Action Plan for People Management in the Health Service

In November of 2001 the Government launched its new National Health Strategy â?" â?oQuality and Fairness, A Health System for youâ?Âù (hereafter referred to as Quality and Fairness). Quality and Fairness was developed following one of the largest consultation processes ever undertaken in the public service. It sets out the vision for the health service, the four principles upon which this vision will be built, it also establishes four National goals and finally sets out six â?~frameworks for changeâ?T, which will be used to achieve the vision, principles and goals. One of the six frameworks for change is Developing Human Resources. The health service is one of the largest employers in the public sector, with the employment level at the end of 2001 approaching 93,000 full time employees. These employees are spread across a large number of organisations, in multiple locations and settings across the country. Each employee plays a key role in the delivery of health service, in all settings, to the public. Download document here

Interventions with Parents in the Early Years for improved health outcomes: A focus on behaviour and cognitive development/school readiness

Equity Action is a Joint Action between the EU and Member States aiming to reduce health inequalities by helping to improve policies at national and regional level and harness the contribution of stakeholders. Dr Cotter of IPH completed this literature review as part of Equity Action Work Package 6

End of life care standards for people with dementia

End of life care standards for people with dementiaThis project, funded under Call 1 of CARDI’s Grants Programme and led by Dr Suzanne Cahill, School of Social Work and Social Policy, Trinity College Dublin, highlights the need for guaranteed standards of care for older people with dementia at the end of their lives.The research recommends the introduction of standards as a matter of urgency because of the huge increases in the number of people affected, and the number likely to be affected in the future. It is estimated that the number of people with dementia in the Republic of Ireland will rise from 44,000 to 104,000 by 2036 and in Northern Ireland from 16,000 to 47,000 in 2051.The research draws attention to the importance of agreeing new standards in Ireland, North and South, by proposing guidelines to develop policies and practices that can reflect the best available throughout the world.Research Team:•������ Dr Suzanne Cahill, School of Social Work and Social Policy, Trinity College Dublin•������ Ms Daphne Doran, Quality Initiatives, Belfast•������ Dr Max Watson, University of Ulster and Northern Ireland HospiceResearch briefingFull report��

The meaning of dependence and independence of older people with a disability in Ireland

The paper presents the findings of a research study carried out in Ireland in 2006 (Murphy et al., 2007) which explored the meaning of dependence and independence for older people with a disability. The research adopted a grounded theory approach; purposive sampling was used initially with some relational sampling towards the latter interviews. The sample was comprised of 143 older people with one of six disabilities: stroke (n=20), arthritis (20), depression (20), sensory disability (20), a learning disability (24), and dementia (18). All participants lived at home, some participants required high levels of help in activities of living while others were mostly independent. An interview schedule was used to guide interviews, all of which were tape recorded and transcribed. Data was collected on levels of dependence and independence using the Katz scale. Participants recorded high levels of independence in relation to transferring (93%), toileting (92%), dressing (87%), continence (87%) and feeding (98%). The main area of dependence where participants required assistance from others was with bathing (77%). The constant comparative technique was used to analyze qualitative data. The findings of the study would suggest that participants personal definition of their independence or dependence shifted relative to others and/or improvement or worsening of their capacity People were aware of the difference between independence and dependence, but these two concepts were not always perceived as opposites. It was possible to be independent and dependent at the same time. People valued being able to do things for themselves, accepted help when necessary but wanted to reciprocate when possible. Participants used varied coping strategies to regain and retain control of their lives. Strategies to promote older peoples independence and self esteem will be explored in this paper.

Social support group interventions in people with dementia and mild cognitive impairment: a systematic review of the literature

Abstract Despite the large number of studies evaluating social support groups for people with dementia, there are no systematic reviews of current evidence.The aim of this study was to evaluate the effectiveness of social support group interventions for people with dementia and mild cognitive impairment.A systematic review was performed. We searched electronic databases for randomised controlled trials. Two reviewers worked independently to select trials, extract data and assess risk of bias. A total of 546 studies were identified of which two met the inclusion criteria. We were not able to pool data for further analyses, as the interventions tested in the studies meeting the inclusion criteria were too dissimilar in content.The first trial (n = 136) showed a benefit of early-stage memory loss social support groups for depression and quality of life in people with dementia.The second trial (n = 33) showed that post-treatment self-reported self-esteem was higher in the group receiving a multicomponent intervention of social support compared with that in the no intervention control group.Limited data from two studies suggest that support groups may be of psychological benefit to people with dementia by reducing depression and improving quality of life and self-esteem.These findings need to be viewed in light of the small number, small sample size and heterogeneous characteristics of current trials, indicating that it is difficult to draw any conclusions. More multicentre randomised controlled trials in social support group interventions for people with dementia are needed.������������

The Costs of Caring for People with Dementia and Related Cognitive Impairments

The National Council on Ageing and Older People has undertaken a programme of research into dementia in Ireland. An Action Plan for Dementia provided a framework for the provision and planning of services for people with dementia in Ireland The Costs of Caring for People with Dementia and Related Cognitive Impairments is a complementary report to the Action Plan but with a more quantitative focus. The role of carers is one that is often taken for granted and is seen by many as a free resource. Dr Oâ?TShea explores what caring for a person with dementia entails in terms of the carers time, finances and stress. Evaluating the cost of caring for a person with dementia is the main focus of this study Download the Report here

Speech by Mr. Micheál Martin TD – Meeting The Challenges Of Cultural Diversity In The Irish Healthcare Sector

It gives me great pleasure to accept the invitation to address this conference on “Meeting the Challenges of Cultural Diversity in the Irish Healthcare Sector” which is being organised by the Irish Health Services Management Institute in partnership with the National Consultative Committee on Racism and Interculturalism. The conference provides an important opportunity to develop our knowledge and understanding of the issues surrounding cultural diversity in the health sector from the twin perspectives of patients and staff. Cultural diversity has over recent years become an increasingly visible aspect of Irish society bringing with it both opportunities and challenges. It holds out great possibilities for the enrichment of all who live in Ireland but it also challenges us to adapt creatively to the changes required to realise this potential and to ensure that the experience is a positive one for all concerned but particularly for those in the minority ethnic groups. In the last number of years in particular, the focus has tended to be on people coming to this country either as refugees, asylum seekers or economic migrants. Government figures estimate that as many as 340,000 immigrants are expected in the next six years. However ethnic and cultural diversity are not new phenomena in Ireland. Travellers have a long history as an indigenous minority group in Ireland with a strong culture and identity of their own. The changing experience and dynamics of their relationship with the wider society and its institutions over time can, I think, provide some valuable lessons for us as we seek to address the more numerous and complex issues of cultural diversity which have arisen for us in the last decade. Turning more specifically to the health sector which is the focus of this conference, culture and identity have particular relevance to health service policy and provision in that The first requirement is that we in the health service acknowledge cultural diversity and the differences in behaviours and in the less obvious areas of values and beliefs that this often implies. Only by acknowledging these differences in a respectful way and informing ourselves of them can we address them. Our equality legislation – The Employment Equality Act, 1998 and the Equal Status Act, 2000 – prohibits discrimination on nine grounds including race and membership of the Traveller community. The Equal Status Act prohibits discrimination on an individual basis in relation to the nine grounds while for groups it provides for the promotion of equality of opportunity. The Act applies to the provision of services including health services. I will speak first about cultural diversity in relation to the patient. In this respect it is worth mentioning that the recognition of cultural diversity and appropriate responses to it were issues which were strongly emphasised in the public consultation process which we held earlier this year in the context of developing National Anti-Poverty targets for the health sector and also our new national health strategy. Awareness and sensitivity training for staff is a key requirement for adapting to a culturally diverse patient population. The focus of this training should be the development of the knowledge and skills to provide services sensitive to cultural diversity. Such training can often be most effectively delivered in partnership with members of the minority groups themselves. I am aware that the Traveller community, for example, is involved in in-service training for health care workers. I am also aware that the National Consultative Committee on Racism and Interculturalism has been involved in training with the Eastern Regional Health Authority. We need to have more such initiatives. A step beyond the sensitivity training for existing staff is the training of members of the minority communities themselves as workers in our health services. Again the Traveller community has set an example in this area with its Primary Health Care Project for Travellers. The Primary Health Care for Travellers Project was established in 1994 as a joint partnership initiative with the Eastern Health Board and Pavee Point, with ongoing technical assistance being provided from the Department of Community Health and General Practice, Trinity College, Dublin. This project was the first of its kind in the country and has facilitated The project included a training course which concentrated on skills development, capacity building and the empowerment of Travellers. This confidence and skill allowed the Community Health Workers to go out and conduct a baseline survey to identify and articulate Travellers’ health needs. This was the first time that Travellers were involved in this process; in the past their needs were assumed. The results of the survey were fed back to the community and they prioritised their needs and suggested changes to the health services which would facilitate their access and utilisation. Ongoing monitoring and data collection demonstrates a big improvement in levels of satisfaction and uptake and ulitisation of health services by Travellers in the pilot area. This Primary Health Care for Travellers initiative is being replicated in three other areas around the country and funding has been approved for a further 9 new projects. This pilot project was the recipient of a WHO 50th anniversary commemorative award in 1998. The project is developing as a model of good practice which could inspire further initiatives of this type for other minority groups. Access to information has been identified in numerous consultative processes as a key factor in enabling people to take a proactive approach to managing their own health and that of their families and in facilitating their access to health services. Honouring our commitment to equity in these areas requires that information is provided in culturally appropriate formats. The National Health Promotion Strategy 2000-2005, for example, recognises that there exists within our society many groups with different requirements which need to be identified and accommodated when planning and implementing health promotion interventions. These groups include Travellers, refugees and asylum seekers, people with intellectual, physical or sensory disability and the gay and lesbian community. The Strategy acknowledges the challenge involved in being sensitive to the potential differences in patterns of poor health among these different groups. The Strategic aim is to promote the physical, mental and social well-being of individuals from these groups. The objective of the Strategy on these issues are: While our long term aim may be to mainstream responses so that our health services is truly multicultural, we must recognise the need at this point in time for very specific focused responses particularly for groups with poor health status such as Travellers and also for refugees and asylum seekers. In the case of refugees and asylum seekers examples of targeted services are screening for communicable diseases – offered on a voluntary basis – and psychological support services for those who have suffered trauma before coming here. The two approaches of targeting and mainstreaming are not mutually exclusive. A combination of both is required at this point in time but the balance between them must be kept under constant review in the light of changing needs. A major requirement if we are to meet the challenge of cultural diversity is an appropriate data and research base. I think it is important that we build up our information and research data base in partnership with the minority groups themselves. We must establish what the health needs of diverse groups are; we must monitor uptake of services and how well we are responding to needs and we must monitor outcomes and health status. We must also examine the impact of the policies in other sectors on the health of minority groups. The National Health Information Strategy, currently being developed, and the recently published National Strategy for Health Research – Making Knowledge Work for Health provide important frameworks within which we can improve our data and research base. A culturally diverse health sector workforce – challenges and opportunities The Irish health service can benefit greatly from successful international recruitment. There has been a strong non-national representation amongst the medical profession for more than 30 years. More recently there have been significant increases in other categories of health service workers from overseas. The Department recognises the enormous value that overseas recruitment brings over a wide range of services and supports the development of effective and appropriate recruitment strategies in partnership with health service employers. These changes have made cultural diversity an important issue for all health service organisations. Diversity in the workplace is primarily about creating a culture that seeks, respects, values and harnesses difference. This includes all the differences that when added together make each person unique. So instead of the focus being on particular groups, diversity is about all of us. Change is not about helping “them” to join “us” but about critically looking at “us” and rooting out all aspects of our culture that inappropriately exclude people and prevent us from being inclusive in the way we relate to employees, potential employees and clients of the health service. International recruitment benefits consumers, Irish employees and the overseas personnel alike. Regardless of whether they are employed by the health service, members of minority groups will be clients of our service and consequently we need to be flexible in order to accommodate different cultural needs. For staff, we recognise that coming from other cultures can be a difficult transition. Consequently health service employers have made strong efforts to assist them during this period. Many organisations provide induction courses, religious facilities (such as prayer rooms) and help in finding suitable accommodation. The Health Service Employers Agency (HSEA) is developing an equal opportunities/diversity strategy and action plans as well as training programmes to support their implementation, to ensure that all health service employment policies and practices promote the equality/diversity agenda to continue the development of a culturally diverse health service. The management of this new environment is extremely important for the health service as it offers an opportunity to go beyond set legal requirements and to strive for an acceptance and nurturing of cultural differences. Workforce cultural diversity affords us the opportunity to learn from the working practices and perspectives of others by allowing personnel to present their ideas and experience through teamwork, partnership structures and other appropriate fora, leading to further improvement in the services we provide. It is important to ensure that both personnel units and line managers communicate directly with their staff and demonstrate by their actions that they intend to create an inclusive work place which doesn´t demand that minority staff fit. Contented, valued employees who feel that there is a place for them in the organisation will deliver a high quality health service. Your conference here today has two laudable aims – to heighten awareness and assist health care staff to work effectively with their colleagues from different cultural backgrounds and to gain a greater understanding of the diverse needs of patients from minority ethnic backgrounds. There is a synergy in these aims and in the tasks to which they give rise in the management of our health service. The creative adaptations required for one have the potential to feed into the other. I would like to commend both organisations which are hosting this conference for their initiative in making this event happen, particularly at this time – Racism in the Workplace Week. I look forward very much to hearing the outcome of your deliberations. Thank you.

Interim Report of the Steering Group on the Review of the Mental Health Act 2001

Interim Report of the Steering Group on the Review of the Mental Health Act 2001 There is a commitment in the Programme for Government to review the Mental Health Act 2001. In line with this, Minister Lynch appointed a Steering Group to review the Mental Health Act 2001. Their report is now with an Expert Group. The review takes accounts of the significant changes in thinking about the delivery of mental health services that have taken place in the last ten years (including the introduction of the UN Convention on the Rights of People with Disabilities (CRPD), the shift to community based services, the adoption of a recovery approach in every aspect of service delivery and the involvement of service users as partners in their own care and in the development of the service). Click here to download PDF 471kb

Housing Strategy for People with a Disability 2011-2016 National Implementation Framework

Housing Strategy for People with a Disability 2011-2016 National Implementation Framework The Government's National Housing Strategy for People with a Disability was published in October 2011 by the Department of the Environment, Community & Local Government and the Department of Health. The strategy covers the period to 2016 and outlines the broad proposals and strategic objectives involved in effectively addressing the housing and related support needs of people with disabilities. The Implementation Framework develops the key actions from the Strategy and assigns responsibilities to stakeholders, within relevant timelines, and provides key performance indicators, as appropriate.   Click here to download PDF 3.8mb

Standards for the Assessment of Need process under Part 2 of the Disability Act 2005Consultation Process

Standards for the Assessment of Need process under Part 2 of the Disability Act 2005 In 2004, the Irish Government launched the National Disability Strategy as a framework of positive action measures to support the participation of people with disabilities in Irish society. Two new pieces of legislation â?" the Education for Persons with Special Education Needs Act, 2004 (EPSEN Act 2004 hereafter) and the Disability Act, 2005 â?" form an integral part of this strategy and deal with the special education and/or health needs of persons. Click here to download PDF 279kb The Report on the Consultation Process on Standards for the Assessment of Need process as referred to on page 6 of the Standards document above. Click here to download PDF 369kb

Future Health - A Strategic Framework for Reform of the Health Service 2012 - 2015

The Programme for Government promises the most fundamental reform of our health services in the history of the State. Future Health – A Srategic Framework for Reform of the Health Service 2012 – 2015 details the actions that we will take to deliver on this promise. The need for change in the health service is unquestionable. The current system is unfair to patients; it often  fails  to meet their needs fast enough; and it does not deliver value for money.   Click here to download