Department seeks policy advice for disability services

Paul Mulholland

The Department of Health has issued a tender for a consultancy service to provide advice and guidance “in relation to the development of evidence-based health sector policy and practices” for people with disabilities.

The successful candidate will be required to provide policy analysis expertise and advisory services to the Department on a range of disability-related issues, including economic and financial matters.

“This work will include the preparation of advice papers, research and analysis of disability data and trends, attendance at meetings with senior Departmental officials and the Minister, and presentations to senior health decision-makers, as and when required,” according to tender documents.

The budget for the service is €50,000 excluding VAT, while the timeframe is one year, with an option to extend the contract for 12 months, should the need arise.

The successful candidate should be able to demonstrate a good knowledge and understanding of the current disability regulatory framework, as well as a good knowledge of the disability services’ operational environment in Ireland and other relevant jurisdictions.

“Demonstrable experience in policy development, with a particular focus on financial and economic analysis, in the health sector is essential,” according to the tender.

The deadline for a response to the tender is 12 May.

It is noted that one of the key policy development priorities for the dedicated disability unit within the Department is progression of the Action Plan for Disability Services 2022-2025

The unit is also working on the reform of the disability sector under Sláintecare including implementation of the reconfiguration of residential services as recommended in Time to move on from congregated settings and rolling out the ‘New directions’ programme of day service improvements.

The Office of the State Pathologist (OSP) is “continuing to work” with the Department of Justice, Faculty of Pathology, and Medical Council, to prepare an application for specialty status for forensic pathology.

Making an application for specialty status was one of recommendations in a 2019 review of the OSP, undertaken by the RCPI.

According to the review, which was commissioned by the Department, the absence of a training pathway “appears to be a major barrier to recruitment and sustainability”.

While it was possible to train abroad, “the concern is that a trainee may not then return,” it noted.

The review outlined that while a forensic pathologist may train through the Royal College of Pathologists, UK, and then register with the UK General Medical Council as a forensic pathologist, in Ireland they would have to register as a histopathologist or on the general division of the Medical Council, “which is where they would have been eligible to register immediately after completion of internship. This would not be considered professionally attractive.”

The OSP currently has staffing of 9.4 whole-time equivalents (WTEs) with one vacancy for a Deputy State Pathologist. The total staffing consists of the Chief State Pathologist, two State Pathologists, one Deputy State Pathologist, one Senior Lab Analyst, 0.6 WTE Higher Executive Officer, one Executive Officer, and 2.8 Clerical Officers.

The OSP has taken on one Deputy State Pathologist (a qualified consultant histopathologist to train in forensic pathology) and will take on a second this year, according to the Department spokesperson.

“The Department has previously experienced challenges in attracting candidates for State pathology roles: This is not unique to Ireland, but rather reflects similar challenges encountered globally.

“The role of Deputy State Pathologist, previously called Acting Deputy State Pathologist, was introduced in order to ensure that a full cohort of pathologists is available to support the service provided by the OSP. In order to be considered for the Deputy role, candidates have to have a consultant level qualification, usually as a histopathologist, and to have been performing medico-legal autopsies throughout their training.

“The successful candidate would be expected to complete a fellowship-style programme in forensic pathology, fully supervised by the Chief State Pathologist and State Pathologists, and so complete their forensic training in a defined period. Upon successful completion of this training, that candidate would then be appointed as a State Pathologist.

“The Deputy State Pathologist is only permitted to undertake autopsies in criminal or homicide cases when they are deemed to have sufficient forensic experience by the Chief State Pathologist.” powder and suspension for injection in vials (Please refer to SmPC before prescribing) Composition: After reconstitution, one dose (0.5 mL) contains: Varicella Zoster Virus glycoprotein E antigen1,2 50 micrograms. (1 adjuvanted with AS01B containing: plant extract Quillaja saponaria Molina, fraction 21 (QS-21) 50 micrograms, 3-O-desacyl-4’-monophosphoryl lipid A (MPL) from Salmonella minnesota 50 micrograms, 2 glycoprotein E (gE) produced in Chinese Hamster Ovary (CHO) cells by recombinant DNA technology). Therapeutic indications: Prevention of herpes zoster (HZ) and post-herpetic neuralgia (PHN) in adults 50 years of age or older and in adults 18 years of age or older at increased risk of HZ. The use of this vaccine should be in accordance with official recommendations. Posology and method of administration: For intramuscular injection only, preferably in the deltoid muscle. Primary Vaccination: Initial dose of 0.5 ml followed by a second 0.5 ml dose 2 months later. For flexibility the 2nd dose can be administered between 2 and 6 months after the first dose. For subjects who are or might become immunodeficient or immunosuppressed and whom would benefit from a shorter vaccination schedule, the 2nd dose can be given 1 to 2 months after the initial dose. Booster doses: need not established. Contraindications: Hypersensitivity to the active substances or any of the excipients. Special warnings and precautions for use: The name and the batch number of the administered product should be clearly recorded. Appropriate medical treatment and supervision should be readily available in case of an anaphylactic event. Administration of Shingrix should be postponed in subjects suffering from an acute severe febrile illness. However, the presence of a minor infection, such as cold, should not result in deferral. A protective immune response may not be elicited in all vaccinees. Never administer intravascularly or intradermally; subcutaneous administration not recommended as it may lead to an increase in transient local reactions. Caution in individuals with thrombocytopenia or any coagulation disorder since bleeding may occur following intramuscular administration. Syncope can occur following, or before any vaccination as a psychogenic response. This can be accompanied by several neurological signs such as transient visual disturbance, paraesthesia and tonic-clonic limb movements during recovery. It is important that procedures are in place to avoid injury from faints. There are no data to support replacing a dose of Shingrix with another HZ vaccine. There are limited data to support the use of Shingrix in individuals with a history of HZ and in frail individuals including those with multiple comorbidities. The benefits and risks of HZ vaccination should be weighed on an individual basis. Interactions: Shingrix can be given concomitantly with unadjuvanted inactivated seasonal influenza vaccine, 23-valent pneumococcal polysaccharide vaccine (PPV23) or reduced antigen diphtheriatetanusacellular pertussis vaccine (dTpa). The vaccines should be administered at different injection sites. Fertility, pregnancy and lactation: There were no effects on male or female fertility in animal studies. It is preferable to avoid the use of Shingrix during pregnancy. The effect on breast-fed infants of administration of Shingrix to their mothers has not been studied. It is unknown whether Shingrix is excreted in human milk. Effects on ability to drive and use machines: Shingrix may have a minor influence on the ability to drive and use machines in the 2-3 days following vaccination. Undesirable effects: Very common (≥1/10): Headache, GIT symptoms, myalgia, injection site reactions, fatigue, chills, fever. Common (≥1/100 to <1/10): injection site pruritus, malaise. Uncommon (≥1/1000 to <1/100): lymphadenopathy, arthralgia. Rare (≥1/1000 to <1/100): Hypersensitivity reactions. Legal Category: POM

A. Marketing Authorisation Number: EU/1/18/1272/001. Marketing Authorisation Holder: GlaxoSmithKline Biologicals S.A., Rue de l’institut 89, B-1330 Rixensart, Belgium. Further information is available from GlaxoSmithKline (Ireland) Ltd. 12 Riverwalk, Citywest Business Campus, Dublin 24. Telephone: 01-4955000. Code: PI-7757. Date of preparation: March 2021.

Adverse events should be reported directly to the Health Products Regulatory Authority (HPRA) on their website: www.hpra.ie. Adverse events should also be reported to GlaxoSmithKline on 1800 244 255.