how they changed their practice. The AMRIC team has added three new courses to the eLearning suite. They are available now on HSeLanD, the courses support all health and social care staff in IPC and AMR. Learners are awarded 1 CEU from NMBI and 2 CPD credits from RCPI for each completed course in the AMRIC programme.

The 3 new courses are: Prevention and Management of Urinary Tract Infection In this course, you’ll learn

how to reduce antibiotic-related harm and reduce the incidence of healthcare associated urinary tract infection, to manage urinary tract infections and reduce antibiotic-related harm.

Surgical Antibiotic Prophylaxis This course supports you to provide every patient who needs surgical antibiotic prophylaxis, the right agent, the right dose, at the right time for the right duration.

Prevention of Peripheral and Central Venous Catheter Related Infections

This course supports you to safely insert, maintain, monitor and remove an indwelling intravascular device in line with infection prevention and control best practice.

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The other IPC and AMR courses available on HSeLanD are:

• Introduction to Infection Prevention and Control and Antimicrobial Resistance • Basics of Infection Prevention and Control • Standard and Transmission-based Precautions Hand Hygiene

• • • •

Personal Protective Equipment (PPE) Respiratory and Cough Etiquette Aseptic Technique Antimicrobial Stewardship

Each course takes between 20 – 40 minutes to complete and includes assessments and extend my learning pieces for staff who want to undertake further learning or who want practical activities to help transfer the learning into their local area of work. You can dip in and out of the courses at any time and can find them by following the AMRIC Resist logo on the HSeLanD homepage, by searching for ‘IPC’ in the search box or by visiting the Clinical Courses catalogue.

Karen Marriano, nurse and Infection Control Link Practitioner, Farranlea community nursing unit, Cork city I found the course to be better than a face to face course as it was saving time, no travel required, very convenient and very easy to access and follow. It is not complicated to do the courses, the information can be complex but it is explained very simply using examples.

After doing the course I am much more aware of what I am doing compared to before I did the course. The learning has made me stop and think. The more you do them the more you are reminded of the best way of improving infection prevention and control. I have definitely put my new knowledge into practice, most recently the module on urinary tract infections and using dip-sticks. We are moving away from the practice of using dipsticks and we are following the new guidance. We are reducing our antibiotic

Ann O’Connor, nurse and Infection Control Link Practitioner, St Anne’s, Caherciveen, Co Kerry Our first introduction to AMRIC online training was at the beginning of the pandemic when we followed the PPE donning and doffing e-learning programmes. It was a time when people were very worried about COVID-19 and it was good to see the demonstration of best practice so we could follow it. There is no denying that we benefitted from that. Since then there have been some important developments around managing urinary tract infections (UTIs). In the past antimicrobial stewardship would have been left to the doctors and prescribers, but now I feel that nursing and health care assistant staff have the authority to take action. We have changed our practice in relation to using dip sticks and have reduced antibiotic use. Our health care assistants are now very much aware that our residents may need to take on more fluids. We are managing our antimicrobial stewardship on the floor, putting our learning into action. We can see first-hand the in antimicrobial stewardship. One of the other changes that we have put in place following the online training is having hand sanitiser at the point of care so that staff have easy access and it acts as a reminder to sanitise before and after caring for our residents. We have also done education and training for our residents in managing their own hand hygiene and cough etiquette. The AMRIC online course is simple to use and interactive, as a Link Practitioner, I welcome this online training as it is easy to access, is available 24 hours and open to all healthcare staff.

prescribing for UTIs and have made changes to fluid intake for our residents. It has made me more aware of our role in antimicrobial stewardship and antibiotics use The AMRIC online course is a great place to go if you have any doubts on doing infection control, it is very simple to use and good to have that resource to check. I really like that is always on, you can check in at any time I appreciate that AMRIC is its own ‘brand’. The colour is bright and when I see and read AMRIC, I automatically know that I’m going to be dealing with concepts on IPC.

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TAKING BACK CONTROL Promoting continence for all adults through a national education programme on HSELanD

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national education programme to promote continence and appropriate management of continence problems for adults is now available online at HSELanD.ie. Intended for healthcare professionals who are engaged in the assessment and management of adults with continence issues, the programme supports the HSE National Guideline for the assessment, promotion and management of continence in adults by registered nurses (2019).

Continence care in Ireland has generally been varied and has in the past lacked a standard approach. This led the Community Funded Schemes Service Improvement Programme, under Primary Care Operations, to look at standardising the approach here in Ireland. In 2019 an expert working group finalised and published the new national guideline, based on international best practice.

The guideline and supporting resources are available at www.hse.ie/continencecare. These include a comprehensive toolkit of supporting assessment and referral forms, pathways and information leaflets. As well as the resources for healthcare workers, a section on the webpage also contains information leaflets which are helpful for people who are experiencing continence issues.

The education programme to support the national guideline was developed and launched via online webinars in 2020. The programme has been further revised this year and a series of continence care modules to support better continence care across all healthcare settings (primary care, older persons, intellectual disability, mental health and acute hospital) have been added.

As reported by the continence advisors involved in the programme, conservative management for patients through lifestyle changes empowers them to take a greater role in managing their symptoms better. And it enables them to take back control of their lives again.

The programme is available now on HSELanD and is suitable for healthcare professionals engaged in the assessment and management of adults with continence issues. Each participant will develop knowledge and acquire the skills to perform a holistic bladder and bowel continence assessment.

Modules focus on • prevalence and impact of continence in Ireland, • types and classification of incontinence, • assessment and management, • case studies, • skin care and • integrated care - shared care plan.

The modules were developed by a team with a wealth of teaching experience and clinical expertise. They include Continence Advisors, Nursing Practice Educator and a Consultant Urologist.

There are four modules in total (with three topics in each module) and all modules can be completed in the participant’s own time. The course is NMBI category 1 approved 7 CEUs. Our team (Margaret Tiernan, Continence Advisor, Roscommon Primary Care; Breda Moore, Continence Advisor Carlow / Kilkenny Primary Care; Rachel Long, Continence Advisor, Cork North Lee; AnnaMarie Mills Continence Advisor Mullingar Primary Care; Mary Bell, Education and Practice Development Manager; Una McCarthy, Primary Care Operations) wish to thank the staff from the ONMSD, Cork Kerry CNME who assisted with the webinars in December 2020 and Mr Eamonn Rogers, National Clinical Advisor for Urology to the National Clinical Programme in Surgery (NCPS). We thank all for taking the time to share their knowledge and expertise.

More information National Guideline and supporting toolkit: The guideline, assessment forms, patient information leaflets and associated resources via hse.ie/continencecare Online education programme: Login and register at www.hseland.ie. Once registered, select course catalogues, then ONMSD catalogue. Scroll down for National Adult Continence Education Programme 2021 -2020.

For more information contact: Una McCarthy, Programme Manager, Primary Care Operations CFS National Service Improvement Programme email: una.mccarthy@hse.ie

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INNOVATIONS IN RENAL DIETETIC PRACTICE IN CORK UNIVERSITY HOSPITAL

Dietitian team produce videos to educate patients in treatment of chronic kidney disease

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y 2040, Chronic Kidney Disease (CKD) will be the fifth biggest cause of death globally, primarily driven by hypertension, diabetes and obesity. The estimated prevalence for CKD in Ireland in adults over 45 years of age is 11.6%. Dietitians are a key health professional in tackling this disease but we need to intervene at the earliest stages. By educating people with/at risk of CKD about important dietary interventions such as a reduced salt diet to improve hypertension, they can work synergistically with pharmacological therapy to delay progression and reduce the risk of complications, such as cardiovascular disease, malnutrition and renal bone disease.

The National Renal Office has identified lack of renal dietetic posts nationally as a major risk for patient care.

“Innovative solutions need to be developed to make the most effective use of highly skilled but under resourced dietetic staff and allow more patients achieve the benefit of this expertise. While patients may have been given dietary advice earlier in their diagnosis by their doctor, this is generally in the form of a recommendation without any supporting or practical measures necessary to generate a change,” explained Irene Cronin and Doireann Ni Mhurchu, Renal Dietitians at Cork University Hospital (CUH).

In early 2020, the renal multi-disciplinary team in CUH agreed to support a proposal of the renal dietitians to create education videos designed to complement diet sheets, be an additional tool for dietitians in the nutritional management of CKD and be a credible and reliable source of information for patients with CKD. A collaboration with Health Innovation Hub Ireland (HIHI) led to an introduction to the technology company Incareview Ltd. Incareview Ltd has a strong background in building patient engagement technologies “We worked with Incareview Ltd to build interactive dietary information using videos and web-based technologies. The project group also included two patient body representatives from the Cork Branch of the Irish Kidney Association, who provided insight into what people affected by CKD

Renal dietitians at CUH, Doireann Ní Mhurchu and Irene Cronin.

needed and would benefit most from in terms of dietary education,” said Irene.

“Initially we created a short animated video on salt and CKD which patients can be directed towards by a range of health professionals including nephrologists, GPs, community dietitians and clinical dietitians working in other settings such as weight management and diabetes clinics.”

This 3.5 minute video provides information on how salt reduction can improve known risk factors for CKD progression, how to successfully reduce dietary salt intake and how to interpret food labels.

“The health message is presented in a visual easy-to-understand format. It provides an alternative to diet sheets and information leaflets which may not be appropriate for all patients. This resource to initiate appropriate dietary change can be offered to the majority of patients diagnosed with CKD, while they wait for individualised dietetic referral. This video was launched in January 2021 and is available by link from national websites that people with CKD navigate towards including www.irishkidneydiet.ie and the Irish Kidney Association website, ensuring that it is easily accessible,” said Irene.

Our second education video is on the topic

of phosphate and CKD has been funded by the CUH Charity Office with the support of the Department of Renal Medicine, Cork University Hospital. This video will be appropriate for patients with advanced CKD already under the care of a renal dietitian and will complement the existing resources available to the dietitian.

“The experience of collaborating with a tech company has been very positive and has led to the development of a new set of skills by the renal dietitians. It is our plan to study the metrics of the first 2 videos, and if found to be an effective resource, we will plan for additional videos addressing further aspects of the renal diet. If dietitians or other HSCPs have plans to develop a similar product we are very happy to share our experience,” added Irene.

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IS BLENDED CARE THE NEW NORMAL? In health, Blended Care refers to a mixture of online appointments and in-person treatment for a range of health needs.

Its underpinning logic is that quality healthcare services can be made more accessible by delivering at least part of a care plan or service online, to help improve patients’ health in a way that is local and helpful for them.

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Blended Care helps families, individuals and carers Living with cancer When one of your three children has a serious health condition it affects the daily life of the whole family.

For Tom and his family being able to do a few of the many hospital appointments needed online has been a game changer.

Being able to attend even one or two online appointments from home, means he can help Maria more with the regular health consultations. In this way Tom can manage online consultations within his work day without having to take more unpaid leave. Also he gets to feel more hands-on involved with Kayla’s treatment plan and spend more time with her himself.

Rural community Jan loves living in an idyllic part of Ireland with a close community. One downside is you can have to travel long distances when you’re not

well. As part of her treatment plan Jan is able to access expert medical opinion for some appointments online which saves her two trips to Dublin each month Parent is ill Juggling family life, work-life, life-life is always a bit tricky, now Sue, can have some of her regular health support appointments and consultations online, which helps the whole family.

New baby Fiona had gestational diabetes, managing her condition with some of her scheduled appointments online resulted in greater access and more frequent appointments than would have been possible with only face-to-face. It was also ideal for the group work classes. Fiona is now in full health, helped by receiving excellent care when she needed it.

IS BLENDED CARE FOR YOU/YOUR SERVICE? The HSE is providing easy to access support Equipment Licences Training

Practical benefits of Blended Care There are a range of benefits for people adopting the blended care approach: • fewer in-person appointments – saves time and money • online content and support materials can be shared easily • empowers users to take an active role in the process • more convenient for families, individuals and carers • improve access or frequency options Through collaboration, service users and their healthcare professionals can identify an ideal combination of in-person and online treatments for their therapeutic goals. When it becomes apparent that a blended care approach will suit both parties, healthcare professionals can take advantage of emerging blended care technologies, to streamline elements of the care pathway that can be digitised and help clients achieve their goals through modes that are most convenient for them.

Additional needs Children with autism have additional needs which can result in a lot of health care appointments. Now they are able to take some of the regular consultations and classes online it saves Roisin’s family time and money but above all means less stress.

Solo parent Work/Life balance is so important.

Less time off paid work for some routine healthcare appointments makes a big difference to people. Katie benefits too as keeping to her routine is very helpful at this age.

Retired couple Mary and John had been looking forward to retirement for a long time.

One of the things that took a lot of time from their schedule were the regular health checks they needed at this age and stage. Being able to do some of their health consultations via video really helped them to plan their trips and have more free time.

Contact the National Virtual Health Team at virtualhealth@hse.ie www.hse.ie/online-health/about

Blended Care helps healthcare providers Dietician “…I talk about food, about motivation about portions and about making healthier choices with people and when that person is sitting in their own kitchen it becomes much more personal to the person. They take ownership of the session which is as it should be, they are the expert in their own lives.”

Physiotherapy “Online consultations are ideal for triage or initial consultation to establish clinical need.”

Occupational therapy “Older population are adapting well to video consultation technology… will be using a blended care approach going forward.”

Paediatric care “There is a huge huge difference having patients in their own environment much more relaxed.”

Mental health “I see a role for it always, for patients with poor mobility, transport difficulties or any number of reasons. The format is easy to use…”

National Virtual Health Team – Delivering Video Enabled Care (VEC) “You can access the right care at the right time and in the right place and you feel empowered listened to and safe” - HSE Corporate Plan 2021 'Our Aim'

HEALTH MATTERS WINTER 2021 | 51

COLOSTRUM HARVESTING HELPS MUMS GET OFF TO BETTER START An initiative at Sligo University Hospital to help breastfeeding mothers was launched to coincide with National Breastfeeding Week

Sabina Higgins; Marla Kennedy, CMM2 Antenatal Education, Sligo University Hospital; and Meena Purushothaman, HSE Assistant National Breastfeeding Coordinator.

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he antenatal education team in Sligo University Hospital are distributing Colostrum Harvesting Packs to pregnant women as a way to increase breastfeeding initiation rates. The packs, which were launched by breastfeeding advocate Sabina Higgins, contain storage syringes, labels and an information leaflet with a link to an information video. The video instructs women on how to hand express, collect and store colostrum which is so beneficial for newborn health.

Women who can express and store colostrum before their baby is born will have the peace of mind of knowing that if they have to be separated from their baby immediately after the birth, their baby will still have a supply of breastmilk and the risk of supplementing with formula is reduced.

Antenatal expressing of colostrum can assist in the promotion of successful, exclusive breastfeeding for women and their babies.

Colostrum is produced at around 20 weeks of gestation and it is generally safe for women express colostrum at either 38 weeks or two weeks from their expected delivery date. It is normal to express tiny amounts of colostrum but it has immense health benefits for women and their babies for the rest of their lives.

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In launching the packs, Marla Kennedy CMM2 Antenatal Education, Sligo University Hospital, said, “In our hospital we believe that empowering, enabling and protecting the breastfeeding journey is of the upmost importance. Breastfeeding comforts a new baby and also helps prevent against common infection and illness. We are delighted to make Colostrum Harvesting Packs available to women attending Sligo University Hospital and we encourage pregnant women to come to a breastfeeding preparation class where our midwifes and lactation specialists will answer any questions you have.”

Sligo mum Katie Loftus and baby Louis

SLIGO ANNOUNCES ITS PLAN TO BECOME MORE BREASTFEEDING FRIENDLY An exciting new initiative, Sligo’s ‘We’re Breastfeeding Friendly’ was launched to coincide with National Breastfeeding Week.

Breastfeeding publically in Ireland is protected by law and no person or premises can deny you the right to feed your child. ‘We’re Breastfeeding Friendly’ Sligo aims to improve the health and wellbeing of breastfeeding mothers, babies and their families by encouraging businesses, organisations and communities to go the extra mile and become even more ‘Breastfeeding Friendly'. Speaking at the launch, Katie Loftus, a breastfeeding mother from Sligo, welcomed the initiative. “I’m really pleased that Sligo Town and County have adopted this campaign. This is a hugely positive and progressive move and it makes me much more confident that I can feed anywhere when I am out and about with my baby,” said Katie. This sentiment was echoed by another breastfeeding mum, Lorna Hanmore, also from Sligo, who said, “It’s so important for mothers to see other mums breastfeeding, to make this normal.” By signing up to ‘We’re Breastfeeding Friendly Sligo’, private, community and statutory organisations across Sligo can show they welcome and support breastfeeding by some easy and zero-cost actions. Any business, community group or organisation that has premises open to the general public is eligible to join. Hotels, community centres, sports and recreation facilities, cafes, restaurants, libraries or health centres can all fall under the breastfeeding friendly banner.

BELOW: Maeve Whittington, Breastfeeding Friendly Steering Group; Liz King, Steering Group; Liz Martin, Steering Group; Cara O’Neill, HSE Head of Health and Wellbeing CHO1; Frank Feighan, Minister of State for Public Health, Wellbeing & the National Drugs Strategy; Kate Donnelly, Steering Group; Sarah Murphy, Project Coordinator.

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he HSE wants to ensure that all parents, whichever way they feed their baby have access to accurate and effective information free from the influence of marketing. Health service staff are already playing an important role in providing evidenced-based impartial information for parents.

The new HSE policy on marketing of breast milk substitutes outlines we can ensure that we do not undermine breastfeeding, protect ourselves from conflict of interests and take active measures to eliminate the advertising of breast milk substitutes within the HSE, within our workforce and HSE facilities.

This means working to ensure that there is no advertising of any of the following to mothers and their families: • formula milks • baby foods marketed for use before 6 months (eg cereals, baby teas, juices) • bottles • teats • soothers As a healthcare worker, what do you need to consider?

All public health service staff should be aware of the International Code of Marketing of Breast-Milk Substitutes and

NEW HSE POLICY ON MARKETING OF BREAST MILK SUBSTITUTES Health service staff play a key role in providing evidence-based and impartial information for parents the various ways companies will attempt to promote their brand. The HSE have produced a guide to help you use the Code in your day to day work. Companies use a variety of marketing techniques to grow their markets, including development of follow on formula products, crosspromotion, digital marketing, and forming alliances with health professionals. The various ways in which companies will attempt to promote their brand through the health services are; • through the procurement and distribution of infant formula • distributing company information on products to staff • provide parents with information on infant feeding, e.g. helplines, leaflets • engage staff through company representatives

• staff receiving invites to attend or speak at study days or events sponsored by companies • provide parents with any resources from commercial companies, e.g. websites, samples • engage in or are associated with infant feeding research and/or research sponsored by companies.

The HSE policy on the marketing of breast milk substitutes in the public health services and the guide for staff are available at www. hse.ie/nhcp.

Eliminating industry marketing practices across our public health services is another important step for ensuring all children, regardless of feeding method get the best possible start in life and for promoting, supporting and protecting breastfeeding in Ireland.

BREASTFEEDING PHOTO EXHIBIT OPENS AT UHW

LEFT: Senior staff nurses in the UHW Neonatal Intensive Care Unit Marie Claire Skehan and Eveleen Herron at the launch of the exhibition. RIGHT: Claire Bulfin, Lactation Consultant, UHW, and Nicola O’Rourke launching an exhibition of submitted photos of UHW born babies as part of National Breastfeeding Week at the Maternity Department, UHW.

As part of National Breastfeeding Week, an exhibit has been installed at University Hospital Waterford (UHW) based on photos sent in by recent mothers of their babies born there. Organised by recently appointed Lactation Consultant Claire Bulfin, inclusive of donated art works for the Maternity Department’s Expressing and Family Rooms, the exhibit was opened by Nicola O’Rourke, recent mum to baby Rían, and addressed by Paula Curtin, Director of Midwifery, UHW. The launch also featured senior staff nurses in the UHW Neonatal Intensive Care Unit (NICU), Marie Claire Skehan and Eveleen Hearne, who spoke about the starter pack given to mums with all she needs (information and equipment) to get the process of hand expressing started. Speaking about the exhibit at UHW, Lactation Consultant Claire Bulfin said, “The pandemic was a very difficult time for pregnant mothers and of course for new mothers. It is may be in years to come that we’ll become aware of the ‘untold stories’ of many such women during the pandemic.

This exhibit is an acknowledgement, a contribution in that respect.”

HEALTH MATTERS WINTER 2021 | 53

SCREENING ESSENTIAL FOR EVERYONE WITH A CERVIX Abnormal cells detected and treated early after celebrity death raised awareness of benefits of cervical cancer screening for Dublin woman Ruth

MY Y STOR

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ike most people of her generation, 46-year-old Ruth O’Mahony became aware of cervical cancer when English personality Jade Goody was diagnosed with the disease. “I was a fan of Big Brother and I remember when she died in 2009. It resonated. At this stage I had two children – the youngest was nine. That story frightened me a lot, and I had it in mind I should have gone for screening at some point,” says Ruth.

In the summer of 2009, with the National Cervical Cancer Screening programme

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Ruth O’Mahony

CervicalCheck still in its infancy, Ruth had her first screening test.

“The nurse phoned me to say they weren’t happy with the results of the test. I had precancerous cells. She was reassuring on the phone but said I did need to go to the colposcopy clinic in Cork. This was arranged for me and a week or two later I had an appointment in St Finbarr’s. I met the consultant and he was very good at

FIND OUT MORE www.hse.ie

explaining what was going on,” said Ruth About six in every 10 people who go on to colposcopy after cervical screening will have abnormal cells detected in their cervix.

These abnormal cells are called ‘cervical intra-epithelial neoplasia’ or CIN. CIN is not cancer, but there is a risk it could turn into cancer if left untreated. Ruth’s consultant told her it was likely she had CIN3 – which meant there was a high chance the cells

would become cancerous, and treatment to remove them was recommended.

“My consultant said it had to be dealt with as quickly as possible. He explained that if I had let it go for a number of years, it was highly likely the abnormal cells would turn into cancer. I felt I was very, very lucky. If I had continued to do nothing, and not go for screening, I would have been in trouble.

I would have been dealing with cervical cancer and worrying about my children… I was very relieved I had gone for screening,” she said.

The biopsy confirmed that Ruth had CIN3, and she had a LLETZ procedure to remove the cells. “At my follow-up six month screen I wasn’t given the all-clear. But by September 2010 my result was clear and I have been going for my follow-up screens since.”

Ruth is a member of LINC – the lesbian and bisexual women advocacy group based in Cork. The group has been involved in the creation of a new report from the National Screening Service entitled LGBT+ Cervical Screening Study.

LGBT+ CERVICAL SCREENING STUDY EXAMINES KNOWLEDGE OF AND PARTICIPATION IN CERVICAL SCREENING IN IRELAND

The National Screening Service, in September, launched its report entitled LGBT+ Cervical Screening Study, in partnership with LINC - a nongovernmental organisation working with lesbian and bisexual women and their families, and CervicalCheck – the national cervical screening programme. The study examined the knowledge of, attitudes towards, participation in, and experiences of cervical screening in Ireland. It was open to lesbian and bisexual women, trans men, non-binary, and intersex people. Approximately 450 people who identify as LGBT+ took part in this study, between October 2020 and March 2021. It was found that while the majority have said they had positive experiences of cervical screening, only about two thirds (or 66%) of people said they attended cervical screening regularly. This compares to 80% attendance by the general population. Dr Sarah Fitzgibbon, Primary Care Clinical Advisor for CervicalCheck said, “One finding that stands out is the inaccurate

“There seems to be quite a number of lesbian and bisexual women who think they don’t need to go for screening because they are not having sex with men."

information circulating in the LGBT+ community that cervical screening may not be necessary for them. CervicalCheck invites every person with a cervix in Ireland aged 25-65 years for free cervical screening, every three or five years depending on age. The aim of the programme is to detect abnormalities in the cervix that, if left untreated, could develop into cancer. Therefore it’s important that everyone who is invited attends.”

Anyone with a cervix is at risk from cervical cancer and should avail of regular screening (HSE.ie, 2020). International evidence, spanning more than two decades and from a broad range of countries, demonstrates that lesbian and bisexual (LB) women and gender minorities with a

International evidence shows that lesbian and bisexual women and gender minorities with a cervix have significantly lower rates of uptake of HPV and cervical screening. Ruth tells her experience of cervical screening to friends and people who use LINC’s services, so they know all about their own options for cervical screening. She emphasises the relevance of cervical screening to all women and people with a cervix.

“There seems to be quite a number of lesbian and bisexual women who think they don’t need to go for screening because they are not having sex with men. And just like women in the community as a whole, many also don’t like the invasiveness of the procedure,” said Ruth. “I do describe it as uncomfortable – but that it’s only for a few seconds. I have found it difficult to convince even close friends – I have one friend who has never been for screening – but I do tell my story to people… what I could have been dealing with if I hadn’t gone for screening.”

cervix (GMC) have significantly lower rates of uptake of HPV and cervical screening. This study sets out to examine the situation in Ireland against this backdrop. Dr Nóirín Russell, Clinical Director, for CervicalCheck, said, “Following the publication of this report, CervicalCheck is committed to a number of actions, such as: increased training and supports for sample takers; inclusion of and communication with the LGBT+ community in cervical screening; more targeted messaging and campaigns for the LGBT+ community, working in partnership with the people we care for in screening; and further research.” We look forward to implementing these recommendations alongside our partners in LINC and the wider LGBT+ community.

HEALTH MATTERS WINTER 2021 | 55

BREASTCHECK CAMPAIGN

FOR BREAST CANCER AWARENESS MONTH Around 3,700 women are diagnosed with breast cancer in Ireland every year

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he COVID-19 pandemic has taught us to change our habits and take precautions on a daily basis. But what else are we doing to protect our long-term health and wellbeing?

October was breast cancer awareness month. Breast cancer is the second most common type of cancer among Irish women.

Around 3,700 women are diagnosed with breast cancer each year in this country.

Our BreastCheck campaign for October 2021 encouraged women to check for lumps or physical changes in the shape, skin or size of their breasts, and to go straight to the GP if any changes do occur. As the risk of breast cancer increases significantly with age, women over 50 need to be particularly vigilant.

The campaign explained that women aged 50-69 are eligible for BreastCheck, the national free breast screening service, and despite the pressure the COVID-19 pandemic has put on the health service, screening appointments are taking place.

Routine breast screening for those aged 50-69 has been proven to be the most effective way to detect breast cancer at an early stage, even if you have no physical symptoms.

The campaign ran across multiple communications channels. We had a partnership with RTÉ, which included ads and editorial in the RTÉ Guide, articles on RTE.ie and two slots on the Today Show.

Advertorials ran in national newspapers during October and November, and we also had online video ads as well as social media and paid search advertisements.

We informed women that there are protective measures in place at all BreastCheck locations and staff have been vaccinated to ensure the safety and security of women availing of the service.

Radiographers and doctors will be wearing some PPE and women are required to wear

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The Today Show on RTÉ do a segment with the BreastCheck team.

a mask for their appointment.

As areas have to be disinfected between each screening appointment, we explained that women may be asked to wait outside until it's time for their appointment. Wait times might be a little longer than normal, and friends and family are not able to come inside on the day.

Our campaign informed women how they can play a part in their own breast health.

Women should check the BreastCheck screening register to make sure their details are correct, as we will send a letter when it’s time for their appointment. They will also receive a reminder text message from ‘Swiftqueue’ a few days before their appointment.

If women can’t make their appointment, we are asking them to get in touch with the

screening unit on their invite letter to reschedule. This means BreastCheck can offer the appointment to someone else in their community.

We are letting women know that if they’ve been waiting for an appointment but haven’t received an invitation yet, this is because their appointment may be delayed by up to at least a year due to the COVID-19 pandemic.

Women who have been waiting the longest will be screened first.

For a while, Ireland will be more in line with England which screens women every three years, but we are letting women know that BreastCheck aims to return to screening every two years as soon as possible. We ask women waiting for their appointment to continue to be aware of symptoms and contact their GP for advice.

FOR MORE INFORMATION AND TO CHECK YOUR DETAILS ON THE REGISTER, visit breastcheck.ie or Freephone 1800 45 45 55.

ADOLESCENT, YOUNG ADULT CANCER CARE ARE WE THERE YET?

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National Cancer Control Programme appoints new Clinical Lead

ach year some 400 – 450 people under the age of 25 are diagnosed with cancer in Ireland. There is almost an equal split between the children (0-15 years) and AYA (16 – 24 years) group. While studies have shown that paediatric and older adult cancers have seen a large increase in survival rates, the same cannot be said for some specific adolescent, young adult (AYA) cancers. AYAs with cancer are a diverse group and face many challenges. These challenges include access to ageappropriate oncological care and representation in clinical trials. They also face short and long term health and psychosocial issues. These issues can include fertility considerations, transition to survivorship care and psychosocial support. Difficulties following a treatment plan can often be a challenge for this group.

National Cancer Strategy

The National Cancer Strategy [2017 – 2026] recognises the unique and distinct needs of AYA cancer patients in Ireland. It sets out specific recommendations to address this health disparity: • Recommendation 26. The HSE will ensure that an age appropriate facility is designated for adolescents and young adults with cancer within the new children’s hospital.

• Recommendation 27: The HSE will develop closer links, on a hub and spoke model, between the National Centre for Child and Adolescent Cancer and the other designated cancer centres to provide appropriate and flexible transition arrangements for adolescents/young adults. This will include the joint appointment of adolescent/young adult oncologists and haemato-oncologists and the provision of age-appropriate psychosocial support for these patients.

• Recommendation 33: The HSE will oversee the further development of children’s palliative care to ensure that services are available to all children with a life limiting cancer

Professor Owen Smith

Progress

The National Cancer Control Programme (NCCP) appointed Professor Owen Smith as the National Clinical Lead for Children and Adolescent/Young Adult Cancers in early 2019. He is a Professor of Paediatric and Adolescent Medicine at University College Dublin. He is also a Consultant Paediatric Haematologist at Children’s Health Ireland at Crumlin and Chief Academic Lead to the Children Hospital Group.

Following his appointment, Professor Smith and colleagues from the NCCP convened the Children, Adolescents and Young Adult Clinical Leads Group. This group focuses on the specific needs and risks of AYA cancer patients. The group’s aim is to improve the care and outcomes for this group over the lifetime of the Strategy. It meets on a regular basis and continues to give of their time, knowledge and expertise and consists of healthcare workers, patient advocacy and support groups. Perhaps most importantly, the group includes survivors of child and adolescent cancer.

Speaking about the next steps, Prof Smith said, “Treating AYAs with cancer, is very different from treating cancer in AYAs. Adolescents and young adults undergoing cancer treatment have unique needs that are complex. The NCCP plans to fully implement the recommendations of the strategy. This includes creating a state-ofthe-art integrated AYA cancer care programme to be delivered locally when possible but centralised when necessary, by providing separate facilities and specialist care teams in the new Children’s Hospital and in a number of the eight designated cancer centres around the country. The ultimate aim being is to improve the standards and quality of cancer care provided to AYAs.”

“Treating AYAs with cancer, is very different from treating cancer in AYAs. Adolescents and young adults undergoing cancer treatment have unique needs that are complex."

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FIRST CALL

FOR PROPOSALS ON CHANGES TO SCREENING PROGRAMMES LAUNCHED IN IRELAND

TELL US WHAT YOU THINK ABOUT ...

NSAC Chair, Professor Niall O’Higgins, launched the inaugural NSAC Annual Call on November 1st.

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he National Screening Advisory Committee (NSAC) is an independent advisory committee which advises the Minister for Health about new national population based screening programmes, or changes to existing programmes.

The Committee has launched its first Annual Call seeking proposals from the public on new screening programmes that may be adopted in Ireland, as well as suggestions for changes to five existing programmes, delivered by the HSE and the National Screening Service: BreastCheck, CervicalCheck, BowelScreen, Diabetic RetinaScreen and the National Newborn Bloodspot Screening Programme.

Since its establishment in 2019, the NSAC has made two recommendations to the Minister for Health which are currently being implemented by the HSE: In 2020 the NSAC recommended the addition of ADA-SCID (Adenosine Deaminase Deficiency – Severe Combined Immunodeficiency) to the list of conditions screened for as part of the National Newborn Bloodspot Screening Programme.

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• • • • •

BreastCheck CervicalCheck BowelScreen Diabetic RetinaScreen National Newborn Bloodspot Screening Programme • New screening programmes The call will remain open until Thursday, December 23rd 2021.

If you have any questions on how to submit a proposal, please get in touch with the NSAC Secretariat by email NSAC_Annual_Call@health.gov.ie

The NSAC also recommended the modification of the Diabetic RetinaScreen - the National Diabetic Retinal Screening Programme in 2020, to extend the interval between screens from one to two years for people with diabetes who are at low risk of retinopathy. This change will reduce unnecessary clinic visits and examinations for lower risk patients.

However, the Annual Call is the first time that the public and professionals alike can make proposals to the Committee.

At the launch of the Annual Call the Chair of the NSAC, Prof Niall O’Higgins, said, “The

Committee is excited to move into the newest phase of its important work by launching the first annual call for proposals for changes to screening in Ireland.

“This call gives the public an opportunity to contribute to the work programme of the Committee as it considers the possibility of introducing new programmes or indeed in making changes to our existing population- based screening programmes.

“There is abundant and convincing evidence from around the globe that screening for many diseases can aid prevention, early diagnosis and treatment which can reduce death rates, prevent illness and improve quality of life for people.

“It is very important that we consider these matters within a rigorous, scientific process in an open, transparent and inclusive way so all members of society can have an input.”

The Minister for Health Stephen Donnelly was delighted to welcome the launch of the Annual Call and encouraged anyone who has a proposal for a new screening programme or changes to one of our existing programmes to take this opportunity to make a submission, noting that it is really important that the NSAC hears from the public and patients as we strive to develop policy in relation to screening in a transparent and inclusive manner.

There is still time to make a submission to the NSAC and the Committee are encouraging anyone with a proposal to engage with this process.

Detailed information on how to make a proposal to the Committee can be found on the NSAC website www.nsacommittee.gov.ie

MENTAL HEALTH

MENTAL HEALTH PROBLEMS IN TRAVELLER COMMUNITY HIGHLIGHTED

BY NEW REPORT

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new report highlights the mental health problems faced by the Traveller Community in Co Wicklow.

This Co Wicklow Traveller Mental Health Report 2019 presents the findings of a local peer-led survey which was developed by the Co Wicklow Traveller Mental Health Steering Group. 133 adult members of the Traveller Community in the county took part in the survey in 2019 which was conducted by staff working within Co Wicklow Traveller Primary Healthcare Project and the Daish Project in Bray, the majority of which were also members of the Traveller Community living in the county.

In many key areas, such as depression, stress, and anxiety, the report identifies a prevalence significantly higher than that of the general population. Alcohol dependence, particularly among males, is also above the national average. All but three participants associated mental health as something negative in an open ended question.

Suicide is sadly a major issue within the Traveller community. An astonishing 42%

ABOVE: Linda Moore, Head of Mental Health Service, HSE Community Healthcare East.

CARE AND REPAIR SCHEME MAKES HOMES SAFER FOR OLDER PEOPLE Supported by Cork Kerry Community Healthcare through Cork South Community Work Department, a pilot hospital discharge programme started in Cork in 2020 with the aim of supporting people to make their home safer following a hospital stay. In 2021 the need to expand the service was clear and when HSE agreed to provide national funding for the programme, Age Action launched their expanded Care & Repair programme nationally. Age Action’s Care and Repair does small DIY jobs, free of charge, for older people to help them maintain their homes and their independence.

Operating in Cork, Dublin and Galway, it prioritises carrying out jobs in the homes of older people who are being discharged or have recently been discharged from hospital.

If someone is coming out of hospital, no matter where they live, Age Action would support them to make sure their house is safe. Care and Repair can remove trip hazards, install handrails, replace toilet seats or move a bed downstairs to make sure the home is ready for their return.

of Travellers’ in the survey have been affected by suicide. 34% know a family member who has attempted suicide or has had thoughts of suicide.

The results of the survey show a need for increased awareness of both mental health in general, including psychoeducation, as well as of mental health services available and how to access them, in particular for those of the younger age groups. They also stress the community’s wish to have services that are culturally appropriate and local.

The launch was hosted by Jim O’Brien, chair of the County Wicklow Mental Health steering group and the report was launched by Linda Moore, Head of Mental Health Service, HSE Community Healthcare East.

While the results of the survey were compiled in February 2020, the publication of the report was delayed due to the COVID-19 pandemic.

The information will guide the Mental Health Steering Group in developing specific actions to support the mental health needs of the community. In addition, it will be used to update projects and services on the local situation regarding Traveller mental health and will identify issues, needs and gaps as well as what is working well. It will also provide information on the current position of Travellers in relation to mental health.

TO ACCESS THE SERVICE, an individual, their representative or health care professional can contact Age Action’s Care & Repair requesting the service. An Age Action representative will contact the individual or their representative to make arrangements to gain access to the home to carry out the requested job. You can get in touch between 9am and 5pm Monday – Friday by calling Age Action on 0818 911 109 Alternatively, if you are a professional working with older people who would benefit from this service you can complete the referral form available on www.ageaction.ie and send it to careandrepair@ageaction.ie

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COMMUNITY HEALTHCARE NETWORKS Support people to live in their homes for longer

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key goal of the Enhanced Community Care (ECC) programme is to deliver more services closer to people’s homes or in their communities. It aims to provide more services through general practice, primary care and community-based services.

As part of this 96 community care networks are being established across the country. Each network will serve a population of about 50,000 people.

Networks will provide the foundation and structure for the delivery of integrated care. Delivery of this care will be near to patients and at the appropriate level of complexity. GPs, health & social care professionals, nursing leadership & staff will be able to respond to community needs, in an integrated way.

The Integrated Care Programmes for Older People and Chronic Disease has shown improved outcomes. Particularly among older people who are frail and people with chronic disease, in terms of their diagnosis and ongoing care. The model of care allows the specialist multidisciplinary team to engage with services at a network level.

Implementation of these models is happening at scale. Thirty Community Specialist Teams for Older People are in place. A further thirty Community Specialist Teams Chronic Disease are also in situ. These specialist teams support networks and GPs to respond to the needs of the local population. The teams bridge and link the care pathways between acute and community services. This means improved access to and from acute hospital

ROLE OF THE NETWORK MANAGER

Each of 96 Community Healthcare Networks (CHN) will have a Network Manager.

They are responsible for the delivery of primary care services in each Network.

They will be the operational line manager for staff in primary care teams. This includes physiotherapists, occupational therapists, speech & language therapists, podiatrists, dieticians and social workers. Therapy Managers will continue to provide clinical supervision and governance to the clinical teams. The Network Managers work with the GP Lead, HSCPs and Assistant Director of Nursing and the multi-disciplinary team. Their goal is to meet the needs of people living in the local network area. Alice McGinley, Community Healthcare Network Implementation Lead, said, “Despite the impact of COVID-19 and the cyber incident, we are making significant progress in achieving our key milestones.

We are recruiting many new posts in each of the 96 networks. Some 39 Network Managers are already in place. Recruitment of GP leads into the networks is also under way.” The HSE is committed to learning from the role out of this transformative CHN model. This ensures that the rollout is being conducted in a safe manner, with as little disruption as possible to existing services. There is a particular focus on nine selected learning sites. These learning sites form part of the structured evaluation process agreed with our Trade Union partners.

Learning from these sites will inform any future development of the model.

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MAURA GILLEN Community Healthcare Network Manager CHO1, Inishowen The Inishowen network learning site is now “live” since mid-September. Work on the Network Operational Model of allocating clinical and operational management of staff has begun. There have been extra posts across all therapy services including nursing. The process of assigning skill mix within the Network is complete.

ANNE KENNEDY Community Healthcare Network Manager CHO2, Tuam, Athenry & Loughrea Excellent staff were working in the community in my experience and with the additional posts coming to the network we are enhancing community care and therefore enhancing patient care.

services. ECC is also implementing Community Healthcare Network initiatives in Health and Wellbeing. For example, the coordination of volunteer and community supports in networks linked to the community call model.

Implementation of this new model and for the new teams to be operating at full capacity will take time. But, we are making progress. Our next milestone is establishing teams with leadership roles and core staff.

The teams will always be working to ensure that people are receiving integrated care. Currently, we are recruiting extra staff and implementing new integrated pathways of care.

Network Managers in the nine learning sites share their experiences

MARIE BOYLE Community Healthcare Network Manager CHO3, South Limerick City Primary care team engagement is of great value. Two engagement sessions have enabled me to ascertain the ‘As Is’ current model of care. Integrating nursing and HSCP and engaging with GPs are seen as a priority. GP lead Dr Geaney has joined the team and met with staff at Primary care team engagements.

GRAINNE KELLY Community Healthcare Network Manager CHO 7, Ballyfermot & Palmerstown One of the positives has been the establishment of the network management team. The conversations and planning at these meetings has been very open, honest, productive and assistive in the implementation of the CHN model. Staff attending comment on how they have come away from these meetings energised and committed to the changes needed to be made for improved healthcare delivery.

NEVILLE COEN Community Healthcare Network Manager CHO 5, North Kilkenny The enthusiasm of the patient facing staff in working groups and focus group meetings, relating to real changes in the network working dynamics and patient services is palpable. Without this, nothing would change. My GP Lead is pivotal in the roll-out of the integration of Primary Care Networks and GPs.

KATHY WALSH Community Healthcare Network Manager CHO 6, South East Wicklow Through the collaboration and support of the therapy managers, nursing colleagues, clinicians, administration and GP Lead in the network, we have achieved many of the key communication targets identified from our stakeholder engagement, for example Clinical Team Meetings, Staff Directory, PC Service Directory, Referral Pathway foundation.

Our next focus is building our vision for needs-led, client-centred services.

DEIRDRE CULLEN Community Healthcare Network Manager CHO 4, Bandon, Carrigaline, Kinsale Our monthly Network Management meetings allow us to bring key areas of concern so we can share ideas and help with any on-going issues. This forum with Network Manager, Network Coordinator, GP lead and the 2 ADPHNs has been very successful. Work is on-going with Therapy Manager Rep and clinical coordinators at local management meetings for more effective leadership at local level.

CORINA GLENNON Community Healthcare Network Manager CHO 8, East West Meath Excellent staff engagement as outlined by a staff member from a recent staff development day: “The opportunity to meet other disciplines face-to-face that I would previously had contact with by e-mail/telephone and learning about what is working well in other areas.”

CAROLINE LAWSON Community Healthcare Network Manager CHO 9, Poppintree, Ballymun, Santry The new Network Operating Model for clinical and operational management of staff has commenced. A dedicated GP Lead is in place. Recruitment of additional posts across therapy services is progressing. We have strong engagement amongst Primary Care Teams.

HEALTH MATTERS WINTER 2021 | 61

T

he National Clinical Programme for Early Intervention in Psychosis (NCP EIP) is a joint initiative between the HSE and the College of Psychiatrists of

Ireland.

The Model of Care (2019) sets out how EIP services should be established across the HSE and the required care standards.

In 2020/21, we were delighted to work with the National Clinical Audit of Psychosis (NCAP) in the UK to initiate the process of extending the NCAP EIP audit into Ireland for the first time.

The National Clinical Audit of Psychosis (NCAP) is a clinically led audit which measures the quality of psychosis care provided to service users across England, Wales and Ireland. NCAP aims to improve the quality of care provided to people with psychosis, by evaluating services against a set of access and care standards. These standards are set out in the HSE Model of Care. In 2020, two early intervention in psychosis teams in the HSE participated in this audit for the first time.

Key findings: In 2020 the audit evaluated complete data on 63 service users across two teams. All service users were aged 18 years and over and were attending a specialist EIP team for the first time. The average age was 36 years with 62% male and 42% female.

• 97% of service users experienced timely access to services, starting treatment within 2 weeks of referral • 57% took up an offer of cognitive behavioural therapy for psychosis (CBTp)

NATIONAL CLINICAL PROGRAMME FOR EARLY INTERVENTION TEAMS IN PSYCHOSIS First National Audit Report of Clinical Standards for Ireland • 51% took up an offer of Family Intervention (FI) • 55% of carers took up an offer of carer-focused education and support programmes • 100% of service users who required it received an intervention for the harmful or hazardous use of alcohol • 92% of service users who required it received an intervention for substance misuse The development of EIP services in Ireland is at an early stage. Nonetheless, this year’s audit findings are very encouraging and indicate that people who can access specialist EIP teams are receiving a quality service. Access to timely expert assessment, psychological interventions and family support were in line or better than those reported in England and Wales.

The National Clinical Programme for EIP is planning to invite additional EIP teams to join the audit in 2022. We will

work with EIP services and the HSE to ensure that standards are achieved in each team. We wish to express gratitude to the teams who have contributed to data collection and analysis, enabling NCAP to generate this first national report for Ireland.

CONTACT THE TEAM Audit Report available here: Royal College of Psychiatrists (2021) National Clinical Audit of Psychosis – Ireland National Report for the Early Intervention in Psychosis Audit 2020/2021. London: Healthcare Quality Improvement Partnership.

Available from: www.rcpsych.ac.uk/ NCAP

Research grants for ADHD studies

ADMiRE (ADHD Assessment, Diagnosis, Management initiation, Research and Education) is the first public specialist ADHD service in Ireland. Set up in September 2018 in South Dublin Linn Dara CAMHS, the primary goal of the ADMiRE Team is to provide excellence in healthcare for children and adolescents with ADHD. The team have developed a psychoeducational website about ADHD www. tcd.ie/medicine/psychiatry/research/adhd/ and there is a strong focus on ADHD research in ADMiRE. This year Jane McGrath, clinical lead in ADMiRE and Associate Professor of Child and Adolescent Psychiatry in Trinity College Dublin, and collaborator Professor Rob Whelan, Trinity College Institute of Neuroscience; and industry collaborator Cumulus Neuroscience, was awarded two large research grants by Science Foundation Ireland and the Trinity Provost Project Award totalling over €650,000 for cutting-edge ADHD research. The research projects aim ultimately to improve clinical management for children with ADHD. The first project focuses on developing a better understanding of the mechanisms by which the commonly used stimulant medication Methylphenidate, or ‘Ritalin’ reduces ADHD symptoms. The second project aims to develop a computerised measure that will allow clinicians to predict whether a child is going to respond to stimulant medication for ADHD or not. These two projects have the potential for significant positive impact in a number of areas including health and wellbeing, international engagement, as well as the Irish economy and society. The projects aim to develop an objective measure to aid clinicians, patients and parents in choosing appropriate treatment options, therefore reducing negative outcomes associated with poorly-managed ADHD and facilitating delivery of personalised medicine. These projects will grow research interest in ADHD, will build research capacity in Ireland, and will refine the delivery of commercially-viable technologies, positioning Ireland as a leader in an under-researched but high-impact area.

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T

he United Nations Interagency Taskforce (UNIATF) award recognises the Chronic Disease Management (CDM) programme’s work to develop the ‘GP Chronic Disease Contract and rolling it out despite the COVID-19 pandemic’. The Irish College of General Practitioners (ICGP) nominated the CDM programme for an award.

Commenting on the award, HSE National Clinical Advisor and Programme Group Lead for Chronic Disease, Dr Orlaith O’Reilly said: “It’s an honour to see the CDM Programme recognised in this way. The CDM Programme works with GPs across Ireland to prevent and manage patient chronic diseases using a population approach. Before this Ireland had no formalised structure for Non Communicable Diseases (NCD) management in primary care. We remain committed to the roll-out of this programme.

“The CDM programme provides a structured management programme for people with a history of cardiovascular disease, COPD, asthma and type 2 diabetes in general practice. It focuses on prevention, patient empowerment, early diagnosis and intervention, multi-morbidity and the provision of care as close to home as possible.

“The programme emphasises lifestyle and medical risk factor control, disease management and the creation of a patient care plan. The GP in partnership with the patient works to develop this plan. We rolled out an ITissolution, embedded in What a chronic general practice, which provides decision disease? support for NCD management. It also gives A chronic disease is a long-term health real-timecondition returnthat of needs dataongoing to a central treatment data and management. repository.

This supports service planning and quality improvement initiatives in Benefits of the primary care,” she added. programme The CDM programme supports GPs to is designed so thatwith you identify The andprogramme manage patients, a and your GP (family doctor) can work together monitor condition and medical card or toGP card,your who are at risk of identify the best way to treat it now. chronic disease or who have been diagnosed with one or more specified The Chronic Disease chronic diseases.

Treatment Programme Pat Healy, National Director, HSE Clinical supports you by Programme Implementation and providing: Professional Development said: “I am set reviews of your chronic disease delighted• that the work of the HSE with your GP or practice nurse • Chronic a personalised care planManagement that you Structured Disease develop and agree with your GP Programme has been • reviews of your care plan recognised and medicine internationally.

The development and • support you to manage your condition of implementation this programme • early detection of any new conditions happened you because groups and may developof • earlyworking detection of complications institutions collaboratively, in your condition including• the of Health and careDepartment in your community, to your home DPER, theclose IMO, the HSE (Clinical Programmes, Primary Care, ICT, Public

HSE WINS INTERNATIONAL UN AWARD FOR TACKLING CHRONIC DISEASE The HSE Chronic Disease Management (CDM) programme has scooped an international award for developing a structured illness and preventative care programme in general practice. The aim of the programme is to reduce morbidity and mortality from Non Communicable Diseases (NCDs).

Health doctors and managers), the GPs, practice nurses and the wider practice teams. It was to launch in March 2020, just as the COVID-19 pandemic spread to Ireland. But rather than pause the programme, and recognising the syndemic of NCDs and COVID-19, we accelerated the roll-out of the programme. We expanded the initial age cohort. We also brought remote consultations on stream to protect our most vulnerable patients.

“GPs have played a significant role in the role out of the CDM programme. Over 85% of GPs in Ireland have registered to provide

the programme to date. Between March and December 2020, GPs and practice nurses undertook over 119,000 consultations for people aged over 70 years. Programme data shows that 90% of people with these conditions are being managed solely in general practice for their NCDs.” A significant part of this programme is Making Every Contact Count. This focuses on interventions relating to tobacco, alcohol, sedentary behaviour and obesity or overweight. Year one data shows that smoking status, BMI and blood pressure were examined in over 90% of all consultations.

What is a chronic disease?

A chronic disease is a long-term health condition that needs ongoing treatment and management.

Benefits of the programme The programme is designed so that you and your GP (family doctor) can work together to monitor your condition and identify the best way to treat it now.

Chronic Disease Treatment Programme

The Chronic Disease Treatment Programme supports you by providing: • • • • • • •

set reviews of your chronic disease with your GP or practice nurse a personalised care plan that you develop and agree with your GP reviews of your care plan and medicine support you to manage your condition early detection of any new conditions you may develop early detection of complications in your condition care in your community, close to your home

Order code: HPC01327

Order code: HPC01327

HEALTH MATTERS WINTER 2021 | 63

Chr Dise Trea Pro

METHADONE MAY PROTECT AGAINST COVID-19

Researchers Dr Eamon Keenan, Dr Marie Eagleton, Siobhan Stokes and Dr Fiona Fenton.

HSE research examines why COVID-19 infections in people being treated for opioid addiction is lower than expected

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N

ew HSE research by Dr Marie Eagleton, Siobhan Stokes, Dr Fiona Fenton and Dr Eamon Keenan of the National Drug Treatment Centre examines why COVID-19 infections in people in treatment for opioid addiction is lower than expected. At the start of the pandemic last year, it was assumed that people in receipt of opioid agonist treatment (OAT) would be more vulnerable to COVID-19. Due to

impaired immune systems and prone to underlying health conditions, many felt that people in treatment for opioid addiction were more at risk of the virus.

Crowded living conditions and maintaining social distancing were also seen as challenge. Restrictions in support services due to staff shortages or public health guidelines were additional concerns.

Yet published research from the HSE shows the number of people in receipt of OAT testing positive for COVID-19 was lower than expected.

While the Public Health guidelines and contingency planning for those in receipt of OST contributed to this outcome, research by the National Drug Treatment Centre and the National Social Inclusion office points to other factors.

Initial research in April explored the possibility that drugs used for OAT such as methadone may protect against the disease.

A follow-up cross-section observational study was carried out with patients on OAT at the National Drug Treatment Centre. The Irish Journal of Medical Science published this research in August 2021. In this study, only a few of the 524 patients displayed signs or symptoms of COVID-19 throughout the pandemic. A small number of patients tested had antibodies to the virus.

Research published this autumn explores how long-acting opioids could improve the immune response to the virus. Researchers suggest that longacting opioids may help in preventing and treating COVID-19.

Speaking as one of the co-authors, Dr Eamon Keenan, Clinical Lead, HSE Addiction Services, said, “These important pieces of research carried out during the COVID- 19 pandemic are further examples of collaborative working between disciplines that was a hallmark of the response in this country. An observation from clinicians of low rates of infection among those in receipt of Opioid Agonist Treatment was discussed with biochemists working in the laboratory at the National Drug Treatment Centre.

“A hypothesis was produced postulating the potential protective and therapeutic effects of these drugs in respect of Covid 19 infection. Reinforcing this, a cross-sectional observation study was published by the National Drug Treatment Centre. This research has important implications for the scientific community and warrants further examination.”

NEW NMH WEBSITE TO HELP PARENTS OF INTENSIVE CARE BABIES The National Maternity Hospital (NMH) has launched a comprehensive, educational site www. nmhnicu.ie, which is dedicated to supporting parents with babies in the neonatal intensive care unit and their families. The site was funded by Rethink Ireland through The NMH Foundation.

The NMH Neonatal unit is recognised as a centre of excellence for the care of premature babies and is one of four tertiary level NICUs in Ireland. The NMH NICU and its specialist neonatal multidisciplinary team care for nearly 1,500 premature babies from all over Ireland each year.

The remarkable website is a collaboration between NICU clinicians and its multidisciplinary team who updated and expanded previous paper-based resources for parents to provide an optimal online resource to guide parents through their precious baby’s journey through the neonatal unit. The information contained within the site represents the knowledge, expertise, and experience of a highly committed group of neonatal healthcare staff including doctors, nurses, midwives, dieticians, physiotherapists, pharmacists, psychologists, clinical engineers, and social workers. The team focused on ensuring that the resource communicates clearly and in an easy-to-understand manner.

Speaking at the launch of the resource at the hospital today, Professor John Murphy, Consultant Neonatologist, said, “This website has been an exciting development for the hospital and is the result of tremendous work by our multi-disciplinary team. The aim of the website is to provide parents with clear information on care and treatments that are being administered to their baby. The layout of the website provides an illustrated guide of the baby’s NICU journey and informs parents on how they can interact with their baby during their time in NICU. There are also sections on how to prepare for taking baby home and extensive advice on how to manage baby at home after discharge.” www.nmhnicu.ie was developed specifically for parents of babies who are or who may be admitted to a neonatal unit, to help them to understand the challenges their babies face while in a NICU and to give them the skills and confidence they need to be an integral part of their baby’s care from day one. The NICU team in The NMH is deeply grateful to those parents who have participated in the development of this resource for use by other parents whose babies in the future may need to be admitted to a NICU. They have contributed enormously to the understanding and continuous improvement of patient experience and neonatal outcomes at The NMH.

‘IF YOU GO, GO SLOW’

Drugs.ie has launched a new initiative reminding people who choose to use drugs ‘If You Go, Go Slow’.

The campaign, aimed at young people who use club drugs, promotes harm reduction messages about emerging drug trends and drug market concerns.

Robbie Kitt, Dublin DJ and musician; Somhairle Brennan, USI Welfare Officer; Fionnuala Moran, RTÉ Pulse Radio presenter; Dr Eamon Keenan, HSE National Clinical Lead Addiction Services; Sophie Ridley, Event Safety Controller; Craig Connolly, Director at District; and Nicki Kileen, HSE Social Inclusion.

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o launch the campaign, a community of key stakeholders came together to consider safer nightlife responses, with insights from panelists Nicki Killeen, HSE National Social Inclusion Office; Sophie Ridley, Event Safety Coordinator; Robbie Kitt, Dublin DJ; Somhairle Brennan, Welfare Officer, Union of Students in Ireland; and Craig Connolly, Director at District, who was also on the Emerging Drug Trends and Drug Checking Working Group 2021.

Speaking at the campaign launch, Nicki Killeen said, “The reopening of nightlife is an exciting time, but we are concerned that people may be at greater risk due to time off from using drugs, as tolerance levels may have changed. This means they could be at a greater risk of overdose. While it’s safer not to use drugs at all, we want to remind people of the practical steps they can take to reduce the harms to their health.”

This campaign is based on recent recommendations from the HSE ‘Emerging Drugs Trends Report Working Group Report 2021’. The report reviews drug use and health responses among people who use drugs in nightlife spaces. It recognises that an emerging stimulant and polydrug culture among new user groups is currently a major issue of concern across Europe and here in Ireland.

Dr Eamon Keenan, HSE’s National Clinical Lead, Addiction Services, said, “Our report identifies a need to improve research and develop new services in response to these trends. Nightlife outreach and drug analysis are recognised ways in which we can engage with young, hard to reach populations. This campaign is an important step forward to improving the provision of information and support to young people to minimise the harms to their health.”

Leaflets, factsheets and posters were designed to appeal to the nightlife community by illustrator Jacky Sheridan. New video content features three well-known DJs discussing their experience of Irish nightlife from their ‘View from the Booth’. The emphasis is on creating a conversation around the use and effects of drugs and addressing the social impacts they have. While touching on the excitement of a return to nightlife, the videos emphasise the key messages around risks and harm prevention.

For more information see www.drugs.ie/afterlockdown and #IfYouGoGoSlow on social media.

HEALTH MATTERS WINTER 2021 | 65

ARE YOU WINTER READY? r u o y d te a d p u u o y Have SEVERE WEATHER PLAN? HSE Emergency Management Office highlights importance of HSE managers and staff planning for severe weather

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he HSE Emergency Management Office updated the Severe Weather Planning Guidance document in October 2021 which will help HSE managers and staff to develop and update their local severe weather plans. It includes checklists and advice and you will find it at www.hse.ie/emergency management/ severeweather. Given the reality of climate change and the real risk of severe weather events it is vital that HSE managers and all staff plan and prepare so that our ability to deliver health services during periods of severe weather is not compromised.

If you are a HSE manager please check the updated Severe Weather Planning Guidance document and:

• update your existing severe weather plans, include any learnings from 2020 and ensure all your staff are aware of them.

If you are a HSE staff member please ensure:

• you are familiar with severe weather plans for your area or department and discuss these plans with your line manager as needed.

HSE managers have to plan to ensure that all key services are resilient to severe weather and mitigate the impact that it may have on the dayto-day activities of the HSE. We must keep in mind that Severe Weather will not just impact HSE services; it will impact on other associated businesses - those providing service support and those in our supply chain, in Ireland and globally. The format is flexible and has the adaptability to cater for the diverse range of HSE services and facilities.

The document is to provide the individual manager with the freedom to plan within his/her domain without the prescriptive constraint of an imposed template. Each manager is required to address the document and develop Severe Weather preparedness for his/her area of responsibility. New challenges exist such as dealing with COVID-19 requirements, and plans now need to incorporate the associated constraints on service capacity during a severe weather event.

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H S E EMERG EN CY MA N AG EMEN T O F F I C ES CO N TAC T D ETA I L S

HSE staff battling the 'Beast from the East' in February 2018. The huge snowfall had a massive impact on the health services and managers are being urged to make sure their Severe Weather Plan has been updated.

GUIDANCE DOCUMENT

The document includes checklists which are a practical way to support managers and staff to plan for a severe weather event. They cover a range of areas including assessing your starting point, carrying out a risk assessment, communications, preparing for the impact of such an event on staffing and on patients or the people who use our services, Estates and Maintenance and engaging with the Area Crisis Management Teams.

The HSE Severe Weather Guidance will assist individual managers to put in place appropriate measures to deal with the following areas during a Severe Weather event: • Coordination of activities to minimise the effect of Severe Weather • Anticipating the impact of the requirements of COVID-19 on severe weather episodes • Ensuring effective communications systems are in place • Maintaining the delivery of essential services • The implementation of contingencies where necessary • Monitoring and maintenance of adequate phased staffing levels within all clinical and

non-clinical areas, including the redeployment of staff to critical areas where required • Ensuring staff awareness of its service’s contingency arrangements and those of other HSE services during a Severe Weather event.

The document comprises two parts: Checklist and Guidance Document. Neither are standalone and both documents are structured around planning, response and recovery. The Checklist should be completed in association with the guidance provided. The Checklist and supporting documentation can be expanded to include each individual service’s criteria as appropriate. This document should be listed as an appendix to the service’s Major Emergency or Site Specific Emergency Plan and reviewed/updated accordingly. All Area Emergency Management Offices are available to provide managers with support and advice to complete the process of updating existing severe weather plans.

HSE National Emergency Management Office Contact: Assistant National Director for Emergency Management Postal Address: HSE National Office for Emergency Management, Stewarts Care Limited, Stewarts Hospital, Mill Lane, Dublin 20, D20 XT80 Email: nemo@hse.ie Phone: 01 6201658 HSE East Major Emergency Management Office Contact: Chief Emergency Management Officer East Region Postal Address: Major Emergency Management Office, Phoenix Hall, St. Mary's Hospital Campus, Phoenix Park, Dublin 20, D20 CK33 Email: emergency.planning@hse.ie Phone: 01 7959840 HSE South Emergency Management Office Contact: Chief Emergency Management Officer South Region Postal Address: Emergency Management Office HSE South, Eye, Ear and Throat Hospital, Western Road, Cork, T12 WP62 Email: emo@hse.ie Phone: 021 4921622 HSE West Emergency Management Office Contact: Chief Emergency Management Office West Region Postal Address: Regional Emergency Management Unit, Clinical and Administrative Building, Block A, Merlin Park Hospital, Old Dublin Road, Galway, H91N973 Email: emergency. managementwest@hse.ie Phone: 091 775933

HEALTH MATTERS WINTER 2021 | 67

WORLD PATIENT SAFETY DAY Safe Maternal and Newborn Care the theme of 2021 celebrations

contribute to better healthcare. We work in close partnership and collaboration with the HSE and other healthcare agencies in Ireland.”

Peter McKenna, Clinical Director with The National Women and Infants Health Programme (NWIHP), said one of the ‘cornerstones’ of the National Maternity Strategy is patient safety and ‘arguably it could be said to be the most important’.

LEFT AND BELOW: Staff from the Quality & Patient Safety Department, UHL and UMHL who hosted information stands and created awareness with patients, staff and visitors during World Patient Safety Day 2021.

S

afe Maternal and Newborn Care was the theme of this year’s World Patient Safety Day, which took place in September.

World Patient Safety Day is an opportunity to promote healthcare safety, increase awareness about patient safety and recognise the work already under way.

Dr Colm Henry, HSE Chief Clinical Officer, highlighted patient safety as a key priority for the HSE. “We are committed to the implementation of the Patient Safety Strategy and the improvement of quality and patient safety throughout all our services. It has been a tough and unprecedented 18 months, but throughout this pandemic our healthcare staff have adapted to the crisis and have constantly endeavoured to provide the highest quality care possible. For these extraordinary efforts we are grateful,” said Dr Henry.

Dr Orla Healy, HSE National Clinical Director for Quality and Patient Safety Directorate, explained that keeping patients and everyone in our services safe is the priority for all of us who work in healthcare.

“The HSE Quality and Patient Safety Directorate is committed to working with you, our patients and our staff, to make our services as safe as they can be; to acknowledge when things go wrong and to learn and improve our services for all our patients and those in our care,” she said.

Patients for Patient Safety is based on a World Health Organisation initiative that

68 | HEALTH MATTERS WINTER 2021

aims to improve patient safety in healthcare, working in collaboration with the health services.

“We believe that every individual patient experience, from birth to end of life, should have safe care as a core principle,” said Tibbs Pereira, from Patients for Patient Safety.

“Our members have a unique relationship with patient safety issues as a result of our experience. We participate in activities that engage patients as advocates to influence all aspects of patient care. We actively

NWIHP was founded in 2017 in order to drive on the values of the National Maternity Strategy, which came out in 2016.

“We gather information on patient safety from a multitude of sources in the HSE. The only point really of collecting this information is so that we can target resources at making our services safer,” he said.

“Safety is not an add-on to our service.

It is a fundamental core component of it, and this is what we must work to achieve at everything that we do.”

FOR MORE INFORMATION on Patient Safety in the HSE please go to https:// www.hse.ie/eng/about/qavd/patient-safety/

SYPHILIS OUTBREAK SUCESS STORY

Sláintecare and HSE pilot online STI testing service

Ordering Condoms:

In 2021, the HSE Sexual Health & Crisis Pregnancy Programme (SHCPP) piloted an online STI testing service in partnership with online provider SH:24 and integrated with HSE public STI clinics. Individuals who required further testing and treatment were referred to public STI clinics, ensuring a seamless individual experience. The project was piloted in the counties of Dublin, Cork and Kerry, allowing anyone with an address in these counties to order a free STI test to their home.

Nearly 13,749 STI test kits were ordered during the pilot (with almost 5000 test kits ordered in the first 24 hours!)

• 734 STIs were diagnosed (8% reactive rate) • 57% of service users had never accessed a sexual health service before • 99.4% of users rated the service 4 or 5 out of 5 An evaluation report of the pilot is currently being completed. The online STI testing service is currently available in Cavan, Cork, Dublin, Galway, Kerry, Kildare, Laois, Louth, Mayo, Meath, Monaghan, Offaly, Roscommon and Wicklow. Visit sh24.ie to order a test. This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number ID57.

In June 2021 Public Health declared a national outbreak of early infectious syphilis (EIS) and convened an outbreak control team (OCT) tasked with developing and implementing an action plan to address the outbreak. The OCT includes representation from HPSC, Public Health, HSE SHCPP, clinical services, laboratories, antenatal services, NGOs and community representatives. A key response to the outbreak was to increase access to syphilis/STI testing and diagnostics. Three pop-up syphilis testing clinics were run in Dublin in July through a joint collaboration between Public Health, HSE Sexual Health and Crisis Pregnancy Programme (SHCPP), HIV Ireland’s MPower programme, the National Viral Reference Laboratory (NVRL) and public STI clinics. Some public STI clinics made walk-in testing available and the free online/home STI testing service was promoted in the available counties. A communications response was initiated to raise awareness of the increase in syphilis among gay, bisexual and other men who have sex with men (gbMSM) and young people aged 18+ to encourage those who may be at risk of syphilis to get tested. Messages were promoted across HSE Sexual Wellbeing digital channels; and in collaboration with community partners, messages targeting gbMSM were promoted across digital channels, in social venues and on Grindr. The campaign messages for gbMSM and young people 18+ will continue to be advertised across man2man and Sexual Wellbeing digital channels.

FOR MORE INFORMATION Information on syphilis is available here • www.sexualwellbeing.ie/syphilis • man2man.ie/stis/syphilis/ • mpower.hivireland.ie/syphilis/

The National Condom Distribution Service (NCDS) has advised that, following the cyber-attack in May, the usual process to order condoms and lubricant is still not operational. Registered services wishing to place orders can do so by email to owen.brennan@hse.

Please include the following details in your email: • Products and quantities required • Delivery address (including Eircode) • Contact details (Name, email address, phone no.)

If your organisation is not yet registered, please find the application form and Terms and Conditions for use of the service here https:// www.sexualwellbeing.ie/for-professionals/national-condomdistribution-service/terms-and-conditions/

HEALTH MATTERS WINTER 2021 | 69

CHANGE IMPLEMENTATION

DELIVERING CHANGE IN HEALTH SERVICES HSE Organisation Development and Change have developed a new CPD Certificate Programme (12 points).

The CPD Certificate is a collaboration between HSE Organisation Development and Change and the RCSI Graduate School of Healthcare Management (formally RCSI Institute of Leadership). The CPD Certificate is underpinned and supported by the Health Services Change Guide and associated eLearning programme on HSeLanD. Completion of the eLearning programme is a prerequisite to advancing to the CPD Certificate and award recognition.

Once you have completed the eLearning programme you are encouraged to identify a change challenge within your service and apply the learning, knowledge, skills and tools to your service improvement, in collaboration with your service manager and team colleagues. The application of learning to your change challenge can take place over nine months from completion of the elearning programme. You are then required to complete a Learning Review Template which demonstrates how you applied your learning in practice and how you engaged with your service/team.

To apply for the CPD Certificate and 12 CPD Points you need to submit the following documentation: • Completed Learning Review Template • Completed Verification Form signed and dated by the Applicant and Line Manager • Service/date stamp located on the Verification Form or submission made on recognised headed paper • Copy/scan of your eLearning Programme Certificate of Completion from HSeLanD (must be within nine months of the application)

The CPD Certificate - Delivering Change in Health Services is available to all healthcare personnel who wish to develop as change leaders and to lead their teams to introduce innovative practices to deliver better outcomes for service users. It welcomes everyone in health and social care including community and voluntary sectors - nurses and midwives, medical staff, health and social care professionals, business/administrative professionals, leaders and managers, frontline staff and academic faculties. This programme supports professional development within health and social care services. It will also be of interest to change and improvement practitioners and will complement the people approaches for all who currently practice quality improvement, project approaches.

Check out: youtu.be/Q_c6CheSSsQ

Submission dates are February 1st, May 1st or October 1st yearly. Submit your application to Changeguide@hse.ie. Following verification your CPD Certificate will be issued to you by RCSI Graduate School of Healthcare Management/ HSE Organisation Development and Change. Please contact us at 046 9251466 if you have any questions on the process.

Full information on the CPD Certificate Programme is contained here at www. hse.ie/eng/staff/resources/changeguide/change-guide-educational-resources/.

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GOVERNANCE

HSE NATIONAL FRAMEWORK FOR THE GOVERNANCE, MANAGEMENT AND SUPPORT OF RESEARCH LAUNCHED The HSE National Framework for the Governance, Management and Support of Research (RGMS Framework) was launched recently by Dean Sullivan, Chief Strategy Officer. The RGMS Framework is the first key output of the 10-year HSE Strategic Action Plan for Research.

The RGMS framework aims to protect research participants and to support health and social care staff to do research in a very complex ethical, legal and regulatory environment. Health research is crucial to find better ways to prevent and treat diseases and to contribute to improve the way healthcare systems work. Research enables evidencebased practice, and together with innovation, teaching and training, it is key to deliver the best outcomes for patients, carers, service users and their families.

At the launch of the framework, Dr Philip Crowley, National Director of Strategy and Research, said, “As we move towards a system of integrated care, the HSE wants to ensure that research becomes a key enabler of evidence-based practice, which contributes to the delivery of better services and to attracting the best of research active staff, nationally and internationally.”

Dr Ana Terrés, Assistant National Director, Head of Research and Evidence, explained that international evidence indicates that research active health and social care services deliver better care.

“It is therefore in the interests of patients and service users to ensure that the transformation of the health service makes provisions to embed research as part of our normal practice. This has to be done in the context of appropriate governance to ensure that we can guarantee the trust of the public and with appropriate supports for our staff.

This Framework provides the foundation to do just that,” she said.

As outlined in a benchmark report published

by HSE National R&D in 2019 (www.hsereserach. ie), a significant number of clinical and nonclinical HSE staff are engaged in research activities, often involving collaboration with academic partners and other organisations.

Hence, the HSE has an obligation to ensure that research is safe and conducted to the best international standards, and to manage any potential risks.

The RGMS Framework lays the foundation for the performance of good quality research in healthcare organisations, within a context of good governance that is essential to guarantee public trust. The implementation of the framework will develop national cohesiveness with regards to the processes required to manage research activity, creating effective and efficient research management systems that support staff and encourage rather than hinder research.

The framework highlights the importance of patients as equal partners in the research process and the value of patient and public involvement (PPI) in research. Patients, service users, carers, and the public must be given more opportunities to be involved in research as they can help to expand its impact, by helping researchers to focus on issues that are of greatest importance to them and their families.

The HSE National RGMS framework is built around the following key principles: • Research activity needs to be registered and risk assessed before it commences • Research ethical opinion should be independent and separate from institutional governance • Institutional governance for individual research studies should be proportionate to the level of risk, and span the lifetime of the research study • Both ethical and governance approval is

The RGMS Framework and a video of the event are available on the HSE R&D website (https://hseresearch.ie/).

required before proceeding • The roles and responsibilities of the various parties involved in research studies need to be articulated and agreed before the research commences • Research studies need to comply with relevant legislation and regulatory requirements • Oversight is required through the lifetime of the research study • Research participants and patients are key partners in the research process and their opinions and needs should be considered though the life cycle of the research Implementation of the RGMS Framework The implementation of the Framework will take time and require collective effort and commitment from all parties involved. Its implementation will require the reform of the current Research Ethics Committee System, and the establishment of Research and Development Offices throughout the organisation.

These offices will be essential to facilitate effective research governance and collaboration between different legal entities (Section 38 and 39 healthcare providers, academic institutions, charities, industries, etc), and to support staff to navigate the complex regulatory environment of health research. In order to achieve national cohesiveness, there is also a requirement for the development of standard legal agreement and data sharing templates for research, and additional research policies and protocols to streamline, standardise and simplify approval processes. The implementation of the framework will ultimately help embed research as part of organisational practices.

Dr Terrés concluded by noting, “It is acknowledged that the RGMS Framework represents a significant programme of change, but it will act to strengthen a culture of research and innovation in the Irish health service for the good of patients, their families and carers, staff, the public and the economy.”

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NATIONAL INTEGRATED STAFF RECORDS AND PAY PROGRAMME (NISRP) NiSRP preparing to complete implementation in remaining areas in coming months Since mid-2019, the National integrated Staff Records and Pay Programme (NiSRP) has successfully implemented SAP Staff Records, SAP Payroll, SAP time entry and SAP self-service functionality across HSE East and South East, areas which feature more than 30,000 staff and pensioners. My HSE Self Service will be implemented in all the sites already on SAP HR/Payroll.

The sites already on SAP HR/Payroll are the sites that went live with PPARS, noted in green on the map of Ireland and listed in detail below. The areas are the former health board areas North West, Midlands and Mid West. These do not geographically match current structures.

In CHO1, for example, you will see only some counties (Donegal, Leitrim and Sligo) will receive My HSE Self Service in this current implementation.

NiSRP will complete implementation in the remaining counties at a future date: • CHO1 - North West (Donegal, Leitrim, Sligo) • CHO3 - Mid West Community Healthcare (Limerick, Clare, North Tipperary) • CHO8 - Midlands (Offaly, Laois, Longford, Westmeath) • University of Limerick Hospital Group • Dublin/Midlands Hospital Group – Regional Hospitals Tullamore and Portlaoise • Ireland East Hospital Group – Regional Hospital Mullingar • Saolta Hospital Group – University Hospitals Sligo and Letterkenny • Corporate - Staff paid through HSE NW, MW & Midlands • National Ambulance - Staff paid through HSE NW, MW & Midlands • Other National Services – Staff paid through HSE NW, MW and Midlands

What is My HSE Self Service?

My HSE Self Service is an online facility (using SAP software) which allows employees to view or change a range of personal information, request leave and submit travel/expenses claims. Managers use it to approve applications for leave and travel.

What are the benefits?

• Easier access and more control over your own information • Available to you 24/7 online • Eliminates paperwork and streamlines tasks, saving time for both employees and managers

1. Go to www.hse.ie/nisrpselfservice 2. Click on “Register for My HSE Self Service” 3. Complete and submit the form

What can I use it for?

A range of functions will be available to employees such as: • View payslips • View and change personal details • View and change bank details • Apply for various types of leave • Submit travel and expense claims • Apply for travel privileges and update documentation • Run reports on leave and travel expenses

How will I access it?

My HSE Self Service can be accessed by employees using a, desktop or laptop computer with internet access. If you are a manager, you must access My HSE Self Service using an HSE device for security reasons.

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What are the main changes for me?

Employees: • Your payslip will only be available on My HSE Self Service from the go-live date • Staff claiming travel and expenses (subsistence) will now use My HSE Self Service • Staff applying for leave will use My HSE Self Service.

Managers: Managers are those who currently approve leave or travel. They will have access to all the employee features in addition to following functions: • Approving leave and travel • Run report reports on teams leave/ expenses • Access to team calendar

FURTHER INFORMATION AVAILABLE ON healthservice.hse.ie/staff/benefits-services/ pay/online-payslips/

@NiSRP_HR

How can I find out more?

National integrated Staff Records & Pay (NiSRP) are running a series of online demonstrations (webinars) • There are video tutorials and step by step guides on the NiSRP Support site, see below • There are three My HSE Self Service courses on www.

HSELand.ie • There is a NiSRP Helpdesk already supporting employees which will be available to new users. It is available via email and phone which you can use from go-live.

NiSRP Support: www.hse.ie/ nisrpselfservice

Paperless Payslips:

HSE staff transition from paper to online payslips As part of the HSE’s initiative to modernise and improve services, HSE Finance Shared Services are rolling out the transition from paper payslips to online payslips for all HSE employees. The Midwest and Northwest have seen the continued roll-out of this project to all staff in 2021. The expansion of online payslips and its benefits are set to continue early in the New Year with all South Payroll staff migrating online during February 2022. HSE Finance Shared Services are focussed on continuously enhancing the online payslip service. Feedback received from HSE staff has informed the redesign of the Online Payslip staff webpage and the following support information is now available:

• User guides on how to register and log in to your online payslip • Unique webpage for each individual HSE Payroll Area • HSE Payroll Teams contact and support details • Frequently asked questions section Benefits of Online Payslips: • 24/7 access to current and historic payslips • Payslips available the day before your pay date • Print payslips at your own convenience • Option to download and save payslips • Environmentally friendly way to receive your pay details HEALTH MATTERS WINTER 2021 | 73

NATIONAL ESTATES INFORMATION SYSTEM FROM GO, TO GO-LIVE

NEIS was given approval to proceed at the turn of the New Year and what a year it has been

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he NEIS system will provide the tools to strategically manage HSE Capital & Estates’ asset portfolio in line with international best practice.

Business Administration and Quality & Standards will form part of the core of NEIS. The system deploys a cloud-based

solution on a software as a service (SaaS) basis; it will play a key role in building a more sustainable Capital & Estates workforce that has the capacity, ability, flexibility and adaptability to meet the changing healthcare environment.

The project team looks back at their achievements in the first year of delivery and anticipates what’s still to come.

The year began with building a dedicated NEIS team of HSE Capital & Estates personnel together with IT and business support professionals to work with IBM and Oracle on the delivery of NEIS Phase 1A which facilitates the management of Capital Projects and Construction Management.

Initial planning workshops began in February and the pace quickly intensified with full weeks of design workshops beginning in March even as some team members transitioned out of their previous roles.

A cycle of intense design, build, testing and review has continued all year, but good teamwork and focus has ensured that Phase 1A is ‘Go-Live’ since October and available for active use. Pilot projects have commenced on NEIS and training sessions are underway for the first intrepid volunteers.

Introductory information sessions have been delivered to key stakeholders and more information and training will be delivered over the coming months as NEIS is implemented.

A regular newsletter is issuing to HSE Capital & Estates personnel and our new webpage provides further information which can be accessed on HSE.ie.

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WHAT IS IT? The NEIS project is delivering six modules over a 33-month programme: • Capital Projects / Construction Management • Maintenance Management • Medical Equipment • Property Management, • Facilities / Space Management • Environmental & Sustainability Management

2022 looks set to be another intense year of system design, testing and delivery of the next phases of NEIS which will enable operations and maintenance and medical equipment on the system. We are excited to continue our mission to bring digital change and enhanced information management to HSE Capital & Estates.

Partnership will deliver savings on the energy budget & reduce the carbon footprint of Tallaght Hospital Tallaght University Hospital (TUH) has entered a new energy performance contract with Centrica Business Solutions. The 15-year contract will see significant investment in the hospital’s aging infrastructure, reduce energy consumption onsite and reduce the organisation’s carbon footprint. The contract will deliver guaranteed savings of almost €1m in energy expenditure per annum and see a capital investment of over €6m. Overall, the scheme provides for a 70% drop in grid supplied electricity, a 20% saving on electrical consumption and a 26% reduction in carbon consumption. Director of Facilities & Estates Ciaran Faughnan, said, "We want to reduce our carbon footprint and ensure we are using the most efficient means of energy for an increasingly busy and enlarged campus.”

Pictured from left to right at the announcement were Seamus Foran, Head of Project Management Office TUH; Shane Minehane, Head of Business Operations Centrica Ireland; Lucy Nugent, Chief Executive of TUH; Edel Wyse, Director of Carbon & Energy Ireland Fund; Dermot Carter, Director of Finance, TUH and Ciaran Faughnan, Director of Facilities & Estates at TUH.

FIND OUT MORE The NEIS helpdesk is now live and welcomes any feedback, queries or suggestions to NEIS.Support@hse.ie

WOODLAND WONDERS

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Cavan mental health service users return to Woodlands for Health

n our attempts to get back to normality, this summer in Cavan saw the return of the Woodlands for Health programme. There were several happy faces when the news was announced that the programme would be returning after lockdown.

Woodlands for Health helps to encourage people to get-together for a social activity that involves moderate exercise, all while enjoying the beautiful woods and forests of their locality. This programme has been proven to be beneficial for people’s mental and physical wellbeing.

“Thirteen service users from around the county took part in the 10-week programme.

It was challenging for all involved - from getting used to being COVID-compliant during our bus trips to following hand hygiene and mask wearing while serving refreshments. It was really positive to see the high turnout and how people pulled together to make it a success,” explained occupational therapist Jay Seetharaman.

“The various Woodlands walks took us all around the county, to places like Cootehill, Lough Gowna, Bailieborough, Blacklion. Led each week by Noel, our fantastic tour guide, all fitness levels were catered for. Stories were told about the history and folklore of the woodlands that we visited. We learned about things like the restoration of the Dawson Mausoleum at Dartrey Forest, about how Castlesaunderson overlooks the border with Northern Ireland, and about the unique landscape of the Cavan Burren. There was no shortage of humour either, and Noel gave as good as he got.

“Many a conversation was had - everything from the weather to the GAA to hybrid cars was chatted about (and of course... COVID).

There was no shortage of interesting topics for people to chat about. Speaking of the weather, it didn’t rain once during our 10 walks - unbelievable! No social outing is complete without the obligatory cuppa and of course, a healthy snack. We even got to celebrate the birthday of two participants with birthday cake and song.”

The programme is a partnership between several organisations and efforts of the following: Dean McElroy, Sports Inclusion Development Officer at Cavan Sports Partnership; Miffy Hoad, Development

Officer at Mental Health Ireland; Noel Cassidy, our Tour Guide; Jay Seetharaman, Occupational Therapist; and Finian McNamara, OT Assistant, both from Cavan Monaghan Mental Health service. Access to the woodlands is provided by Coillte.

Last but not least, the service users expressed their appreciation to the all staff

for the opportunity to take part. Likewise, the staff wish to give a huge thanks to all service users who made the programme so worthwhile - see you at the next Woodlands walk! Plans are now afoot for our next big event - the Kickstart to Recovery soccer programme.

PROGRAMME ‘A GREAT EXAMPLE OF PARTNERSHIP WORKING’ Woodlands for Health is an innovative development initiated by Coillte based around walking or exercising in groups in nature. It is a 12-week free guided walking programme in a wooded area and open to participants attending the Adult Mental Health services. It is modelled on Branching out which was successfully applied by the Forestry Commission in Scotland. In Ireland it was initially developed in partnership with the Wicklow Mental Health Services, Wicklow Mental Health Association and Mental Health Ireland. The first programme launched in 2012. In Kildare West Wicklow, the Occupational Therapy department launched the first programme in September 2020. This programme met many obstacles due to COVID-19 and lockdowns. However, even with the challenges, the outcomes for the participants were very positive. Organisers are now extremely excited to be part of the second Woodlands for Health programme in Donadea Forest which commenced in September. “As occupational therapists working in the mental health services, we focus very much on the importance of increasing activity and engagement with others. This programme is also a great example of partnership working,” said one of the OTs. “The occupational therapy department in the mental health service working with Kildare Sport Partnership, Coillte and Mental Health Ireland have combined our resources to provide an opportunity for individuals who experience mental health challenges to walk in a nature-based environment, which for us is the beautiful setting of Donadea forest. The programme will run over 12 weeks bringing us right up to December 2021.”

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SLÁINTECARE HEALTHY COMMUNITIES INITIATIVE TO ADDRESS HEALTH INEQUALITIES

'Each programme will be tailored to the local needs of the community to build sustainable improvements in the health and wellbeing of people of all ages living there'

ABOVE: At launch of the Sláintecare Healthy Communities at Darndale Bell Centre, were Minister for Public Health, Wellbeing and the National Drugs Strategy Frank Feighan; Tom James, Head of Healthy Ireland; Minister for Health Stephen Donnelly; Ellen O’Dea, HSE, Head of Service for Health and Wellbeing CHO, DNCC; and Helen Deely, Interim Assistant National Director, HSE, Health & Wellbeing.

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he Sláintecare Healthy Communities Programme is a new cross-Government initiative to deliver increased health and wellbeing services to 19 targeted community areas across Ireland. The programme will be delivered in partnership with HSE Health and Wellbeing, local authorities, local communities, statutory, voluntary and community groups. Minister for Health Stephen Donnelly and Minister for Public Health, Wellbeing and the National Drugs Strategy Frank Feighan launched the new €13m initiative recently. This new investment will fund posts working at community level to deliver, support and coordinate these activities.

Speaking at the launch in the Darndale

Bell Centre, Minister Donnelly said, "The goal of the Healthy Communities Programme is to improve the long-term health and wellbeing of the people living in these communities. These initiatives will be delivered in partnership with a number of groups working together to provide a range of dedicated services to build lasting improvements in health and wellbeing.”

Minister Feighan said that “taking an evidence-based approach, this work will build on existing programmes in these areas and mobilise available resources to address local needs to promote health and wellbeing”.

“The 19 areas chosen to participate in this programme are diverse and have distinct needs and requirements. Each programme will be tailored to the local needs of the community to build sustainable improvements in the health and wellbeing for people of all ages,” Minister Feighan said.

Helen Deely, Interim National Director, HSE, Health & Wellbeing, said, “We are really pleased to see our partnership working and health and wellbeing programmes reach into the communities where they are most needed.

"We can help build the overall wellbeing of these communities through the increased delivery of supports to quit smoking, improve healthy eating and improve mental wellbeing and reduce isolation.

"For example the increased rollout of parenting programmes with Tusla under Sláintecare Healthy Communities is one of the most fundamental and positive things we can do to support parents and children’s health and wellbeing.”

Healthy Communities will support the physical and mental health of the communities as well as support improvement in the wider determinants of health in those communities, such as education, housing, social support and the built environment.

FOR MORE The Healthy Communities website is available here: www.hse.ie/eng/about/ who/healthwellbeing/slaintecarehealthy-communities/

KEY HSE HEALTH AND WELLBEING PROGRAMME COMPONENTS SOCIAL PRESCRIBING: A Social Prescribing link worker will provide interventions and referrals to communitybased services in the statutory and non-statutory sector. Social prescribing offers GPs and other health professionals a means of referring people to a range of non-clinical community supports which can have significant benefits for their overall health and wellbeing and has been used to target social isolation, loneliness and mental health difficulties.

STOP SMOKING ADVISOR: A Stop Smoking Advisor will provide one-to-one support to quit smoking including the provision of NRT or other Stop Smoking medication. They will also promote the extension of smoke free environments.

While Ireland has made great strides in reducing tobacco consumption, we still need to make a concerted effort to support the continued development of a tobacco-free society where people can have healthier lives free from the detrimental effects of tobacco.

WE CAN QUIT: We Can Quit is a friendly and supportive 12-week programme, providing group behavioural support, NRT and other stop smoking medication, to help attendees quit smoking and stay quit for good. This group programme has been proven to support people around their smoking by utilising peer and social support as well as professional input.

PARENTING PROGRAMMES: Parenting Programmes will provide families with greater access to evidence-based parenting programmes which have been shown to be one of the most effective ways to improve child and parental mental health and wellbeing.

HEALTHY FOOD MADE EASY: This healthy food programme will provide a user-friendly nutrition and cookery course that helps people increase their skills to implement a healthy diet, plan healthy meals on a budget and make easy to cook meals.

MECC: The Making Every Contact Count programme will work with local health professionals to ensure they have the skills to deliver brief interventions and advice for all patients regarding healthy behaviours (smoking, alcohol use, physical activity, diet and nutrition). This will see an increase in service users being advised to make healthy lifestyle choices and directed to supports.

COMMUNITY FOOD & NUTRITION WORKERS: These healthcare workers have a remit to build capacity, knowledge and skills across communities and to work with local statutory and voluntary partners to improve the food environment and address food poverty and activate agreed national campaigns. These workers will be funded by HSE Health and Wellbeing and employed by community organisations.

HSE INTEGRATED ALCOHOL SERVICES: New Integrated Alcohol Services are being rolled out in community settings to provide support for people with harmful alcohol use and their families. The community-based team will consist of four counsellors, a nurse, and a project worker. In 2021, services will commence in Cork and Limerick and more services will be rolled out across the country in the future. The services will work closely with Alcohol Liaison Nurses in hospitals so that there is a joint approach to service delivery across community and hospital settings.

KEY LOCAL AUTHORITY PROGRAMME COMPONENTS Each of the respective local authorities will coordinate and support the Sláintecare Healthy Communities Programme with the Local Community Development Committees and their existing Healthy City and Healthy County plans as well as recruiting Healthy Community Local Development Officers to coordinate activity from a local authority perspective. This increase in resource for local authorities is aimed at integrating the health and wellbeing agenda with their broader agenda and supporting a social determinants approach to health inequalities.

LOCAL PARTNER PROGRAMME COMPONENTS Key to local operational delivery are the locally commissioned community partners such as the Local Development Companies, Family Resource Centres and others who have an existing reach and engagement into these communities.The Healthy Food Made Easy, the Community Food & Nutrition Worker as well as Social Prescribing initiatives will be delivered by local community agencies such as these to build on existing programmes and assets at community level.

Sláintecare Healthy Communities 2021 Cavan Town & County (Cavan) Gaeltacht (Donegal) Inishowen (Donegal) West Mayo (Mayo) Limerick City (Limerick) Clonmel (Tipperary) North Cork City (Cork) Enniscorthy & Wexford Town (Wexford) Waterford City (Waterford) Bray (Wicklow) Athy (Kildare) Cherry Orchard (Dublin) Clondalkin (Dublin) Tallaght (Dublin) Athlone & Mullingar (Westmeath) Longford Town (Longford) Ballymun (Dublin) Finglas & Cabra (Dublin) Kilmore & Priorswood (Dublin)

Following the official launch, HSE Health & Wellbeing hosted a launch webinar in collaboration with Healthy Ireland, Sláintecare in the Department of Health to share information and insights on the new Healthy Communities Programme. Over 800 attendees heard presentations from Tom James, Head of Healthy Ireland in the Department of Health, Dr Paul Kavanagh from the HSE Health Intelligence Unit, and Helen Deely, Interim Assistant National Director, HSE, Health & Wellbeing. The webinar also included inputs and videos from many colleagues in HSE Health and Wellbeing and their partners in local authorities, Family Resource Centres and Local Development Companies. The webinar is available to view on the HSE Health and Wellbeing YouTube channel.

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OBESITY

HSE and partners challenge weight stigma and improve understanding

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he HSE, Health Eating & Active Living programme hosted its third event Overweight and Obesity...Lets Talk! in October.

The event aimed to share the science behind obesity, give practical information to help people to manage and understand behaviours related to weight, continue to break the stigma of obesity through sharing lived experiences and explore conversations about weight and health in healthcare settings The virtual event was free and open to everyone with an interest in the area, including the general public, clinicians and healthcare professionals.

With nearly 1000 attendees, the event was a collaboration between the HSE Obesity Management Clinical Programme, the Association for the Study of Obesity in Ireland (ASOI) and the Irish Coalition for

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People Living with Obesity (ICPO).

Sarah O’Brien, HSE, National Lead,Healthy Eating & Active Living Programme, said, “Investment in community services will see community weight management services, delivered by dietitians, available in many areas.

"Training for healthcare staff to help them talk with patients living with overweight and obesity about health lifestyles will be available as part of Making Every Contact Count by the end of the year.”

Currently 60% of adults and 20% children have overweight and obesity in Ireland.

Susie Birney, Executive Director ICPO, and Patient Representative, ASOI, said she was delighted to see the continuation of a patient-centred approach with the involvement of the Irish Coalition for People Living with Obesity in planning this awareness event.

“It is clear that hearing the lived experience of those who live with obesity, combined with the science and the research, is an impactful approach for discussing health and weight and also towards addressing the stigma which comes with this disease,” she said.

FOR MORE INFORMATION about HSE proposed services, please see HSE Model of Care for the Management of Overweight and Obesity www.hse.ie/ eng/about/who/cspd/ncps/obesity/ model-of-care/obesity-model-of-carehighlights.pdf

NEW NUTRITION STANDARDS FOR STAFF AND VISITORS Healthy Eating at Work Awards launched

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he HSE has a key role to play in providing supportive work environments for staff to lead a healthy and active lifestyle. A healthy and balanced diet along with exercise helps maintain a healthy body weight and reduce the risk of chronic conditions, such as type 2 diabetes, some cancers and coronary heart disease.

HSE Health & Wellbeing has launched the Nutrition Standards for the provision of food and beverages in healthcare settings.

These standards support those employed and contracted by the health service to offer staff and visitors a choice of healthier food.

They are a combination of nutrient and food-based standards and they specify the minimum levels to be attained.

By developing these standards, we aim to move from the current “obesogenic” environment, where unhealthy foods are readily available in most places, to one that actively promotes the consumption of healthier food and drink.

Launched by Minister of State Frank Feighan, the Healthy Eating at Work webinar had over 300 participants on the day and you can watch it back on the HSE Health and Wellbeing YouTube channel.

The session included some examples of how healthy eating at work is being implemented in the HSE. Project dietician Geraldine Sexton presented new Nutrition and Healthy Eating training modules now available on HSEland to support staff and catering services, researchers in NUIG spoke about the HSE Calorie Posting Policy and Catering Services in Cork University Hospital produced a short video on how they achieved Gold Standard in the Happy Heart Healthy Eating Awards programme on their first attempt!

The Happy Heart Healthy Eating Awards is a well established

programme of the Irish Heart Foundation and, since 2020, we are delighted to partner with Irish Heart to work exclusively with catering facilities in HSE and healthcare settings.

Through this award programme catering facilities are supported to: • adopt healthier cooking practices and healthier options without incurring substantial costs • ensure healthier options are promoted and provided • ensure food and beverages comply with HSE nutrition standards for staff and visitors Catering facilities get the opportunity to work to achieve the Nutrition Standards through a certification level process - Gold, Silver, and Bronze. Dieticians support the catering team to implement changes to food provision such as portion sizes, increasing fruit and veg, reducing salt fat sugar content and replacing products with healthier versions whilst also keeping customers informed and happy. The award is valid for two years.

We aim to support every healthcare catering facility in the HSE to achieve the highest standard possible and their achievements are recognised in an annual awards ceremony.

FOR MORE The awards programme is open to catering facilities in the health services who prepare and provide a hot meal on site for staff and visitors. We are encouraging all catering facilities to work with us on the Healthy Eating Awards.

For more information visit https://hse.ie/ healthyeatingatwork/

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GO EASY ON TREATS Let’s go easy on the treats – try to give them to children less often and in small amounts

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hildren are having more treat foods such as crisps, sugar and biscuits than the recommended amount to keep them healthy.

Latest research on treats for the START campaign found that parents and guardians believe that giving them in smaller amounts and less often should help families to cut back and replace them with healthier snacks. Sarah O’Brien, HSE national lead for the Healthy Eating and Active Living programme, explained that the health advice is to limit treat foods to small amounts once or twice a week for

The START campaign is brought to you from safefood, the HSE and Healthy Ireland. The campaign encourages families to take the first step towards a healthier lifestyle for their children by supporting them with one daily win and to persist with the changes, no matter how difficult they become.

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children over five and no more than once a week for children under five.

“This is so far from the norm in our society and the marketing of these products is so widespread that parents struggle to achieve it,” she said.

“Children, and particularly small children, often need healthy snacks between meals to provide all the nutrients they need for their growing bodies. Simple options such as yoghurt, fruit, popcorn, cheese or peanut butter and crackers are all good choices.

Getting children involved in preparing food, organising a healthy eating family challenge

or using star charts for younger kids are ways of introducing healthier snacks.”

Parents and guardians also said that by having a discussion with children on the health benefits of cutting back on treats should help them understand and accept having less. This is preferable to just saying no outright. They asked for advice on how to have such discussions with children.

Parenting expert and child & adolescent psychotherapist Colman Noctor gave some advice on how to navigate those tricky conversations: Tip one ‘No’ can be a tough word at any age for a child. Small amounts of treats and a few times a week is ok, but it’s important to agree this. By knowing how much and when they can have a treat, you can minimise meltdowns and can give children a feeling of control. Remember, being a parent often involves giving a child what they need as opposed to what they want.

Tip two To avoid bargaining in the sweet aisles, agree if you will buy a treat and if so, what type of treat before you go to the shop.

It can reduce the ask and help you control the shopping trips.

Tip three Children have to learn to regulate their desire as they develop, but they need help with this. Remind yourself that limiting treats is teaching a necessary life skill that will help your child to know when to cut back.

Dr Aileen McGloin, nutritionist with safefood added, “Parents are aware that they need to say no to treats more often but they believe that encouraging treats in moderation feels much more achievable and realistic for them. While healthy eating guidelines don’t include treats as being necessary for good health, if children are eating them, the rule of thumb is ‘small amounts and not every day’.”

Further help and resources VIEW videos with HSE parenting experts, recipes and healthy snack options on www.makeastart.ie. Order hard copies of START publications by searching “Start publications” on www.hse.ie FOLLOW START on Facebook www.facebook.com/safefood.net and Twitter @safefood_net #makeastart

Fair Deal Proceeds of the sale of the main residence What is FairFair Deal?Deal Changes for Farmers and Business owners The Nursing Homes Support Scheme known as Fair Deal, provides financial support for people who need long term residential care. The amount you pay towards your nursing home fees depends on your income and assets.

Financial assessment and the 3 year cap

If you little assets, you payFair less.

If you more, Ashave part of theincome financialand assessment under Deal, youhave will contribute of the value of certain assets each year towards the cost of your care you 7.5% pay more. for a maximum of 3 years. This is known as the ‘3-year cap’. Farmers and businesses owners need to apply to have a farm or business included in the 3-year cap. For your application to be successful you need to meet some conditions. These conditions include:

Financial assessment andyour the 3 year cap • You must apply to us to appoint family successor

As part of the financial assessment under Fair Deal, you will contribute 7.5% • Your successor will commit to running the farm or business for at least of the value 6 yearsof certain assets each year towards the cost of your care for a maximum of 3 years. This is known as the ‘3-year cap’.

• Your farm or business must have been actively run by you, your partner or your proposed family successor for at least 3 of the last 5 years • A charge in favour of the HSE will be placed on the chargeable property of a business or farm

What happens after 3 years?

Your home will automatically be removed from your financial assessment a care family successor afterAppointing you have been in for 3 years.

You do not need to do anything.

You need to apply to us using the Fair Deal application form to appoint your family successor. Information on who can be a family successor, the conditions to be met and the supporting documents you need to send us is on section 5 of www.hse.ie/nhss

Selling your home while in care

From 20 October 2021 if you choose to sell your home while in nursing People under Fair before 2021 home care thein netcare proceeds of the saleDeal can qualify for 20 the 3October year cap and People in care under Fair Dealon before October 2021 can still apply for the will be an allowable deduction your 20 financial assessment.

3 year cap under the old guidelines (if they have not done so already). This should be done by 20 April 2022.

To qualify under the old guidelines, you will need to provide the following to your local nursing homes support scheme office: People in care under Fair Deal before 20 October 2021 1. Evidence that you suffered a sudden illness or disability which caused you to need long Peopleterm in care under Fair Deal before 20 October 2021 who sold their home nursing home care, and while nursingthat home canpartner apply for the 3 yearengaged cap on the netdaily proceeds 2. in Evidence youcare or your was actively in the working of the of the sale of their home.

To request a review please provide details of the farm or business up until the time of the sudden illness or disability, and sale 3. to Certification your local nursing homes support scheme office. by a family successor that they will continue to work the farm or business.

For more information www.hse.ie/nhss HSELive 1800 700 700 00 353 1 240 8787 (from outside Ireland)

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