Poots launches £18m state-of-the-art Telemonitoring NI service

Health Minister Edwin Poots today marked the roll-out of a ground-breaking hi-tech scheme which will enable more patients to monitor their health in their own homes. Following funding of £18m from the Department of Health, the newly named Centre for Connected Health and Social Care (CCHSC), part of the Public Health Agency, worked in partnership with business consortium TF3to establish the innovative Telemonitoring NI service. The service is now being delivered by the TF3 consortium in partnership with the Health and Social Care Trusts.Remote telemonitoring combines technology and services that enable patients with chronic diseases to test their vital signs such as pulse, blood pressure, body weight, temperature, blood glucose and oxygen levels at home on a daily basis. The service will now be rolled out to 3,500 patients across Northern Ireland per annum for a period of six years.Mr Poots today visited the home of Larne pensioner Michael Howard who has Chronic Pulmonary Obstructive Disorder (COPD) to hear how Telemonitoring NI has changed his life.During the visit Mr Poots said: "Chronic diseases such as heart disease, diabetes and COPD affect around three quarters of people over the age of 75. This is the generation from whom transport and mobility pose the biggest problems. The Telemonitoring NI service will allow thousands to monitor their vital signs without having to leave their own homes."It means that patients are able to understand and manage their condition better. Many say it has improved their confidence and given them peace of mind. With a health professional monitoring each patient's health on a daily basis, there is less need for hospital admission. Carers are also better informed with the pro-active support provided. It means earlier intervention in, and the prevention of, deterioration of condition, acute illness and hospital admissions."Telemonitoring NI is an excellent example of how the Health Service can innovateusing modern technology to deliver a better service for our patients."Eddie Ritson, Programme Director of CCHSC, PHA, said: "The roll-out of Telemonitoring NI represents a significant step towards providing quality care for the growing number of people with heart disease, stroke, some respiratory conditions and diabetes who want to live at home while having their conditions safely managed."This new service will give people more information which combined with timely advice will enable patients to gain more control over their health while supporting them to live independently in their own homes for longer."A patient will take their vital sign measurements at home, usually on a daily basis. and these will automatically be transmited to the Tf3 system. The resulting readings are monitored centrally by a healthcare professional working in the Tf3 triage team. If the patient's readings show signs of deterioration to an unacceptable level, they will be contacted by phone by a nurse working in a central team and if appropriate a healthcare professional in the patient's local Trust will be alerted to enable them to take appropriate action."Families and carers will also benefit from the reassurance that chronic health conditions are being closely monitored on an ongoing basis. The information collected through the service can also be used by doctors, nurses and patients in making decisions on how individual cases should be managed. "Using the service, Mr Howard, 71, who has emphysema - a long-term, progressive disease of the lungs that primarily causes shortness of breath - monitors his vital signs using the new technology every weekday morning. The information is monitored centrally and if readings show signs of deterioration to an unacceptable level, Mr Howard's local healthcare professional is alerted."Taking my readings is such a simple process but one that gives me huge benefits as it is an early warning system to me and also for the specialist nurses in charge of my care. Without the remote telemonitoring I would be running back and forward to the GPs' surgery all the time to have things checked out," he explained."Having my signs monitored by a nurse means any changes in my condition are dealt with immediately and this has prevented me from being admitted to hospital - in the past I've had to spend six days in hospital any time I'm admitted with a chest infection."The telemonitoring is not only reassuring for me, it also gives me more control over managing my own condition and as a result I have less upheaval in my life, and I'm less of a cost to the health care system. Most importantly, it gives me peace of mind and one less thing to worry about at my age."Patients seeking further information about the new telemonitoring service should contact their healthcare professional.

Valuing Diversity ... A Way Forward A Strategy For Nursing And Health Visiting 1998 (PDF 8.3 Mb)

Valuing Diversity ... A Way Forward A Strategy For Nursing And Health Visiting 1998

Health Impact Assessment and Waste Management with particular reference to Incineration: An introductory paper

This introductory brief has been written as a response to a request for information on HIA and waste management, with particular reference to incineration. EU legislation forms the basis for much of Irish waste management policy. Waste Management – Taking Stock and Moving Forward (2004) sets targets for increased prevention and minimisation, encourages reuse and gives preference to recovery and recycling, which is in line with the EU’s Sixth Environmental Action Plan (2002). In the area of waste incineration, the Waste Incineration Directive (2000/76/EC) has been transposed into Irish law and sets operating requirements for the incineration of waste.

Framework for Preventing and Addressing Overweight and Obesity in Northern Ireland 2012-2022: A Fitter Future for All (PDF 1MB)

A Framework for Preventing and Addressing Overweight and Obesity in NI 2012-2022 This Framework aims to “empower the population of Northern Ireland to make healthy choices, reduce the risk of overweight and obesity related diseases and improve health and wellbeing, by creating an environment that supports and promotes a physically active lifestyle and a healthy diet”. In addition, the following overarching targets have been set: Adults • To reduce the level of obesity by 4% and overweight and obesity by 3% by 2022. Children • A 3% reduction of obesity and 2% reduction of overweight and obesity by 2022åÊThe target is in two parts; the proportion that are obese and the proportion that are overweight and obese. Prevention is typically taken forward through action to address two main areas – improving diet and nutrition, and increasing participation in physical activity. Acknowledging this, two overarching objectives for the Framework have been set: to increase the percentage of people eating a healthy, nutritionally balanced diet; and to increase the percentage of the population meeting the CMO guidelines on physical activity.

Personality Disorder: A Diagnosis for Inclusion - The Northern Ireland Personality Disorder Strategy - The Way Forward - June 2010

Personality Disorder: A Diagnosis for Inclusion - The Northern Ireland Personality Disorder Strategy - The Way Forward - June 2010

National Council on Ageing and Older People - Annual Report 2008

National Council on Ageing and Older People РAnnual Report 2008 2008 was a year of change for the National Council on Ageing and Older People. In January the Government announced the establishment of the Office for Older People at the Department of Health and Children and that the Office would have a key role in progressing the Government̢?Ts agenda for older people. The decision provided that Council staff would be transferred to the Office and that the Council would be replaced by an Advisory Council. Although a sad day for the Council itself, we regard this as a significant step forward in bringing older people̢?Ts issues right to the centre of Government policy-making. Click here to download PDF 333kb

Joint Commissioning Plan of the Health and Social Care Board and the Public Health Agency: 2010-2011

Legislation enacted on 1 April 2009 created a new Commissioning system with the establishment of a region-wide Health and Social Care Board, including 5 Local Commissioning Groups (LCGs), and a Public Health Agency. In line with Departmental direction and guidance the objectives of the new commissioning arrangements were to: - Approach the future delivery of Health and Social Care from a region-wide perspective focused on outcomes. - Ensure local sensitivity through the creation of five Local Commissioning Groups reflective of their areas. - Give appropriate weight to the public health agenda to ensure that commissioning reflects the drive to reduce health inequalities in our society and works in partnership with others to improve health and wellbeing. In this regard the legislation signalled a new way forward which would first be expressed in a Commissioning Plan for 2010/11 and beyond. This plan outlines how the Health and Social Care Board and the Public Health Agency are approaching that task. It is our aim that this plan is straightforward and written in a manner which will encourage public engagement and understanding. We wish to show clearly how the commissioning task is to be approached and to signal the decisions necessary to ensure the maintenance of a health and social care system in Northern Ireland which responds to the population it serves.

PHA supports World Hospice and Palliative Care Day

Saturday 8 October 2011 marks World Hospice and Palliative Care Day. The Public Health Agency would like to celebrate and support hospice and palliative care around the world by raising awareness and understanding of the needs - medical, social, practical and spiritual - of people living with a life-limiting illness, and their families.This year's World Hospice and Palliative Care Day theme is 'Many diseases, manylives, many voices - palliative care fornon-communicableconditions'.The theme will focus on how people living with conditions thatare notinfectious can benefit from palliative care.Non-communicable diseases (NCDs), which include cardiovascular diseases, cancers, chronic respiratory conditions and diabetes, make up60% of deaths worldwide. The majority of thesedeaths occur in low and middle income countries, where palliative care is often not available. To get involved in World Hospice and Palliative Care Day, log on to www.worldday.org/get-involved/ which gives you ideas and suggestions on what you can do on the day to support people living with life-limiting illnesses, and their families.Mary Hinds, Director of Nursing and Allied Health Professions, PHA, and Chair of the Implementation Process for End of Life Care in Northern Ireland, said: "Good quality palliative and end of life care will be important for us all. 'Living Matters, Dying Matters' is a five year strategy for palliative and end of life care in Northern Ireland, established to ensure that any person living with a life-threatening illness lives well and dies well, irrespective of their condition or care setting. "It has been encouraging to see the plans being taken forward by the Health and Social Care Trusts in partnership with local hospices and other providers, and involving local people."We aim to ensure that people receiving palliative care, their families and carers, are provided with high quality care across all settings and conditions, and are supported to enjoy a good quality of life, maximising their potential through the course of their illness."There is still some progress to be made within the context of the review of health and social services. We are looking for statutory and voluntary services to work together to make a significant difference in improving access to high quality services for those with life-limiting conditions, and to develop innovative approaches to care."

Public Policy and Ageing in Northern Ireland: Identifying Levers for Change

Public Policy and Ageing in Northern Ireland: Identifying Levers for Change Judith Cross, Policy Officer with the Centre for Ageing Research Development in Ireland (CARDI)��������Introduction Identifying a broad range of key public policy initiatives as they relate to age can facilitate discussion and create new knowledge within and across government to maximise the opportunities afforded by an ageing population. This article looks at how examining the current public policy frameworks in Northern Ireland can present opportunities for those working in this field for the benefit of older people. Good policy formulation needs to be evidence-based, flexible, innovative and look beyond institutional boundaries. Bringing together architects and occupational therapists, for example, has the potential to create better and more effective ways relevant to health, housing, social services and government departments. Traditional assumptions of social policy towards older people have tended to be medically focused with an emphasis on care and dependency. This in turn has consequences for the design and delivery of services for older people. It is important that these assumptions are challenged as changes in thinking and attitudes can lead to a redefinition of ageing, resulting in policies and practices that benefit older people now and in the future. Older people, their voices and experiences, need to be central to these developments. The Centre for Ageing Research and Development in Ireland The Centre for Ageing Research and Development in Ireland (CARDI) (1) is a not for profit organisation developed by leaders from the ageing field across Ireland (North and South) including age sector focused researchers and academics, statutory and voluntary, and is co-chaired by Professor Robert Stout and Professor Davis Coakley. CARDI has been established to provide a mechanism for greater collaboration among age researchers, for wider dissemination of ageing research information and to advance a research agenda relevant to the needs of older people in Ireland, North and South. Operating at a strategic level and in an advisory capacity, CARDI�۪s work focuses on promoting research co-operation across sectors and disciplines and concentrates on influencing the strategic direction of research into older people and ageing in Ireland. It has been strategically positioned around the following four areas: Identifying and establishing ageing research priorities relevant to policy and practice in Ireland, North and South;Promoting greater collaboration and co-operation on ageing research in order to build an ageing research community in Ireland, North and South;Stimulating research in priority areas that can inform policy and practice relating to ageing and older people in Ireland, North and South;Communicating strategic research issues on ageing to raise the profile of ageing research in Ireland, North and South, and its role in informing policy and practice. Context of Ageing in Ireland Ireland �۪s population is ageing. One million people aged 60 and over now live on the island of Ireland. By 2031, it is expected that Northern Ireland�۪s percentage of older people will increase to 28% and the Republic of Ireland�۪s to 23%. The largest increase will be in the older old; the number aged 80+ is expected to triple by the same date. However while life expectancy has increased, it is not clear that life without disability and ill health has increased to the same extent. A growing number of older people may face the combined effects of a decline in physical and mental function, isolation and poverty. Policymakers, service providers and older people alike recognise the need to create a high quality of life for our ageing population. This challenge can be meet by addressing the problems relating to healthy ageing, reducing inequalities in later life and creating services that are shaped by, and appropriate for, older people. Devolution and Structures of Government in Northern Ireland The Agreement (2) reached in the Multi-Party Negotiations in Belfast 1998 established the Northern Ireland Assembly which has full legislative authority for all transferred matters. The majority of social and economic public policy such as; agriculture, arts, education, health, environment and planning is determined by the Northern Ireland Assembly at Stormont. There are 11 Government Departments covering the main areas of responsibility with 108 elected Members of the Legislative Assembly (MLA�۪s). The powers of the Northern Ireland Assembly do not cover ��� reserved�۪ matters or ��� excepted�۪ matters . These are the responsibility of Westminster and include issues such as, tax, social security, policing, justice, defence, immigration and foreign affairs. Northern Ireland has 18 elected Members of Parliament (MP�۪s) to the House of Commons. Public Policy Context in Northern Ireland The economic, social and political consequence of an ageing population is a challenge for policy makers across government. Considering the complex and diverse causal factors that contribute to ageing in Northern Ireland, there are a number of areas of government policy at regional, national and international levels that are likely to impact in this area. International The Madrid International Plan of Action on Ageing (3) and the Research Agenda on Ageing for the 21st Century (4) provide important mechanisms for furthering research into ageing. The United Kingdom has signed up to these. The Madrid International Plan of Action on Ageing commits member states to a systematic review of the Plan of Action through Regional Implementation Strategies. The United Kingdom�۪s Regional Implementation Strategy covers Northern Ireland. National At National level, pension and social security are high on the agenda. The Pensions Act (5) became law in 2007 and links pensions increases with earnings as opposed to prices from 2012. Additional credits for people raising children and caring for older people to boost their pensions were introduced. Some protections are included for those who lost occupational pensions as a result of underfunded schemes being wound up before April 2005. In relation to State Pensions and benefits, this Act will bring changes to state pensions in future. The Act now places the Pension Credit element which is up-rated in line with or above earnings, on a permanent, statutory footing. Regional At regional level there are a number of age related public policy initiatives that have the potential to impact positively on the lives of older people in Northern Ireland. Some are specific to ageing such as the Ageing in an Inclusive Society (6) and others by their nature are cross-cutting such as Lifetime Opportunities: Governments Anti-Poverty Strategy for Northern Ireland (7). The main public policy framework in Northern Ireland is the Programme for Government: Building a Better Future, 2008-2011(PfG) (8) . The PfG, is the overarching high level policy framework for Northern Ireland and provides useful principles for ageing research and public policy in Northern Ireland. The PfG vision is to build a peaceful, fair and prosperous society in Northern Ireland, with respect for the rule of law. A number of Public Service Agreements (PSA) aligned to the PfG confirm key actions that will be taken to support the priorities that the Government aim to achieve over the next three years. For example objective 2 of PSA 7: Making Peoples�۪ Lives Better: Drive a programme across Government to reduce poverty and address inequality and disadvantage, refers to taking forward strategic action to promote social inclusion for older people; and to deliver a strong independent voice for older people. The Office of the First Minister and deputy First Minister (OFMDFM) have recently appointed an Interim Older People�۪s Advocate, Dame Joan Harbison to provide a focus for older peoples issues across Government. Ageing in an Inclusive Society is the cross-departmental strategy for older people in Northern Ireland and was launched in March 2005. It sets out the approach to be taken across Government to promote and support the inclusion of older people. The vision coupled with six strategic objectives form the basis of the action plans accompanying the strategy. The vision is: ���To ensure that age related policies and practices create an enabling environment, which offers everyone the opportunity to make informed choices so that they may pursue healthy, active and positive ageing.�۝ (Ageing in an Inclusive Society, Office of the First Minister and Deputy First Minister, 2005) Action planning and maintaining momentum across government in relation to this strategy has proved to be slower than anticipated. It is proposed to refresh this Strategy in line with Opportunity Age ��� meeting the challenges of ageing in the 21st Century (9). There are a number of policy levers elsewhere which can also be used to promote the positive aspects of an ageing society. The Investing for Health (10) and A Healthier Future:A 20 Year Vision for Health and Well-being in Northern Ireland (11), seek to ensure that the overall vision for health and wellbeing is achievable and provides a useful framework for ageing policy and research in the health area. These health initiatives have the potential to positively impact on the quality of life of older people and provide a useful framework for improving current policy and practice. In addition to public policy initiatives, the anti-discrimination frameworks in terms of employment in Northern Ireland cover age as well as a range of other grounds. Goods facilitates and services are currently excluded from the Employment Equality (age) Regulations (NI) 2006 (12). Supplementing the anti-discrimination measures, Section 75 of the Northern Ireland Act 1998 (13), unique to Northern Ireland, places a statutory obligation on public authorities in fulfilling their functions to promote equality of opportunity across nine grounds, one of which is age(14). This positive duty has the potential to make a real difference to the lives of older people in Northern Ireland. Those affected by policy decisions must be consulted and their interests taken into account. This provides an opportunity for older people and their representatives to participate in public policy-making, right from the start of the process. Policy and Research Interface ���Ageing research is vital as decisions in relation to policy and practice and resource allocation will be made on the best available information�۝. (CARDI�۪s Strategic Plan 2008-2011) As outlined earlier, CARDI has been established to bridge the gap to ensure that research reaches those involved in making policy decisions. CARDI is stimulating the ageing research agenda in Ireland through a specific research fund that has a policy and practice focus. My work is presently focusing on helping to build a greater awareness of the key policy levers and providing opportunities for those within research and policy to develop closer links. The development of this shared understanding by establishing these links between researchers and policy makers is seen as the best predictor for research utilization. It is important to acknowledge and recognise that researchers and policy makers operate in different institutional, political and cultural contexts. Research however needs to ���resonate�۪ with the contextual factors in which policy makers operate. Conclusions Those working within the public policy field recognise all too often that the development of government policies and initiatives in respect of age does not guarantee that they will result in changes in actual provision of services, despite Government recommendations and commitments. The identification of public policy initiatives as they relate to age has the potential to highlight persistent and entrenched difficulties that social policy has previously failed to address. Furthermore, the identification of these difficulties can maximise the opportunities for progressing these across government. A focus on developing effective and meaningful targets to ensure measurable outcomes in public policy for older people can assist in this. Access to sound, credible and up-to-date evidence will be vital in this respect. As well as a commitment to working across departmental boundaries to effect change. Further details: If you would like to discuss this paper or for further information about CARDI please contact: Judith Cross, Policy Officer, Centre for Ageing Research and Development in Ireland CARDI). t: +44 (0) 28 9069 0066; m: +353 (0) 867 904 171; e: judith@cardi.ie ; or visit our website at: www.cardi.ie References 1) Centre for Ageing Research and Development in Ireland (2008) Strategic Plan 2008-2011. Belfast. CARDI 2) The Agreement: Agreement Reached in the Multi-Party Negotiations. Belfast 1998 3) Madrid International Plan of Action on Ageing. http://www.un.org/ageing/ 4) UN Programme on Ageing (2007) Research Agenda on Ageing for the 21st Century: 2007 Update. New York. New York. UN Programme on Ageing and the International Association of Gerontology and Geriatrics. 5) The Pensions Act 2007 Chapter 22 6) Office of the First Minister and deputy First Minister (2005). Ageing in an Inclusive Society. Belfast. OFMDFM Central Anti-Poverty Unit. 7) Office of the First Minister and deputy First Minister (2005). Lifetime Opportunities: Government�۪s Anti-Poverty and Social Inclusion Strategy for Northern Ireland. Belfast. OFMDFM Central Anti-Poverty Unit. 8) Northern Ireland Executive (2008) Building a Better Future: Programme for Government 2008-2011. Belfast. OFMDFM Economic Policy Unit. 9) Department for Work and Pensions, (2005) Opportunity Age: Meeting the Challenges of Ageing in the 21 st Century. London. DWP. 10) Department of Health, Social Services and Public Safety (DHSS&PS) (2002) Investing for Health. Belfast. DHSS&PS. 11) Department of Health, Social Services and Public Safety (DHSS&PS) (2005) A Healthier Future:A 20 Year Vision for Health and Well-being in Northern Ireland Belfast. DHSS&PS. �� 12) The Employment Equality (Age) Regulations (Northern Ireland) 2006 SR2006 No.261 13) The Northern Ireland Act 1998, Part VII, S75 14) The nine grounds covered under S75 of the Northern Ireland Act are: gender, religion, race, sexual orientation, those with dependents, disability, political opinion, marital status and age.

Substance Misuse Among People Over 55 - Perspectives from the Community and Voluntary sector in Belfast

The Belfast Health Development Unit (BHDU) was established as a Ministerial priority in March 2010, co-locating staff from The Public Health Agency (PHA), Belfast Health and Social Care Trust (BHSCT) and Belfast City Council (BCC). One of the strategic priorities for the BHDU is: an integrated approach to planning and delivery of services for older people in the city.The PHA and the BHDU had identified a need to examine the extent of substance misuse issues within the older population of the city of Belfast and to explore early intervention programmes targeting this population. It is envisioned that this piece of work will inform and support the Belfast Healthy Ageing Strategic Partnership on older people and its multi-sectoral action plan and will influence the work and priorities of the Belfast Strategic Partnership and its constituent stakeholders in taking drug and alcohol work forward in Belfast.The aim of this research was to review knowledge, awareness and evidence of the impact of substance misuse on the older population (aged 55+) and to review good practice in reducing substance related harm within this population which has been done by undertaking a review of available research, data and information sources. However, the main focus of the research involved consulting with a broad range of community and voluntary sector organisations working in the Belfast area to assess their views and perceptions of the prevalence and extent of substance misuse within the older population and the services currently in place to address this issue.�

BDAWG Scoping Report: Drugs and alcohol services in Belfast

Mary Black, Assistant Director for Health and Social Wellbeing Improvement in the Public Health Agency, established the Belfast Drug and Alcohol Working Group in early 2010 to undertake a scoping exercise of drugs and alcohol services in Belfast, and to produce a report outlining their findings and making some recommendations as to how services could be better promoted, targeted, co-ordinated and ultimately improved.� This report is the culmination of a series of meetings and workshops (from June to November 2010) where members considered all of the available information in the context of what they, and the organisations they represent, consider to be the gaps and areas which could be improved upon for PHA to consider when taking forward alcohol and drug work and services over the next 5-year period (i.e. 2011-2016).� The report takes a systematic approach to scoping and compiling evidence on: funding of drug and alcohol services; information and awareness-raising; education and prevention; treatment and support; services for vulnerable groups; workforce development; skilling up and supporting of communities; reducing availability; tackling substance related crime; and coordination and information sharing. Each section of the report ends with an analysis of the gaps and recommendations for action, with all of the recommendations presented in a tabular format in Section 13.

Regional Health and Social Care Personal and Public Involvement Forum: Annual Update Report 2012/13

Personal and Public Involvement (PPI) is an essential component in the delivery of truly person centred services.�It is also a statutory duty.�The PHA has leadership responsibilities in respect of the implementation of PPI across HSC.�One of the ways in which the PHA discharges that leadership function, is through the Regional HSC PPI Forum.�This body brings together all HSC organisations, working alongside service users and carers, to bring a focus on involvement.�It promotes the sharing of best practice, identifies and tackles issues of common concern and providers a platform for the active participation of service users and carers.� Each year in response to a Priorities for Action (PFA) target, the PHA, working with HSC partners, service users and carers in the Forum, develop an Annual Report on PPI work taken forward through the Forum.The report for 2012/13 details progress in a number of important areas such as training, development of standards etc.