HomeJanuary 2017News from around your health services

News from around your health services

Leopardstown Park Hospital received EcoMerit Cert

Leopardstown Park Hospital in Dublin has received the EcoMerit Certification from Dún Laoghaire Rathdown County Council for its efficient management and use of environmental resources.

Dun Laoghaire Rathdown Cathaoirleach presents EcoMerit certificate to Leopardstown Park Hospital, Margaret Coles, Dun Laoghaire Rathdown County Council, Environmental Protection Agency, Colm Sorohan Engineer LPH, Cllr. Cormac Devlin An Cathaoirleach Dun Laoghaire Rathdown Co Council, Eugene F. Magee, Board Chairman LPH, Ann Marie O’Grady, CEO LPH
Dun Laoghaire Rathdown Cathaoirleach presents EcoMerit certificate to Leopardstown Park Hospital, Margaret Coles, Dun Laoghaire Rathdown County Council, Environmental Protection Agency, Colm Sorohan Engineer LPH, Cllr. Cormac Devlin An Cathaoirleach Dun Laoghaire Rathdown Co Council, Eugene F. Magee, Board Chairman LPH, Ann Marie O’Grady, CEO LPH

This follows the introduction by the hospital of measures which will save up to €50,000 per year and reduce its carbon emissions by up to 39 tonnes.

The EcoMerit programme which is endorsed by the Environmental Protection Agency and supported by Dún Laoghaire Rathdown County Council assists organisations to prevent waste, conserve water and increase energy efficiency, thus reducing their carbon footprint and making them more sustainable.

Established in 1917 as a Hospital and home, for the care and treatment of soldiers who had been disabled or injured in the British Armed Forces, Leopardstown Park Hospital has since developed to become a specialist hospital for older persons, providing care in the form of rehabilitation, residential care, respite services, a welfare home and day care services.

It currently has a capacity of 171 beds and has approx. 250 day care attendances per week.

Dún Laoghaire Rathdown Cathaoirleach, Cllr. Cormac Devlin presenting the hospital with its certification said: “It is a great privilege to award the EcoMerit certification to Leopardstown Park Hospital, which has not only excelled in the efficient management and use of its resources but has also committed to a programme of continuous environmental improvements for the future.”

Ann Marie O’Grady, CEO of Leopardstown Park Hospital said: “By ensuring that equipment is only consuming energy when in use and routinely monitoring our water, waste and energy usage, the environmental and financial benefits are considerable. It demonstrates that, even with an old buildings infrastructure, significant strides can be made in terms of both the environment, but also our commitment as a publically funded agency to effective and efficient use of tax payers’ money”.

Leopardstown Park Hospital achieved EcoMerit Certification by a range of initiatives including completing a major lighting upgrade, including installing LED lights throughout the site. Insulation improvements were also made to the oldest parts of the building in order to conserve heat and improve client and patient comfort. Support of HSE Estates was pivotal in relation to the minor capital works.

Leopardstown Park Hospital has also committed to ongoing monitoring of its performance and ensuring that future refurbishments/capital developments will be carried out to the highest environmental standards in compliance with its environmental policy.

Colm Sorohan, Engineer at Leopardstown Park Hospital said: “In all our activities, we aim to be an environmentally responsible member of the community we serve. We segregate our general waste to maximise recycling and clinical waste is subject to stringent control, with a specialist contractor engaged for its safe disposal. We also regularly monitor our water and energy use to ensure the hospital is operating efficiently in terms of resource management. In addition we are working with the Office of Public Works (OPW) and its Optimising Power @ Work initiative, along with establishing an Energy Champions team and committee across the hospital campus, where staff are enthusiastically engaging in energy awareness in their daily activities. It is expected that this will further improve our environmental performance.”

St. Francis Hospice Wins Top Award

St. Francis Hospice Wins Top Award
From left: Mr. Guy Thompson, President, Fingal Dublin Chamber; Ms. Brenda Lowry, Volunteer Services, St. Francis Hospice Dublin; Ms. Barbara Kilbride, Volunteer Co-Ordinator, St. Francis Hospice Dublin; Sr. Margaret Cashman, Director of Nursing, St. Francis Hospice Dublin; Ms. Brenda Farrelly, Volunteer Co-Ordinator (retired), St. Francis Hospice Dublin; Ms. Bronagh McKee, Sales and Marketing Manager at Clayton Hotel Dublin Airport; Mr. Fintan Fagan, CEO, St. Francis Hospice Dublin, and Mr. Marty Whelan, M.C.

St. Francis Hospice Dublin has won the “Best Public Service Excellence Award” at the Fingal Dublin Chamber of Commerce Business Excellence and Corporate Responsibility Awards 2016.
The award was in recognition of the best practice establishment and development of the volunteer service at St. Francis Hospice Blanchardstown since 2012. There were 15,500 hours of volunteer service per annum at St. Francis Hospice Blanchardstown in 2016. Eighty-nine volunteers worked across 19 different roles.

The independent judges said in awarding the Excellence Award for the volunteer service, “The winner of this award demonstrated how they have delivered a best in class service provision which is now shaping national standards. Their careful implementation and clear understanding of their stakeholders’ needs has brought outstanding benefits to all involved”.

On receiving the award Fintan Fagan, CEO, St. Francis Hospice Dublin, said “I would like to take the opportunity to thank all our volunteers for their selfless commitment to caring for our patients and their families. Sincere thanks are also extended to the people of North Dublin for volunteering and for their ongoing support of the hospice.”

Image Business Woman Of The Year Award

Kay Connolly

Kay Connolly, Chief Operating Officer of St. Vincent’s University Hospital, Dublin was awarded the prestigious Management Professional of the Year Award at the IMAGE Business Woman of the year Awards 2016.

Over 400 nominations were received for the 10th anniversary of the awards with just one in four nominations being shortlisted. Ms. Connolly was the only public sector nominee and winner at the awards, competing with corporate enterprises.
She was nominated for the awards by St. Vincent’s University Hospital. The award criteria covered her various roles, responsibilities and achievements, her capability to deal with challenges in business, insights into her key personal characteristics and her strategic plans for the future of her organisation.

Speaking about her award, she said: “It was an honour and a privilege to win the Management Professional of the Year Award at the 2016 Image Business Woman of the Year Awards. The calibre of the other shortlisted nominees in my category was extremely impressive. This recognition is important for all women in healthcare and especially for women working in management in an acute hospital setting.  The award acknowledges the challenges and sacrifices that have to be made on a professional and on a personal level in order to succeed in managing operations across large and complex organisations.”

Deadline for HTA participation

Health Managers have until Friday, February 3 to participate in a national public consultation on a health technology assessment of smoking cessation interventions.

This independent analysis by HIQA is aimed at identifying what improvements could be made in the mix of interventions offered by the HSE to increase overall quit rates at an acceptable cost.

The findings will inform the development of a national clinical guideline to guide healthcare professionals and smokers on how best to quit smoking successfully.

HIQA’s Director of Health Technology Assessment Dr. Máirín Ryan said this analysis would examines the safety, effectiveness and cost-effectiveness of the smoking cessation interventions available in Ireland that could be used to help smokers quit for good.

These include medicines such as nicotine replacement therapy, varenicline and antidepressants, as well as e-cigarettes and behavioural interventions, such as counselling and telephone support. HIQA also specifically examined the clinical effectiveness of therapies in pregnant women, and those attending secondary mental health services.”

The HIQA assessment is the first of its kind in the EU to examine the cost-effectiveness of e-cigarettes.

Dr. Máirín Ryan said that a HIQA report found that all publicly funded smoking cessation interventions could be considered clinically effective when compared with doing nothing, and cost-effective when compared with unassisted quitting. The most cost-effective strategy wass to maximise the use of varenicline and nicotine replacement therapy (NRT) in combination.”

Significant changes had taken place in smokers’ choice of cessation support since the arrival of e-cigarettes on the market five years ago.

The HIQA analysis looked at current uptake rates of e-cigarettes among those trying to stop smoking in Ireland, as well as trends in other countries, while acknowledging that research into e-cigarettes wass only beginning.

Dr. Máirín Ryan said: “This HTA found a high level of uncertainty surrounding both the clinical and cost-effectiveness of e-cigarettes. While the long-term effects of using e-cigarettes have not yet been established, data from Healthy Ireland reveals that 29% of smokers currently use e-cigarettes as an aid to quitting smoking. HIQA’s analysis shows that increased uptake of e-cigarettes as an aid to quitting would increase the number of people who successfully quit compared with the existing situation in Ireland and would be cost-effective, provided that the currently available evidence on their effectiveness is confirmed by further studies.”

Following the current public consultation, a final report will be prepared for consideration by the HIQA Board, before being submitted to the Minister for Health and the HSE.
The report, along with details on how to take part in the consultation, is available at www.hiqa.ie.

The prevalence of smoking in Ireland is 22.7% in people aged 15 years and over. The prevalence is higher in men (24.3%) than women (21.2%), but has been in decline since 2008.

Approximately 20.5% of deaths each year can be attributed to smoking, including deaths due to second-hand smoke.

Smoking has a harmful effect on the health of smokers and is linked to diseases such as cancer, respiratory and cardiovascular disease. Quitting smoking substantially reduces the risk of disease over time.

In 2013 the estimated cost to the healthcare system of smoking was over €460 million while the cost of lost productivity was over €1 billion.

Currently, the overall cost of smoking cessation in Ireland is estimated to be over €40 million annually. This figure includes the cost to the HSE of providing smoking cessation support though the HSE Tobacco Control Programme, the costs of GP services and pharmacological treatment to those with a medical card, as well as out-of-pocket expenditure by smokers on various smoking cessation products.

According to data from the Healthy Ireland survey 2015, half of smokers attempting to quit smoking in Ireland do so unaided. A further 29% of smokers try to quit using e-cigarettes as a cessation aid. Approximately 16% of quit attempts are made using some form of pharmacotherapy (for example, NRT).

Varenicline is a prescription-only medication which helps people to stop smoking by reducing withdrawal symptoms and reducing the satisfaction that can be gained from smoking.

Nicotine replacement therapy (NRT) includes nicotine gum, patches, inhalers, intranasal and oral sprays, and tablets.

HIQA found that Varenicline was the most effective single pharmacotherapy; more than two and half times as effective as no pharmacotherapy. Varenicline with NRT was the most effective dual therapy; more than three and half times as effective as no pharmacotherapy. Combination NRT was more effective than a single form of NRT alone. E-cigarettes were twice as effective as no therapy; however, this estimate was based on only two trials including a relatively small number of participants.

It also found the effectiveness of pharmacological interventions was improved by an average of 18% by adding behavioural therapy.

Group behaviour therapy was the most effective behavioural intervention; almost twice as effective as brief advice or written materials. Individual counselling, intensive advice and telephone support were all found to be more effective than brief advice or written materials.

HIQA said if uptake of varenicline and NRT in combination increased to the highest likely level in Ireland, this would be considered good value for money compared to other interventions currently funded by the HSE, but it could lead to an average increase of up to €7.6 million in the cost of providing smoking cessation interventions annually.

If uptake rates of e-cigarettes increased to the current rate of 45% in England (while still not being reimbursed through the Primary Care Reimbursement Scheme), this would result in a decrease in expenditure on smoking cessation interventions of approximately €2.6 million per year.

Minister spells out work of National Patient Safety Office


Simon Harris T.D.
Simon Harris T.D.

The newly established National Patient Safety Office (NPSO) will begin a programme of patient safety initiatives working with the HSE, and the service and professional regulators, according to Health Minister, Simon Harris.

He said this would include progression of patient safety legislation, the establishment of a National Advisory Council for Patient Safety, development of a model for Patient Advocacy Services, extending the Clinical Effectiveness Agenda and a National Patient Safety Surveillance System.

The work of the National Patient Safety Office will be located within the Department of Health.

“The programme of legislation will progress licensing of our public and private hospitals, the Health Information and Patient Safety Bill and provisions to support open disclosure,” said the Minister.

“The National Patient Experience Survey, which will take place in 2017, will provide a broad input from patients themselves to inform planning and delivery of a better health service.”

Mr. Harris said that while we could be confident that much of care we provided was of high quality, we all knew that the delivery of healthcare and health systems was never without risk. “We need a vision where we are preventing patient safety incidents and introducing patient safety measures to promote and assure safe health services in a system that listens and learns.

“The challenge we face is not the achievement of perfection, but the development of a service in which the risk of harm and medical error occurring is minimised, the capacity to identify it when it does occur is maximised, and the systems we have ensure that lessons are learned and inform quality improvements.

“We face this challenge in a world of more complex care where, thanks to improvements in medicine, patients are living longer, with multiple illnesses, and where technology is playing a bigger role.

“The CEO of the State Claims Agency estimates that the cost of claims in Ireland will exceed €300 million in 2017. We need a vision where we are preventing patient safety incidents and introducing patient safety measures to promote and assure safe health systems in a system that listens and learns.

“The open disclosure provisions that we are progressing in the Civil Liability (Amendment) Bill form part of a number of initiatives to improve the management of patient safety incidents.

“HIQA and the Mental Health Commission are at an advanced stage of developing Standards on the Conduct of Reviews of Patient Safety Incidents which expand on the National Standards for Safer Better Healthcare. This set of standards, along with the mandatory reporting of serious reportable events provided for in the Health Information and Patient Safety Bill and the provisions intended for open disclosure, will provide a comprehensive patient-centred approach towards preventing, managing and learning from incidents in a consistent manner, and in line with best practice.

“As part of the new National Patient Safety Office, a National Patient Safety Surveillance System will be established in 2017. This will produce patient safety profiles by bringing together data from various health information resources, and the intelligence gathered will inform the setting of priorities for the HSE and the monitoring of implementation of such priorities.

“Similarly, such intelligence will be used by my Department to inform the agreement of priorities with regulators such as HIQA, the Medical Council, CORU and the Nursing and Midwifery Board of Ireland.

“An example of such information is the maternity patient safety statements which have now been introduced in all 19 maternity units. The next phase is to introduce a patient safety statement across all acute hospitals.

“These statements which will report monthly on key patient safety trends, like complaints, infection rates and falls, will be published monthly by hospitals and will be the basis for on-going patient safety improvement programmes.”

The Minister said robust clinical audit at a national level provided further opportunities to examine our practice for quality improvement. Supports for professionals undertaking clinical audit were included in the forthcoming Health Information and Patient Safety Bill.

“In time, we can look forward to the Irish health system having a set of prioritised and quality-assured NCEC national clinical audits in place. This ensures that we are developing a health system that will be more evidence-based, with clear clinical leadership, moving forward our agenda for a patient-centred service.

“My Department will also continue to build the National Healthcare Quality Reporting System. This report makes clear that many areas of our health services are performing well. Immunisation rates have improved and cancer screening rates continue to improve. We continue to see a downward trend for hospitalisation for heart failure and for diabetes. It also shows that survival rates for breast and colorectal cancer are improving. A further positive is the continuing downward trend of the last decade in deaths following admission to hospital with a heart attack or a stroke.

“This analysis also identifies areas where further room for improvement exists. In particular, considerable variation can be seen between counties in rates of hospitalisation for common chronic diseases such as chronic obstructive pulmonary disease, asthma, diabetes and heart failure. Identifying this variation is a first step to addressing the reasons why this variation exists and to improving it.

“I will appoint a National Advisory Council for Patient Safety in 2017 to guide this work. This Council will have an independent chair, significant representation from healthcare leaders and from patients. I see this Council as providing advice and guidance to inform the policy direction for my Department’s new National Patient Safety Office in its delivery of three core functions; patient safety surveillance; patient advocacy; and building further the work of the National Clinical Effectiveness Committee.”

Masters in Human Factors in Patient Safety

Prof. Oscar Traynor
Prof. Oscar Traynor

RCSI has introduced an Masters in Human Factors in Patient Safety, which deals with the relationship between human beings and the systems within which they work.

RCSI says the Masters, which is tailored for those involved in the care of surgical patients will be of interest to surgeons, nurses, physiotherapists and other allied health professionals. It focuses on issues such as team-working, decision-making, leadership and enhancing efficiency, with the goal of minimising errors and improving patient safety.

This two-year part-time Masters is approved by RCSI, the National University of Ireland and the Nursing and Midwifery Board of Ireland, and positioned at Level 9 on the National Framework of Qualifications.

This unique programme is led by Prof. Oscar Traynor and Dr. Eva Doherty. Dr. Doherty said that “this new Masters is designed and delivered by health professionals to meet the learning needs of inter-professional teams working together in acute Irish hospitals. We believe that health professionals who work together should learn together”.

To find out more or register your interest in the programme, please visit www.rcsi.ie/pghumanfactors.

Graduates all offered permanent jobs

The 2016 Bsc Cur Graduates in General Nursing pictured with CEO Tallaght Hospital David Slevin, Director of Nursing Hilary Daly, Nurse Practice Development Co-Ordinator (Adults) Shauna Ennis and Siobhan Connors Nurse Practice Development Co-Ordinator (Paediatrics) All were offered permanent positions in the hospital.
The 2016 Bsc Cur Graduates in General Nursing pictured with CEO Tallaght Hospital David Slevin, Director of Nursing Hilary Daly, Nurse Practice Development Co-Ordinator (Adults) Shauna Ennis and Siobhan Connors Nurse Practice Development Co-Ordinator (Paediatrics) All were offered permanent positions in the hospital.

Hospitals fined for target breaches

Hospital Groups were charged over €16,00 for breaches of the urgent colonoscopy waiting times last year.

The system of introducing a fixed patient charge for breaches of the urgent colonoscopy waiting times commenced on July 1, 2016.  In July, there were 6 patient breaches of the target across 2 hospitals.  The South/South West Hospital Group was charged €1,500 and the Ireland East Hospital Group was charged €3,000.

In August there were 9 breaches of the target that were applied across 2 hospital groups.  The South/South West Hospital Group was charged €6,000 and Saolta Hospital Group was charged €750.

No breaches in September or October.
In November there were 7 breaches resulting in fines of 5,250- Ireland East 3,750 and DML 1,500
No fines applied in relation to ED in 2016.

There were no fines issued in 2016 in relation to Waiting Lists

Early Pregnancy Assessment Unit

A state of the art Early Pregnancy Assessment Unit is to be opened in Wexford General Hospital next June.

This purpose-built facility will house the entire early pregnancy service in one unit, with the dedicated aim of improving the care, dignity and privacy of women in early pregnancy.

The new unit, which will cost €1.1 million to build, is to be named the “Herbert Amon Wing” after the popular local man who left his life savings to the Friends of Wexford General Hospital.

Better known as Herbie to his friends, he was a familiar face from The Wool Shop in South Main Street.  Chairman of Friends of Wexford General Hospital, Ciaran Sheridan said: “Herbert was very clear on how he wanted this money used and it is our duty to see that his wishes are honoured. He was, I believe, a quiet man but his foresight will now touch the lives of almost 3,500 mothers attending the Unit each year.

“This project epitomises everything that The Friends of Wexford General Hospital is about: local people putting their hard earned money into ensuring our hospital is fit for purpose and the very best facility it can be.”

The charity organisation Friends of Wexford General Hospital is now looking forward to its next project which is to raise funds for a much-needed MRI scanner for Wexford General.

The charity needs to raise approximately €300,000 in order to secure the scanner in a funding drive that is fully supported by Wexford General Hospital and the Ireland East Hospital Group. “an MRI scanner is quickly becoming a minimum requirement for a functioning hospital and Wexford General needs one immediately,” said Sheridan. “This is now our main focus and we need to get everyone informed and motivated to help us raise the necessary funds.”

Attracting European Medicines Agency To Dublin

An interdepartmental/interagency group has been established to develop a detailed proposal to promote the selection of Dublin as the new location for the European Medicines Agency.

The EMA is responsible for ensuring that all medicines on the EU market are safe, effective and of high quality.

The Government believes a move to Dublin would minimise the disruption to the business of the EMA, thus ensuring continued protection of EU citizens and providing reassurance to the industries which it regulates.

It says The Irish medicines regulator – the Health Products Regulatory Authority – would be able to provide strong support to the EMA.

Health Minister, Simon Harris visited the European Medicines Agency (EMA) in Canary Wharf in London earlier this month.  He was accompanied by Lorraine Nolan, Chief Executive of the Health Products Regulatory Association (HPRA, formerly Irish Medicines Board).
In early February the Minister will follow up with a series of meeting with officials and stakeholders in Brussels.

New Guidance On Patient Consent for Anaesthesia

New guidance on patient consent for anaesthesia has been issued by The Association of Anaesthetists of Great Britain and Ireland (AAGBI).

The AAGBI – the professional membership organisation representing over 11,000 anaesthetists in the UK and Ireland – first published guidance on consent for anaesthesia in 1999 revising it in 2006.

Its latest, 2017 revision incorporates recent case law and other changes in the legal system, providing guidance and advice to anaesthetists about consent before anaesthesia, whilst recognising the differences between the legal frameworks in England and Wales, Scotland, Northern Ireland and the Republic of Ireland.

Taking over a year to develop, the new guidance has had legal, medical and lay input, and has undergone extensive consultation within the UK and Ireland. The new guidance addresses the particular difficulties faced by anaesthetists compared with other doctors.

The Association said the need to ensure that patients give consent before they receive treatment is a basic principle of modern healthcare.

“Patients will be familiar with the need to give consent before surgery, and the requirement in most circumstances to sign a consent form before the operation can go ahead. However, the situation for anaesthesia is more difficult. This is because anaesthesia enables surgical procedures to happen but is almost always not a ‘treatment’ in itself. Also, anaesthetists rarely have access to patients for detailed discussions far in advance of the surgery itself, and for any one operation there may be many subtly different ways in which anaesthesia can be provided. It is therefore not always clear how much of each anaesthetic technique (which may involve many components) needs to be discussed beforehand.

The AAGBI’s new guidance on patient consent for anaesthesia can be accessed at http://bit.ly/AAGBIconsent.

Evidence for Clinical Guidelines

HIQA has signed a contract with the Health Research Board to provide the evidence for clinical guidelines that are developed for the National Clinical Effectiveness Committee (NCEC).

The five-year contract, worth €2.25 million, will establish the HRB-Collaboration in Ireland for Clinical Effectiveness Reviews (HRB-CICER).

The NCEC quality assures National Clinical Guidelines for use in healthcare in Ireland. The goal of these guidelines is to promote healthcare that is current, effective and consistent, ensuring the best possible outcomes for patients. To achieve this, the guidelines must be based on the best available scientific evidence of clinical benefits and cost-effectiveness and incorporate the budget impact of their implementation.

HRB-CICER will undertake evidence reviews and provide scientific support for the development of the NCEC’s National Clinical Guidelines. The HRB-CICER team will comprise a dedicated multidisciplinary research team supported by staff from HIQA and RCSI, as well as national and international clinical and methodological experts. The team will collaborate closely with the multidisciplinary Guideline Development Groups to ensure that their work can be used to inform evidence-based recommendations.

Speaking on the announcement of the funding, Professor Susan Smith, Professor of Primary Care Medicine at RCSI and the Clinical Lead of the HRB CICER, said “The funding and establishment of the HRB CICER is a welcome development in providing clinicians and researchers the opportunity to engage in the generation of evidence to support clinical colleagues and improve outcomes for our patients.”

National Standards For Maternity Care

National Standards for Safer Better Maternity Services, which describe what safe, high-quality maternity services should look like, to improve outcomes for women and their babies have been published by HIQA.

These standards have been designed to support the implementation of the National Maternity Strategy, launched in January 2016.

The HIQA maternity standards cover eight areas of care – person-centred care and support, effective care and support, safe care and support, better health and wellbeing, leadership, governance and management, workforce, use of resources and the use of information.

Launching the standards, Health Minister, Simon Harris said: “These Standards along with the range of patient safety initiatives taking place in my Department will support better, safer clinical decision-making and a more connected health service, delivering better outcomes for patients.”

Marie Kehoe-O’Sullivan, HIQA’s Director of Standards and Quality Improvement, said: “These standards are informed by national and international research and best practice, as well as the voices of women, patient advocates and front-line staff who participated in our advisory group, focus groups and public consultation.

“The standards put women at the centre of what maternity services do. By promoting practice that is up to date, effective and consistent, and based on best available evidence, they provide a framework of good practice for services to strive towards, but also for women to understand what safe, high-quality maternity care looks like and what they should expect from a service.”

The National Standards for Safer Better Maternity Services cover pre-pregnancy, pregnancy, labour, birth and the postnatal period (up to six weeks after birth), and apply to all maternity services. These services include, but are not limited to, maternity units, and primary and community care settings. The Standards may be viewed at www.hiqa.ie

Minister Visits NRH

Tenders for the main works of new facilities at the National Rehabilitation Hospital (NRH) in Dun Laoghaire, are due to be returned next month.

The new development will deliver a 120 bed ward block, including support therapies to paediatrics, acquired brain injury (ABI) wards, an hydrotherapy unit and a sports hall.

Speaking during a visit to the hospital, Health Minister Harris Simon Harris said, “I believe these new facilities will help make a real difference in the lives of children and adults living with acquired brain injuries, as well as their families. I’m glad to reaffirm my commitment both to the NRH and to the ongoing improvement of neuro-rehabilitation services for people who need them. I know that when patients come to avail of these services they do so often in difficult circumstances where patients and families are facing a major change in their lives. I want to ensure that the best possible services are available to them. I also want to acknowledge the dedication of the staff working here, who work so hard for their patients, and thank them for everything they do.”

The Programme for Partnership Government places a particular focus on a number of key programmes and strategies, including publishing a plan for advancing neuro-rehabilitation services in the community. The National Policy and Strategy for the Provision of Neuro-rehabilitation Services in Ireland 2011-2015 made a number of recommendations for services for people with rehabilitation needs. The Strategy also covered a range of supports including clinical, therapeutic, social, vocational and community supports for these people.

The HSE’s recently published National Service Plan 2017 commits to finalising and progressing implementation of this Strategy.

Other plans, as announced by Minister Harris recently, include funding to the design / planning stage of a specialist rehabilitation unit at Roscommon University Hospital in association with the NRH. The project would deliver 20 beds and therapy suite accommodation.

Waterford Community Nursing Unit

The HSE has been granted full planning permission for the development of a 100 bed Community Nursing Unit on the grounds of St. Patrick’s Hospital in Waterford.

The full funding of €19.8 million for the project is provided as part of
completion of public residential centres in the HSE’s 2016-21 Capital Plan.

The project, which will get under way early in the new year, will consist of two households of 30 beds and two of 20 beds. The new building has been designed to meet modern social care residential standards and will replace the existing older person’s accommodation at St. Patrick’s Hospital and St. Aidan’s ward for psychiatry of later life patients (currently housed on the grounds of the nearby St. Otteran’s Hospital).

Electronic Health Record Launched

Cork University Maternity Hospital was the first site to launch a national project that will introduce an Electronic Health Record across all 19 maternity hospitals in Ireland.

Ireland’s Maternal & Newborn Clinical Management System (MN-CMS) will see the implementation of an Electronic Health Record (EHR) for
all women and babies in maternity services in Ireland.

As the first site to go live, CUMH has a leading role in the design and testing of the eChart, the preparation of training materials, and the development of policies and work flows.

Plans are in place to roll out the system across the country, with the second implementation in University Hospital Kerry followed by The
Rotunda and the National Maternity Hospitals in Dublin.

RCPI President Designate

Professor Mary Horgan
Professor Mary Horgan

Professor Mary Horgan, Dean, School of Medicine UCC, has been elected as President Designate of the Royal College of Physicians of Ireland.

She will become the 142nd President of RCPI in October 2017, serving a 3-year term.

She is the first woman elected President Designate of the RCPI.

Professor Horgan is a Consultant Physician in Infectious Diseases and Internal Medicine at Cork University Hospital.

Originally from Kerry, she graduated from UCD in 1986, was awarded her MD in 1995, MRCPI in 1988 and FRCPI in

University Degree In Paramedic Studies

The School of Medicine, UCC has introduced a BSc (Hons) Paramedic Studies (Practitioner Entry) degree for registered Paramedics.

Unlike the majority of clinical professions across the health-system, paramedics receive their training outside of the university setting.

The academic element of this programme has been constructed to elevate the skills and knowledge applicable to current practice and specialist areas. The degree has been designed in the knowledge that a practising paramedic will be required to manage their current job, in addition to undertaking a rigorous academic programme, with the course delivered and provided through a combination of e-learning and workshops.

Services for ethnic minority communities

Mental Health Reform, in partnership with the Mental Health Commission, has launched a set of guidelines for mental health services and staff on working with people from ethnic minority communities.

The guidelines are aimed at promoting culturally sensitive mental health services for people from ethnic minority communities.

Pictured at the launch of Ethnic Minorities and Mental Health Guidelines were Dr. Shari McDaid, Director of Mental Health Reform, Thomas McCann, Traveller Counselling Service, Professor Agnes Higgins, Chairperson of Mental health Reform and Emilia Marchelewska, Health Advocacy Officer, Cairde. Picture Conor McCabe Photography.
Pictured at the launch of Ethnic Minorities and Mental Health Guidelines were Dr. Shari McDaid, Director of Mental Health Reform, Thomas McCann, Traveller Counselling Service, Professor Agnes Higgins, Chairperson of Mental health Reform and Emilia Marchelewska, Health Advocacy Officer, Cairde. Picture Conor McCabe Photography.

Five New Primary Care Centres

Construction is under way on new state of the art Primary Care Centres at Carrick on Suir, Tipperary Town, Dungarvan, Waterford City and Wexford Town.

The new PCC in Carrick on Suir, for example, will complement services already being delivered at the adjacent St. Brigid’s Hospital. A full range of primary care services will be provided from the new PCC. This includes GP Services, Public Health Nursing Services, Occupational Therapy Services, Physiotherapy, Dental, Podiatry, Speech & Language Therapy and Psychology services. There will also be provision for mental health services.

A number of multi-disciplinary bookable rooms will be available for visiting health professionals. The Centre, which will be ready for operation by March 2018, will be open at least five days a week, with extra hours at weekends and evenings for some services.

Real Time Information For Limerick ED

Real Time Information For Limerick ED
Pictured as the new IMS MAXIMS system went live at the Emergency Department at University Hospital Limerick were Noreen Spillane, Chief Operations Officer, UL Hospitals Group; Paul Matthews, Project Manager, IMS MAXIMS; Dr Damien Ryan, Consultant in Emergency Medicine, UL Hospitals Group and Brian McKeon, Director of Informatics, Planning and Performance, UL Hospitals Group Photo Credit: Don Moloney

The opening of the new Emergency Department (ED) at University Hospital Limerick in May 2017 is a step closer following a significant upgrade to software systems in the Department.

With an excess of 60,000 presentations a year, the ED in Limerick is one of the busiest in the country. The systems upgrade will allow the Department to better manage increasing demand and has built-in additional functionality that will better track patient journeys through the new clinical environment and collect data in real time.

According to Dr. Damien Ryan, Consultant in Emergency Medicine, UL Hospitals Group: “The installation of the latest version of IMS MAXIMS will allow staff in the ED to have a modern, reliable information system so that we can capture more information about attendance patterns, patient flow and outcome. This system has the capability of allowing us in time to move to a paperless environment thus future-proofing our ICT infrastructure for years to come.”

Brian McKeon, Director of Informatics, Planning and Performance, UL Hospitals Group, said: “The new IMS MAXIMS ED system continues our journey towards fully digital care for the people of the Mid-West and throughout Ireland.  It is integrated with our own group-wide patient management system, which has one identifier for all acute patients in the region. Our previous legacy system was unstable and had limited clinical data, but this new system will allow us to analyse real-time ED data through our cloud-based Business Intelligence platform.

“The Medicine Directorate and eHealth Division staff here in the UL Hospitals Group have worked tirelessly to deliver this system in 2016. Always in the background, these talented and dedicated people are transforming the way we care for our patients into the future,” Mr. McKeon added.

Richard Corbridge, Chief Information Officer, HSE, said: “The new system enables real time information to support the management of patient flow and delivers bed side clinical information to staff, enabling safer, more efficient care to be delivered. The project is a great achievement, and a huge credit to the local and national teams and in particular the clinical leadership in Limerick who have championed the need for this system and the adoption of it.
This is another example of the EHR being used to improve processes, while also improving patient safety through the use of technology.
UL Hospitals Group CEO Colette Cowan added: “This is a fantastic achievement for UL Hospitals and the community we serve. The new software enables clinicians to have a shared view of their patients’ conditions and gives them the tools to quickly and accurately treat or discharge them. It also readies the hospital for further digital transformation. We are making great advancements in digital health and I look forward to seeing the continued benefits to staff and patients in Limerick.”

Key functionality of the ED system includes recording the attendance, tracking, clinical triage and recorded outcomes for each and every patient. The solution caters for the design of the new ED, which will be laid out in zones and cubicles, and tracks each patient throughout the department with enhanced data collection.

Mallow Injury Unit

Mallow Injury Unit was officially opened this month by Health Minister, Simon Harris.

In 2016, over 6,000 patients attended the Mallow Injury Unit; one of eleven Injury Units now in place across the country.

Located at Mallow General Hospital, the unit is open seven days a week from 8 to 8 and can treat both adults, and children aged five and over.

The Injury Unit, which opened in March 2013, is staffed by Consultant-led teams of doctors, nurses, radiographers and physiotherapists.  Patients can go directly to the Unit or be referred by a GP.

The unit has shown a continued increase in patient attendances since opening. Up to September 2016, 18,357 patients had been seen, with a 14.22% increase between September 2015 to September 2016. The average time from registration to discharge was 1.5 hours.

Dr Gerard McCarthy, Clinical Lead HSE Emergency Medicine Programme said that the Mallow Injury Unit was linked to a Hub Emergency Department in Cork University Hospital,

He said: “If a patient in an Injury Unit needs to be admitted to hospital they will be referred directly to a linked hospital; in this case, CUH, in exactly the same way as if they had attended the Hub Emergency Department.  While we highlight that our Units provide the same level of expertise and service as Emergency Departments, for the appropriate group of patients, they are not designed to treat serious head, back or neck injuries, abdominal pain, medical illnesses or mental health problems.  The Unit does not treat children under the age of five, because of the special requirements of young children attending hospital.”

Patient care is of paramount importance at the injury units, and research shows that patients generally report positive experiences. Dr McCarthy said; “The feedback from patients on the Unit is very positive. In August and September, the HSE sought feedback from patients who had attended Injury Units.  When asked to rate the Injury Unit Service, 70% of respondents selected excellent, 25% very good and 5% good.”

Standardising Patient Summaries

HIQA has published National Standard for a Procedure Dataset including a Clinical Document Architecture specification.

It says this new standard will ensure compliance with best practice in the electronic exchange of clinical documents between healthcare providers.

This standard is part of a suite of standards that HIQA has developed to support national patient summaries. A patient summary is a summarised version of a patient’s medical information that gives healthcare professionals the essential and most relevant information they need in order to provide appropriate care for a patient, for example, current medical conditions, allergies and adverse reactions.

The Director of Health Information at HIQA, Rachel Flynn, said “The standards will support the development of eHealth systems, which enhance the quality, accessibility and efficiency across all healthcare services through the secure, timely, accurate and comprehensive exchange of clinical and administrative data. These systems ultimately lead to the provision of safer, better care.”

The national standard for procedures was developed to standardise how procedures such as a hip replacement or an appendicectomy are recorded and how this information could be shared between healthcare professionals in order to facilitate safer better care. Up to now, there has been no standardised national dataset to describe a procedure that can be used in patient summaries. The national eHealth Strategy states that the development of patient summaries is a key priority to support the implementation of eHealth initiatives in Ireland, in particular electronic health records.

Standards in this area include data definitions, clinical concepts and terminologies, classification and terminology standards, messaging specifications, the Electronic Health Record, and security standards.

EIB Loan Drives Hospital Expansion

Europe’s long-term lending institution, the European Investment Bank (EIB) has signed a €100 million loan agreement with University College Cork.

The EIB investment will support an ambitious €241 million development plan for UCC.

This will include a €37 million new dental school and hospital, a €12 million new clinical medical school for the Cork hospitals, an €8 million new medical education centre for University Hospital Waterford, a €1 million new medical education centre for University Hospital, Kerry and a €1 million new medical education centre for South Tipperary General.

It will also support a new €12 million Health Innovation Hub Ireland building at the Cork Science & Innovation Centre, as well as student and IT services and other projects.

Statutory Homecare Consultation

Minister of State for Mental Health and Older People, Helen McEntee T.D., has announced that a consultation process is to be launched, with a view to establishing a new statutory homecare scheme.

Minister McEntee said ‘My priority is to ensure that our older people get the best care possible. For many that care can be provided in their own homes, surrounded by the people and communities that they love. Unfortunately, as a country, the only statutory scheme we have in place at present to care for our elderly is the Nursing Homes Support Scheme, a Fair Deal. I am determined to change this and to establish a new statutory homecare scheme.

“Homecare is an increasingly important part of the supports we offer to older people, and will continue to increase in importance into the future, as our ageing population grows. It is estimated that about 20% of the over 65 population receive some form of community-based support service annually from the State. The HSE’s National Service Plan sets a target to deliver 10.57 million Home Help Hours, 16,750 Home Care Packages (HCPs) and 190 Intensive HCPs for clients with more complex needs. However, homecare is not currently regulated by the State and it is not provided on a statutory basis.

“The Department of Health is currently engaged in a detailed process, which will determine what type of home care scheme is best for Ireland, in relation to both regulation and funding. Preparatory work has already been done in this area, including a HRB review of international best practice, which will be used to inform the development of a new statutory homecare scheme, and to regulate this important sector. Establishing exactly what type of scheme will work is a complicated process and while the Department will build on the success of Fair Deal we cannot simply copy it, or integrate homecare into it.

“In creating a new homecare scheme we need to plan for the projected increase in our older population and to devise a cost-effective and sustainable scheme and regulatory regime. In addition, we must also ensure that we don’t damage what is already in place in homes across Ireland. I know from speaking to older people and their families that many have informal home care arrangements in place. We must ensure that any new scheme, which will contain new regulations, does not endanger or restrict the current informal arrangements which are in place.

“A consultation process, which is planned to begin in the coming months, will allow all those who have views on this topic to have their say, including older people themselves, their families and health care workers. This is a hugely important undertaking, which will have implications for generations of older people. I’m looking forward to engaging with all groups and individuals, as well as politicians from across the political spectrum, to ensure we create a system which will allow people to remain in their homes for as long as possible and be cared for with dignity as they grow old.”

Mullingar Healthy Ireland

Staff at the Regional Hospital Mullingar have set up an “active and enthusiastic” Healthy Ireland Committee. They have recently set up a hospital Choir, are involved in Operation Transformation and are planning to launch Sli na Slainte routes from the hospital.

Ros Groarke (Occupational Therapy), Kate Plunkett (Physiotherapy), Caitriona Malone (Occupational Therapy), Gráinne Flanagan (Dietitian Manager & Healthy Ireland Committee lead) and Margaret Williams (Divisional Nurse Manager & Healthy Ireland Committee Co-lead).
Ros Groarke (Occupational Therapy), Kate Plunkett (Physiotherapy), Caitriona Malone (Occupational Therapy), Gráinne Flanagan (Dietitian Manager & Healthy Ireland Committee lead) and Margaret Williams (Divisional Nurse Manager & Healthy Ireland Committee Co-lead).

Standards For Data Collection

HIQA has published information management standards for national health and social care data collections.

It says that when implemented, these standards will improve the quality of national health information and data, contributing to the delivery of safe and reliable healthcare.

There are ten new standards which focus on the information governance practices and the management of national health and social care data collections in Ireland. These standards will apply to all health and social care data collections established and maintained on a national basis, providing a framework of best practice in the collection of health and social care data.

The Director of Health Information at HIQA, Rachel Flynn, said “Compliance with these standards will help to instil confidence in patients, clinicians and all other stakeholders that healthcare decisions are made based on high-quality information, the availability of which will ultimately improve patient safety.”

HIQA said each national health and social care data collection holds a rich source of data. “These information sources are used in many ways to inform decision-making, monitor diseases, organise services and measure, monitor and report on health and social care related activities and outcomes. The HSE uses indicators derived from these data collections through its service plan to monitor its performance on the quality of care.

“The Department of Health also collates these indicators in an annual National Healthcare Quality Reporting system report to provide a national overview of the quality of healthcare in Ireland. These standards will improve the quality of the data collected.
National health and social care data collections are national repositories of routinely collected health and social care data in Ireland. They play a crucial role by providing a national overview of a particular health or social care service.

“National data collections which play a role in providing a national overview of particular health and social care services include the National Cancer Registry of Ireland (NCRI), Immunisation Uptake Statistics, and the Computerised Infectious Disease Reporting (CIDR) System. They enable the assessment of key indicators of the health service, including influenza vaccine uptake, breast cancer screening rates and information in relation to hospital-acquired infections such as MRSA rates.”
HIQA will develop a structured programme of assessing compliance with the information management standards for national health and social care data collections within its legislative remit.

“Recognising that these standards are new, information sessions will be held to support national health and social care data collections to comply with these standards. HIQA plans to initiate a review programme during 2017, which will commence with the distribution of a ‘self-assessment tool’ to national health and social care data collections within its remit. This programme will be phased, and HIQA will continue to engage with national health and social care data collections in advance of the commencement of the process.”

Some cancer rates declining or static

The latest annual report from the National Cancer Registry, Ireland’s premier source of cancer information, suggests that, although the total number of cancers continues to rise, mainly due to the ageing of our growing population, there is some positive news.

For men, the chances of developing (or being diagnosed with) cancer, which had been rising steadily since 1994, may have plateaued. Rates of the top three cancers in men (prostate, colorectal and lung), having adjusted for age, are now declining or static.

For women too, the rate of the most common of the more serious cancers, breast cancer, has decreased since 2008, after a long period of increase from 1994.

The report shows that about 37,600 new tumours were registered annually in 2012-2014, of which 30,700 were malignant cancers, or 20,800 cancers excluding non-melanoma cancer of the skin, which is the commonest cancer overall but is rarely fatal.

The risk of developing cancer was higher for men than for women, overall and for most cancer types.

Cancer is the second most common cause of death in Ireland, after diseases of the circulatory system. About 8,700 cancer deaths per year occurred during 2011-2013. Lung cancer was the commonest cause of cancer death, about 21% of the total. The risk of dying of cancer was about 36% higher for men than for women.

Survival from cancer continues to improve. Over four consecutive periods, five-year net survival for all cancers (excluding non-melanoma skin cancer) increased incrementally: 1994-1998 (44%), 1999-2003 (51%), 2004-2008 (57%) and 2009-2013 (61%). Ten-year survival figures, published in this report for the same time, show a similar trend.

At the end of 2014 there were 139,526 persons still alive whose cancer had been diagnosed over the previous 21 years (1994-2014), equivalent to 3% of the Irish population. The most numerous cancer survivors were those who had been diagnosed with breast cancer (31,655), prostate cancer (30,642), bowel cancer (17,136) or melanoma of the skin (9,254).

Commenting on the figures, Professor Kerri Clough-Gorr, Director of the Registry and Professor of Cancer Epidemiology at University College Cork, said “Cancer now accounts for over 30% of all deaths in Ireland, and its prevention must be a high public health priority. The incidence trend in male cancers is encouraging, as we no longer see an increase in rates for the three main male cancers. Whether these improvements will be sustained remains to be seen. Cancer rates in women also seem to have plateaued due to a recent decline in breast cancer, but female lung cancer rates continue to rise, and it is now the second most common major cancer in women. There is a large and growing number of cancer survivors in our community which will need to be facilitated by expansion of cancer support services in the coming years”.