Understand Together

vol. 10 | issue 8 | WINTEr 2016
staff magazine of the IRISH HEALTH SERVICE
Understand
Together
Dementia
campaign
Values in
Action
features general news you section lifestyle

Welcome to the
latest edition of
Health Matters
I don’t think any reader will fail to be
moved to tears when they read the story
of Tom Fahy, a young baby diagnosed
with Edwards Syndrome in pregnancy
and lived just 11 days. His parents have
bravely shared their experiences and the
support they received from the staff at
the Coombe maternity hospital during
the heartbreaking time.
Our cover story for this edition is the
Dementia Understand Together, a new
campaign to increase awareness of
dementia.
It is an amazing public support,
awareness and information campaign
aimed at inspiring people from all
sections of society to stand together
with the 55,000 Irish people living
with dementia. Nearly every one of
us knows somebody who is directly
affected by dementia.
Another groundbreaking development
we are highlighting is the Values in
Action project which kicked off in the
Midwest recently with 180 volunteers.
Staff were introduced to nine behaviours
that reflect the HSE values of care,
compassion, trust and learning and it is
hoped that these influential individuals
or ‘champions’ will spread the
behaviours to colleagues and put them
into action on the ground.
The project is based on the belief
that real and sustainable culture
change can be shaped by ordinary staff
members across the country. Well done
to all involved.
As ever, we welcome your ideas and
feedback on the magazine.
A sincere thanks to all those who have
sent in contributions to this edition and
I hope you find plenty of interesting
reading in it.
Joanne Weston
Joanne Weston,
Editor
Contents
You Section
06 STAND TOGETHER
New campaign launched to increase
awareness of dementia
08 I QUIT FOR GOOD
One man’s journey to quitting for good
10 SUPPORT FOR PARENTS
Parents of little Tom Fahy share their
heart-breaking experience
12 TALLAGHT NURSE MAKES HISTORY
Helen becomes first Irish Inherited
Cardiac Conditions Clinical Nurse
Specialist
13 SERVICE USER ENGAGEMENT
Interview with Liam Hennessy, new
Head of Service User Engagement in
Mental Health
14 STAFF ACHIEVEMENTS
Staff achievements from around the
country
15 LIMERICK BOOST FOR PIETA HOUSE
Limerick people step out for Pieta House
16 NO ORDINARY SWIMMING CLUB
Mary Arrigan-Langan remembers 35
years of Octopus
17 QUADRULPLETS JOIN TWINS AND
TRIPLETS
Newborn history at University Maternity
Hospital Limerick
18 STAFF UPDATE
Quick updates from around the country
19 CROKE PARK SHOWDOWN
Trainee nurses go head to head at the
All- Ireland Senior Camogie Final
20 BENCHES UNVEILED
Cherry Orchard Hospital teams up with
Irish Prison Service
Features
21 VALUES IN ACTION
Making our values a visible part of our
everyday actions
24 BREASTFEEDING
New expanded services for parents at
www.breastfeeding.ie
26 ACTIVITY-BASED FUNDING
The money follows the patient in new
system
28 NATIONAL OFFICE OF CLINICAL AUDIT
Aiming to improve patient outcomes
29 HSELIVE
New multi-channel information service
to answer your health services
questions
30 COMMUNITY INTERVENTION TEAMS
Service reducing unnecessary hospital
stays
31 STAFF SURVEY
Thanks for giving us your time and
views
32 FRONT LINE OWNERSHIP
Valuing staff knowledge and creativity
34 INDIVIDUAL HEALTH IDENTIFIER
A patient safety initiative
36 INNOVATION SHOWCASE
Exhibition showcases technologies that
will revolutionise healthcare
This magazine is produced by the
HSE Communications Division
Publishers: Celtic Media Group
www.celticmediagroup.ie
Feedback: Send your feedback to
healthmatters@hse.ie, joanne.weston@hse.ie
Healthy Weight
New policy and action plan

HEALTH MATTERS winter 2016
38 QUALITY AND SAFETY COMMITTEE
The care we provide
39 HBS LOOK TO THE FUTURE
Significant success achieved in first
three years
40 COMMUNICATING CLEARLY
New tools to assist staff in how to
speak to patients and colleagues
42 SCHWARTZ ROUNDS
Staff given opportunity to reflect on
emotional aspect of their work
44 SINGLE ASSESSMENT TOOL
Ensuring older people receive
appropriate care and support
46 CHILDREN FIRST
Promoting the safety and wellbeing of
children
46 AGEING WELL
Overwhelming response to St Finbarr’s
Ageing Well group
47 LINN DARA AWARD
Building is ‘welcoming and reassuring’
48 HEALTH AND SAFETY
Thousands of incidents reported
49 NALOXONE USE
How to save a life
50 HOME SHARING
The alternative to traditional respite
services
51 COPD SERVICES
New outreach clinics in Cork
52 MEDICAL CARDS
Three-year plan outlined
52 LITTLE GOES A LONG WAY
Promotion of public health campaigns
24
63
66
77
17
winter 2016 | health matters |

67
Get the
flu vaccine
Contents
55
59
News
53 TRAINING THE TRAINERS
Organ donation and transplant staff
undertake new course
53 DRUGS AND ALCOHOL HELPLINE
Email support service available
54 INJURY UNITS
Positive feedback from patients
55 DA VINCI ROBOT
State-of-the-art technology comes to
Limerick theatre room
56 #HELLOMYNAMEIS IN TULLAMORE
1,000 staff sign up to campaign
57 VIRTUAL DEMENTIA TOUR
Tour offers unique insight
58 HEALTHY IRELAND SURVEY
One in four people still smoke
59 SAFEGUARDING OLDER PEOPLE
Seminar takes place as part of joint
initiative
59 EMERGENCY EXERCISE
HSE staff volunteer in Dublin Airport
exercise
60 FLU VACCINE
‘Jab helps keep me alive’
61 BABY BOX IN LIMERICK
Initiative to reduce incidence of infant
mortality
62 SEXUAL HEALTH PROMOTION
Concludes first year as a national
programme
63 MEDICAL CAREERS DAY
Building your future
63 INTERCULTURAL HEALTH AWARD
Pilot project one of six finalists
64 PSYCHOACTIVE DRUGS
Use in Ireland continues to rise
73
64 INNOVATIVE WEBINAR
QI Talktime launched
65 BALLAGHDERG GARDEN
Revamp at Special Needs preschool
65 WE MUST WORK TOGETHER
Connecting for Life Donegal conference
66 UNDER THE WEATHER
Treating common complaints with
common sense
67 PREMATURE BABIES LEAFLET
New booklet and online information
Lifestyle
68 OPTIMISING POWER IN WORK
New awareness campaign teaches energy
69 NEW GALWAY HOSPITAL WEBSITE
Site launched in early September to
highlight accessible walking routes
70 LEARNING HOW TO GET ACTIVE
46 HSE staff complete the Irish Heart
Foundation Active@Work training
| health matters | winter 2016

online
Sites we like
www.ehealthireland.ie
60
www.irishprematurebabies.com
HEALTH MATTERS winter 2016
www.understandtogether.ie
71 ACTIVE AT WORK AWARDS
18 HSE workplace earn plaudits
for their efforts
72 ACTIVE IN WINTER
Top tips for getting enough exercise
through the cold winter months
73 ST FINBARR’S GET WALKING
Staff lunchtime walking groups proving
a huge success
74 FOOD ALLERGENS
The Environmental Health Service
protecting the public from this very real
food safety risk
76 REDUCE PORTION SIZES
Parents urged to give children childsized
portions
77 REDUCING THE BURDEN
OF OBESITY
New policy and action plan aims to
reverse obesity trends
78 FIRST DRIVE
We check out the Citroen Grand
C4 Picasso
www.undertheweather.ie
winter 2016 | health matters |

You
Section
Understand Together
campaign to tACKLE
DEMENTIA STIGMA
ementia Understand Together,
a new campaign to increase
awareness of dementia, was
D
launched on Monday, October
24th at City Hall in Dublin. It is
a public support, awareness and information
campaign aimed at inspiring people from all
sections of society to stand together with
the 55,000 Irish people living with dementia.
The ultimate aim is to create an Ireland that
embraces and includes people living with
dementia, one which displays solidarity with
them and their loved ones.
Understand Together is led by the HSE
working with The Alzheimer Society of Ireland
and Genio and a coalition of over 30 partners
from business, academic, health and voluntary
and community sectors. The campaign is funded
by the State and The Atlantic Philanthropies.
Any one of us can develop
dementia...
The launch was attended by over 100 people
representing all parts of Irish society showing
their support for building more inclusive and
understanding communities for people with
dementia and their loved ones.
Professor Brian Lawlor, Trinity College Dublin
and chair of the campaign steering group, said,
“Each year over 4,000 people develop dementia
in Ireland - over 11 people a day. All are living
with a brain condition that deeply affects their
lives and the lives of people who love and
care for them.” Research undertaken for the
campaign shows that fear and stigma surround
dementia, resulting in unnecessary loneliness
and isolation for people living with dementia
and for their families. It can also result in delays
in seeking help and diagnosis with people
missing out on available supports and services
as a result. These services and supports can
allow people to live well with dementia for
many years while maintaining their dignity and
quality of life.”
Ronan Smith, who is living with dementia
and is a member of the campaign steering
group, said, “Life doesn’t end when dementia
begins. People with dementia can and do
live meaningful, active lives for many years.
Diagnosis doesn’t mean we immediately lose our
skills and abilities, our need to belong and share
or, above all, our sense of dignity. Respecting
the diversity of the dementia experience and the
individuality of people who are living with it is a
vital step in recognising that the person is a lot
more than the condition.”
everyone can play a part by
understanding more
ONE in two Irish people know or have known
someone with dementia. Despite this, only 1 in
4 people feel they have a good understanding
of what dementia is and what it isn’t. This
campaign, as part of the National Dementia
Strategy, aims to build understanding using
existing projects to promote greater openness
about dementia.
Dementia not only deeply impacts individuals
with the conditioni but also the lives of their
loved ones. Those caring for loved ones with
dementia often experience loneliness and
isolation. Margot McCambridge, who cared for
her husband and is a member of the campaign
steering group, said, “The caring experience is
complicated. It can be rewarding. It can also
be hugely difficult at times. Support is needed
for the carers as much as for the person with
dementia. If the carer is supported, this in itself
supports the person with dementia.”
Dr Stephanie O’ Keeffe, National Director of
Health & Wellbeing, HSE, commented, “The
HSE is proud to be working with the many
organisations and partners who stand with us
today, and look forward to adding to our support
network as the campaign builds over the
coming years.
“Building and sustaining compassionate
MORE INFORMATION
Find out more about the campaign at
www.understandtogether.ie
If you would like to get involved in the
campaign please contact:
Nicola Donnelly, National Dementia Campaign
Manager, HSE Communications Division,
Dr Steevens’ Hospital, Dublin D08 W2A8,
01-6352478 /087-0985529.
Email: nicola.donnelly1@hse.ie
www.hse.ie/dementia
communities supportive of people with
dementia and carers is a challenge which
many key organisations can play a part. We
know from evidence that maintaining social
and community ties is an important element
in helping people live well with dementia and
in helping to support their loved ones. This
campaign seeks to create a collaborative model
in which those already engaged in dementia
specific activities can link with others and
organisations from diverse sectors can work
towards greater understanding of dementia and
inclusion of those affected by it.”
Understand Together is one of six key
elements of the National Dementia Strategy
and is jointly overseen by the HSE’s Health
and Wellbeing Division, and the HSE’s National
Dementia Office in Services for Older People,
Social Care Division. It involves the development
of radio, print, out of home, digital and television
campaigns alongside the development of a
partnership network comprising local and
| health matters | winter 2016

FAR LEFT: Dr Ronan Glynn, Specialist Registrar in
Public Helath (left) with Mary Manning, General
Manager, National Dementia Office and Professor
Brian Lawlor, Chair of the Campaign Steering
Group (right), pictured at the launch of Dementia
‘Understand Together’ campaign held in City Hall,
Dublin. Photo: robbie reynolds
TOP LEFT: Michelle Barrett, Caroline Kennedy,
Margaret Moran, Rosie Jones, Delia Roche and
Hilda Archbold at the Carlow Day Centre. Photo:
Pat Moore
TOP RIGHT: Dr Stephanie O’Keeffe, National
Director, HSE Health and Wellbeing.
LEFT: Watermans Lodge, Dementia-specific
Respite/ Day Centre, Ballina/ Killaloe, Co Tipperary.
Back row left to right: Sean Heaney, bus driver’
Marika Peek, volunteer; Eilish Long, administrator;
Katherine Creamer, carer; Ann Fleming, cook;
Adrian Ryan, carer; Elaine Shields, carer; Nicola
Dooley, community employed carer. Front left to
right: Margaret Larkin, Eileen Flannery, Nuala Foley,
Mera Irwin. PHOTOGRAPHY: DERMOT LYNCH
national organisations and groups aimed at
creating better community environments
that actively embrace people with dementia
and their loved ones. The campaign will also
communicate information about dementia
- what it is, who gets it and things people can
do to reduce their risks of developing dementia.
Alongside this information campaign the
campaign will be promoting simple everyday
things that businesses, organisations and
individuals can do to show their support for
people living with dementia and those caring
for loved ones.
working together to promote
understanding of dementia
UNDERSTAND Together is a collaborative
campaign that has been developed with
partners, including ASI and Genio.
Tina Leonard, Head of Advocacy & Public
Affairs with the Alzheimer Society of Ireland
(ASI) said, “Each day, we hear of stigma and
isolation from people with dementia and
carers. When people realise that dementia
affects so many in our communities, when
people realise that calling for a chat can make
a world of difference and when people realise
that being ill isn’t shameful, we’ll have a better
society for all.”
Madeline Clarke, Executive Director, Genio,
said, “Through the HSE and Genio Dementia
Programme, innovative projects across the
country are developing personalised ways of
supporting people with dementia to remain
living at home for as long as possible. A
supportive and well informed community
is an essential component to this. Genio is
delighted to be involved in the Understand
Together campaign which will not only
increase knowledge of dementia but also
encourage everyone to become actively
involved in supporting people with dementia
in their community.”
This partnership approach is fundamental
to ensuring that people across all sections of
Irish society are inspired to become involved in
building more inclusive communities for people
with dementia and their loved ones. To date, over
30 businesses and organisations have pledged
their support for the campaign. These include
transport providers Irish Rail, Bus Eireann and
Dublin Bus; financial institutions Bank of Ireland,
Ulster Bank and the Irish League of Credit
Unions; An Post; the IFA; IBEC and ISME. Other
partners include Boots, the Irish Pharmaceutical
Union, the ICGP and the Law Society of Ireland,
as well as a wide range of voluntary and
community organisations including ALONE, Age
Friendly Ireland and Active Retirement Ireland.
Together with the campaign, these organisations
hope to promote greater awareness of dementia
and greater inclusion of people affected by the
condition in communities across Ireland.
To find out more:
www.understandtogether.ie
winter 2016 | health matters |

You
Section
Jimmy is 10 years smokefree
200,000 cigarettes
iona Boyle, Smoking Cessation
Advisor, Donegal Community
recently caught up with Jimmy
F
Kavanagh, a former client of the
Smoking Cessation Programme,
for a cuppa as he celebrated 10 years since he
quit smoking which means, for him, that he has
not smoked around 200,000 cigarettes.
Jimmy had made several attempts to quit
smoking and had managed some success - once
for two years and once for three years. On both
occasions, he relapsed while out watching
football in the pub. He confided this week that he
probably smoked up to 60 cigarettes per day and
not the 30 to 40 that he reported at the time.
He used to get up in the middle of the night
to smoke and would normally have had seven
cigarettes taken before starting work in the
morning. He had been smoking for around 30
years and his health was his main reason for
quitting as he was having chest infections.
As is very common, Jimmy’s main concern
about quitting was fear of failure. At the time,
Fiona explained that most clients had this as
their main concern, and that even if you stop
smoking for a short period of time, the chances
are that you will learn something that will
help you on your next attempt. Additionally,
the majority of people make between 5 and 10
quit attempts before they become successful
especially if they are doing it by themselves.
Once motivated to quit ,success is more likely
if appropriate treatments are used ie Champix
tablets, patches, mist etc. and if Smoking
Cessation Services are used also.
Jimmy’s Carbon Monoxide level (breath test)
at his initial appointment was 18ppm in the
breath and 3.2pc in the blood. Normal is 2ppm
in the breath and

etter off
to be –the hardest part was getting the
thinking right
• Try not to think of it as a sacrifice and that
you are giving something up – it’s more
about taking something back as it’s the
biggest favour you’ll ever do for yourself
• Seeing Fiona every few weeks helped
because you knew there was someone
rooting for you and you didn’t want to let
them down. Having the Carbon Monoxide
test each visit also helped to keep you going
Recently, Jimmy was interviewed by Shaun
Doherty on Highland Radio about his achievement
which got a great response on air and as a result
a local woman contacted Jimmy the day after
the radio interview to say that she was inspired
by it. This lady has now quit and is out walking
each day and is keeping in contact with Jimmy by
Facebook. It shows that though quitting smoking
can be difficult, the more support that a person
can get from the people around them and trained
professionals, the more likely they are to quit.
If this story has inspired you to think about
quitting smoking and if you would like free
confidential support at one of the 13 clinics
throughout Donegal then please contact either
Fiona Boyle on 087-2514790 or Catherine
Coleman on 086-0492465. You are 10 times
more likely to quit smoking if you use this service.
Thanks again to Jimmy for allowing his story to
be told.
We Can Quit – Women Supporting Women to kick the habit
The Irish Cancer Society’s ‘We Can Quit’
programme, featured in the summer issue of
Health Matters, is continuing to attract women
in Cork and Dublin who are determined to quit
smoking.
‘We Can Quit’ is a free, community based 12-
week support programme for women who want
to quit smoking. It offers women the opportunity
to develop skills, build confidence and share
experiences with each other in a friendly and
supportive group environment, where everyone
understands what they are going through.
The programme also offers free nicotine
replacement therapy (NRT), a weekly smoking
cessation group and one to one support.
This year will see courses in a total of 10
locations being completed by the end of
this year, with extra locations being added
next year. Over the course of 2015 and
2016, the programme has had a total of 248
women participate in courses in Fettercairn,
Blakestown, Swords, Coolock, Kilmore, Rialto
& Bluebell in Dublin and Mallow, Mayfield and
Ballyphehane/Togher in Cork.
Deciding to quit smoking is no easy feat, as
Carolyn Roche from Tallaght knows only too
well. Carolyn previously tried to stop smoking
on two other occasions. This time, Carolyn was
determined to quit and went along to her local
‘We Can Quit’ programme at Fettercairn in July
of this year. Since then Carolyn has managed
to battle through the highs and lows and is still
off the cigarettes. In fact, Carolyn went on to
be an ambassador at the Tallaght Health and
Wellbeing Week.
Speaking about the programme, Carolyn
said, “I heard about the programme at the
Community Centre in Tallaght where I volunteer
and at the time I was smoking two packs of
cigarettes a day. It was my third time trying to
give up and the first two times I had continued
smoking even with the nicotine patches on me.”
“I was determined to do it this time and I
took it one hour at a time. I thought of the fact
that when anyone gets on an airplane to go
anywhere, they can’t smoke for hours at a time
and that’s a good way to approach it. If I can do
without them when I’m flying somewhere, I can
do it all of the time.
“The course was brilliant, especially the
facilitator Imelda. I was given as much support
and time as I needed and she often took me to
the side and explained things one to one. All of
the women in the group supported each other
and afterwards we started a Facebook group
and we still meet up for coffee and a chat.
“My last cigarette was on May 22nd, so I’m
almost five months off the cigarettes now and I
am delighted with myself. I haven’t had an easy
time recently and was in
hospital for a while, but I
didn’t go back on the cigarettes, even though
at times I was tempted. I keep thinking of that
plane, and I just take it one hour at a time.”
2017 HSE / ‘We Can Quit’
Training
The We Can Quit Programme uses a
co-facilitation model between community
workers and HSE practitioners who are
working with women and families at CHO
area level.
In order to run more courses, the Irish
Cancer Society is urging HSE practitioners,
working at CHO level in Cork and South
Dublin who think this programme would be
relevant to their work, to contact them.
For anyone interested in taking part in HSE
and Irish Cancer Society facilitator training in
the new year, please contact Rachel Burke at
rburke@irishcancer.ie or 01-2316669, or visit
the webpage at www.cancer.ie/we-can-quit
for more information on courses.
Carolyn Roche (centre), with Lavinia Coti and Aisling McGeady at the ‘We Can Quit’ graduation
ceremony in Tallaght. Photo: Andres Poveda Photography
winter 2016 | health matters |

You
Section
Support for parents
Tom’s
Journey
The parents of little Tom Fahy, who was diagnosed
with Edwards Syndrome in Pregnancy, share their
heart-breaking experience with Perinatal Palliative
Care and bereavement standards
n Monday, July 27th, our world
changed forever. Our baby was
diagnosed with Trisomy 18 at
O
the 20-week scan. We were
numb. I remember lying there
hearing the words but almost zoning out
thinking this cannot be happening to us. We
hadn’t planned on finding out the sex of the
baby but Terry asked. The sonographer told us
our baby was a boy.
In the car on the way home, it was so hard to
reconcile the fact that I could feel him moving
yet we were told he was going to die. Our first
instinct was to give this little guy a name. We
decided to call him Tom. By naming him, as
parents we hoped we would give him a strong
sense of belonging. For us, his life started
that day because we knew he would have a
very short life if any outside of the womb.
After we had gotten over the initial shock,
we very quickly realised that we had two
choices: we could spend Tom’s life feeling
sad and miserable or we could celebrate it. I
didn’t want Tom to feel the sadness. We had
an overwhelming desire to breathe as much
love and life into him while he was with us.
It was very much a feeling that this little guy
isn’t going to be around for a long time so
we are going to show him a good time. We
wanted him to feel an overwhelming sense of
love and happiness.
Tom was born on October 30th 2015 and
to everyone’s amazement he lived for 11
wonderful days.
From the moment we got Tom’s diagnosis
till the day he passed away and still to this
day, the staff in the Coombe have been
incredible to us.
We were treated with incredible dignity and
compassion by every staff member we came
into contact with whether they were medical,
administrative, support or auxiliary staff.
There is a strong compassionate ethos that is
almost innate in all of them.
Everyone we met was always up to speed,
from our obstetrician, to the bereavement
midwife, paediatricians, neonatal nurses and
beyond. It was very evident to us that there is
excellent communication behind the scenes
which is incredibly important and reassuring
for parents like us.
The care Tom and I received, both in
pregnancy and beyond, was amazing. Our
obstetrician Dr Michael O’Connell gave us
an enormous sense of security. We knew
we were in safe hands. This took a lot of
the worry off us and allowed us to focus on
the present and be present with Tom. Dr
O’Connell and his colleague whom we saw
while Dr O’Connell was away had the perfect
balance of practicality and compassion. The
neonatal nurses looked after Tom so well. I
stayed awake with Tom for the first 72 hours
of his life and I always looked forward to
seeing the nurses coming in to feed him every
three hours. They always came in with a smile
on their face.
The paediatricians known to us in pregnancy
and present at Tom’s birth treated him with
the utmost concern and dignity.
The emotional support we received from
the bereavement midwife was phenomenal.
She was very much our “life support”. She
was with us every step of our journey and at
our lowest points she carried us through. It
is testament to her and the care we received
from her that our first instinct was to ring her
when Tom died. To lose your baby in your
arms is indescribable but to hear her voice on
the other end of the phone gave us strength.
She continues to give us that strength.
We never felt rushed at any of our
appointments or scans. We were encouraged
from the beginning to embrace our time with
Tom and start memory-making. The foetal
medicine doctor and her midwife manager
always made sure we had plenty of time at
our scans. They got plenty of clear screen
shots and photos of Tom.
The bereavement midwife introduced us
When Tom was born
and the subsequent
days we spent with him in
the hospital were magical.
It was as if time had stopped
and we were living in a
bubble. We were cared for
as a family unit throughout
to the idea of the memory box early on and
she made sure we left the hospital with our
memory box full of keepsakes from Tom’s
time in the hospital, such as locks of his hair
and his footprints. It was incredible to have
people like the bereavement midwife and
the chaplains looking after us because of
their previous experiences they simply knew
10 | health matters | winter 2016

Little Tom Fahy,
pictured during
his very short life,
during which time he
brought immense joy
to his loving parents.
what to do. They put us in contact with the
charity “Now I Lay Me Down To Sleep”. Thanks
to our wonderful photographer we have a
picture of our three boys together, one of our
most treasured possessions. Tom’s name is
also in the book of remembrance which we
are encouraged to visit in the Coombe on
his anniversary each year and we attended
and will continue to attend the annual
remembrance service.
We never felt we were alone on this journey.
The staff helped make an extremely difficult
time an incredibly special time. When Tom
was born and the subsequent days we spent
with him in the hospital were magical. It was
as if time had stopped and we were living in
a bubble. We were cared for as a family unit
throughout. The three of us stayed together
day and night on a ward away from all the
normal healthy crying babies. We looked
forward to our daily visits from doctors,
nurses, the bereavement midwife with her
boundless energy and positivity, the chaplains
and the paediatricians. They very much
became Tom’s second family.
When we left the hospital with Tom, the
Coombe were very much still involved and
put us in contact with an array of community
supports and agencies that supported us
to have Tom at home for the short but very
precious six days.
When we read the National Standards for
Bereavement Care Following Pregnancy Loss
and Perinatal Death, we wondered what was
new about them as we received all and more
than the recommendations outlined.
At their launch, we realised that the care
and support we received in the Coombe was
not standard practice throughout hospitals in
Ireland. We were shocked.
At the launch, we were introduced to the
Minister of Health who went out of his way to
meet with us bereaved parents. We found him
to be very compassionate and were delighted
when he told us that he had already begun
the recruitment of bereavement midwives
nationally and that they would be in post by
the end of the year. It is wonderful to see that
the Minister recognises the need for such vital
support for bereaved parents nationally and
that your postcode should not determine the
care you receive especially when you are at
your most vulnerable.
The staff in the Coombe played such an
important role in Tom’s life. They cared for us
and supported us. They shared our journey.
more information
For more information about the HSE National
Standards for Bereavement Care:
www.hse.ie/bereavementcare
winter 2016 | health matters | 11

You
Section
Tallaght Nurse Makes History
in Inherited Cardiac Conditions
elen Connaughton, a nurse
working at Tallaght Hospital,
has become the first Clinical
H
Nurse Specialist in Ireland in
the area of Inherited Cardiac
Conditions. Her success marks an important
milestone for cardiology and nursing services
nationally and in Tallaght Hospital.
As the first Irish Clinical Nurse Specialist
in this field, Helen is now a national leader in
this area and demonstrates the investment
and advancements that have taken place in
cardiac services at Tallaght Hospital. Helen
was a Clinical Nurse Manager in the Cardiac
Risk in the Young (CRY) unit for eight years.
The CRYP unit aims to provide
comprehensive specialist evaluation of those
diagnosed with or at risk from inherited
cardiac conditions, including
families who have lost
someone to sudden
cardiac death. It
was developed as a
collaboration between
Tallaght Hospital, St
James’s Hospital, St
Vincent’s University
Hospital and Trinity
College Dublin
Helen Connaughton (left) and (above) Helen with some of her colleagues at Tallaght Hospital.
and is located at Tallaght Hospital.
Helen’s post was initially funded by The
Patches Trust, and for the last five years she
has been funded by the charity Cardiac Risk
in the Young (CRY Ireland), who fund much of
the activity at the CRYP Unit.
“It is a great honour to achieve this success
and to be part of this great leap forward
for cardiac services in Ireland,” she said. “I
want to thank all my family and friends who
supported me over the years. I am looking
forward to continuing to bring my developed
skills and experiences to the service of
patients who may be suffering with cardiac
diseases at Tallaght Hospital. The Hospital,
the charities and my colleagues have provided
great support to me over the years and I am
delighted to be part of a team that is doing so
much good for our patients.”
Hilary Daly, Director of Nursing at Tallaght
Hospital, added, “We are all delighted with
Helen’s success. Tallaght Hospital has a
strong ethos of ‘People caring for people’
and Helen achieving this professional
accreditation enables us to put this ethos
into place all the more clearly, in the area of
cardiac services. Helen’s additional expertise
now as a clinical nurse specialist is a huge
asset for the great work that takes place in
the unit.”
nursing graduates
The success of the BSc General Nursing four-year programme in CUH is largely attributed to the ongoing support of students by dedicated preceptors, CNMs
and the Nurse Practice Development Unit during their clinical placements. During their programme, BSc Nursing students have been given the opportunity to
work in a variety of clinical settings within the CUH group to enable them to acquire the skills necessary to practice nursing. The Clinical Placement Co-ordinators
are delighted to announce that all the new graduates have been offered employment in CUH and wish the newly qualified BSc 2012 General Nurses every good
wish and success in their future careers.
12 | health matters | winter 2016

Service-user engagement
a voice for
the patient
s a former service user
himself, the new HSE Head
of Service User Engagement
A
in the Mental Health Division
is only too aware of the value
of involving patients and their family in the
formation of policy and plans.
Liam Hennessy took up his role in
February of this year and is already making
strides in his three-year plan.
The former teacher, senior civil servant,
management consultant and inspector in
the Mental Health Commission revealed
that his office is well on its way to putting
in place the structures needed to bring
about the change needed across the
country.
“The purpose of my job and my role is
to ensure that over the next year that
structures are put in place to deliver
the best healthcare possible. When I say
the structures, I mean the area leads in
particular who will be placed in each of the
Community Health Organisations (CHOs).
Their role will be to gather together the
views of service users and family members
in say Donegal, Roscommon or Kerry and
relay those views to local management
with a view to improving the services based
on those experiences,” said Liam.
The interview process has been
completed and it is hoped to have the nine
leads to be in place in each CHO by the end
of January or the beginning of February.
One main criteria was that each applicant
had to have had experience either as a
service user themselves or as a family
member or carer of a service user.
“Like I do on a national basis, locally they
will reflect the views and experiences
in local services, but they will also have
power and influence in the process. For
the first time ever as part of the senior
management team responsible for making
policy for mental health, there will be
a service user representative in there
with equal standing and equal status,”
explained Liam.
His office was created as the result of
recommendations of a reference group put
together by the HSE.
“I think it was one of the rare times that a
report’s recommendations were all acepted
It will be a challenge
for the new leads to
get around the fact that they
have equal status around
the table that seats many
experienced health service
executives and clinicians.
But they’ll also be expected
to contribute where they
have relevant expertise
and the implementation wasn’t just kicked
down the line, it was made a priority,” he
said.
He acknowledged that the ‘proof will
be in the pudding’ as to whether the new
structures are effective in bringing about
change.
“It will be a challenge for the new leads
to get around the fact that they have equal
status around the table that seats many
experienced health service executives and
clinicians. But they will also be expected
to contribute where they have relevant
expertise. The proof will be in the pudding
as to whether the positions establish the
credibility they deserve,” said Liam.
He added that he envisaged that the
nine leads would establish a tight network
between themselves so they could help
each other out with any problems that
might pop up.
He underlined the need to involve the
experiences of service users and their
families in improving the services.
“Families have not been treated well in
the past, in many cases. Some doctors
have chosen to invoke the veil of patient
confidentiality to avoid talking to family
members about their loved one’s case.
And there have been times where that has
led to major tragedies, simply because
the family were unaware that the person
in question had been engaging with the
mental health services and unaware of the
problems they were going through.
“But I have met with the Minister for
Mental Health Helen McEntee on a number
of occasions and I can see that it has
become a big political issue and one that
people are demanding answers to.”
He said there have been previous
attempts to implement change in the
policy-making in recent years but that
those efforts were not as successful as
they might have been.
His office has employed a full-time action
researcher who will track all the work
done there and track what has worked and
what hasn’t for learning and information
purposes.
“From a qualitative perspective, we will
be able to measure the progress of the
structures by compiling case studies of
good practice and using that to learn how
best to do our work,” he explained.
But for Liam, success in his role will
ultimately come when having a service user
representative at a seat around the table is
accepted as the norm.
“I want it to be no big deal, just part of the
fabric of our policy-making, and that people
will simply say, ‘sure, that’s just the way we
do things around here.”
CONTACT
You can contact Liam’s oiffice by email at:
mhengage@hse.ie
winter 2016 | health matters | 13

You
Section
NAS band celebrate 10 years
n 2006, a small group of
interested people working in
the National Ambulance met to
I
consider setting up a band. Fast
forward 10 years, and the NAS
Pipes and Drum band are going from strength
to strength.
“The idea of setting up a band came about
in 2006 when we saw our colleagues in Co.
Cork had a band made up of serving and
retired Paramedics, Advanced Paramedics,
Emergency Medical Technicians and
Emergency Medical Controllers,” explained
Drum Sergeant Stephen Wilson.
“We were also aware of our colleagues
in the Dublin Fire Brigade Pipe Band, both
bands were a real inspiration to us and the
fact that internationally there were very few
Emergency Medical Services pipebands.”
The band has been invited to ceremonies all
over Ireland and also further afield, one such
invitation was to New York to take part in the
St Patrick’s Day parade alongside emergency
services colleagues FDNY EMS Pipes &
Drums. While in New York the band was also
invited to play in New York’s state capital
Albany at a reception hosted by the New York
State Governor Andrew S Cuomo and also
took part in three other parades.
Pipe Major Brian O’Reilly said, “We have
come a long way from our first outing in the
Monasterevin St Patrick’s Day Parade to
marching down New York’s 5th Avenue in the
World’s largest St Patrick’s Day Parade.
“A couple of my most memorable
moments with the band include performing
with Andre Rieu and his famous orchestra at
the O2 arena in 2012 and playing a lament at
the World Trade Centre Memorial in 2013,”
said Brian.
“But my proudest moment as Pipe Major
was when we represented the Ambulance
Service and marched down Dublin’s O’Connell
Street in the 1916 Centenary parade at Easter
this year.”
He added, “It has been a long hard slog to
get the band to where it is today and there
have been many members of the Ambulance
Service Pipes & Drums who have come and
gone over the last ten years, but we now
have a great bunch of people in the band who
are very committed to keeping the National
Ambulance Service Pipes &Drums going from
strength to strength.
staff perform some amazing feats of cycling and running
After cycling for 78 hours and 31 minutes, four Meath-based
paramedics took an incredible sixth place in the gruelling 2,150km
Race Around Ireland.
The ‘Flatliners’ team consisting of Fergal Murray, Phil Gargan,
Brendan Harte and Marc Tighe, Paramedics and Advanced
Paramedics from the National Ambulance Service, stationed in the
Navan and Trim area, managed to complete one of the toughest
challenges that a cyclist can face and earn their sixth place finish
in the four man team section.
Meanwhile, Wicklow nurse Lillian Deegan became the first
Irishwoman to run the 2,900km Wild Atlantic Way from Derry to
Kinsale in Co Cork.
Lillian battled through wind, rain and occasionally blistering heat
during her 47-day run through nine counties.
The nurse ran alongside Tom Reynolds from Co Louth who
completed the run in just over 34 days.
The pair raised more than €12,000 for Pieta House and the
charity Billy’s World Ireland.
Lillian said, “I’m delighted to be finished. In the early stage,
I thought injury was going to take me out. But I soldiered on as they
say. I will eat now like a horse for a long time, just to refuel and let
the body recover.”
14 | health matters | winter 2016

Limerick boost for Pieta House
huge turnout at 5k
EMBERS of the public have
joined UL Hospitals Group
staff in promoting a healthy
M
lifestyle and raising awareness
for Pieta House.
Over 200 people took part in the annual
5k Run/Walk around Dooradoyle/Raheen, an
increase on the numbers who participated last
year. In so doing, they raised almost €5,000 for
suicide prevention and counselling services in
the MidWest.
UL Hospitals’ Healthy Ireland Implementation
Plan 2016-2019 identifies 60 priority actions do
just that for the almost 380,000 people it serves
and the 3,300 staff it employs in Limerick, Clare
and Tipperary.
“We were delighted to have such a great
turnout from staff, including retired members
of staff, and from members of the public in
supporting the event. Physical health and
positive mental health are in so many ways
interlinked and we were delighted to be able to
support such a deserving cause in Pieta House,”
said Hugh Brady, Executive Lead, Health and
Wellbeing, UL Hospitals Group.
The run/walk was chipped and timed, with
each participant receiving a Healthy Ireland
t-shirt and, on completion, a medal. Trophies
were awarded to the first three men and women
home, to the first walker home, and to the first
male and female members of staff to finish the
line having completed an eight-week training
programme, From Couch to 5k.
“The event got great support from athletic
clubs around the region and the times posted
by Mike Carmody (An Bru AC) and Lisa Griffin
(Dooneen AC) would rival anything we have seen
in Rio over the last few days,” said Laura Tobin,
Project Lead, Healthy Ireland, UL Hospitals.
“But of course, the true object of the event
was to get runners and walkers of all abilities
involved. Walking is a great form of aerobic
exercise and it was great to see so many
participate on the night.”
Another 5k run took place around Nenagh
Hospital back in August and was part of the
wider effort to promote Healthy Ireland in the
region, explained Fiona Steed, Physiotherapy
Manager, Nenagh Hospital and Site Lead in
Nenagh for Healthy Ireland. “When we started
out two months ago, our main aim was to get
as many people active as possible, particularly
people not used to exercise. We were delighted
that 25 people completed the Nenagh run,
donating €10 each to such a deserving cause in
Pieta House.”
“Of these, 10 were members of staff who
participated in a training programme we ran.
These staff had never run a 5k before but
after completing the eight weeks, they were
delighted to be able to run every stride of the
5k. These first-timers are immensely proud of
themselves and rightly so. Indeed, they have
set up a What’s App group with the intention of
continuing their training. This is what Healthy
Ireland is all about.”
“The dedication of staff to put in weeks of
training and the hard yards on the night was
great to see,” said UL Hospitals CEO Colette
Cowan, who herself completed the course.
Ms Cowan paid tribute to the 5k Run/Walk
Organising Committee - Hugh Brady, Laura
Tobin, Seamus Hourigan and Michelle Ryan –
and also to the work of Pieta House, represented
by Marian Long.
TOP: Colette Cowan, CEO UL Hospitals Group
presented 1st prize to Michael Carmody, Annacotty,
2nd prize to Peter Madden, Borrisoleigh and 3rd
prize to Derek Casey, Caherline at the UL Hospitals
Group 5k Run/Walk in the presence of Marian Long,
Administration Manager, Pieta House. Picture by
Dave Gaynor
MIDDLE: 5k prize winners are presented with the
prizes by Colette Cowan and Marian Long.
BOTTOM: Competitors setting off on the UL
Hospitals Group 5k Run/Walk from the University
Hospital Limerick in aid of Pieta House. Picture by
Dave Gaynor
winter 2016 | health matters | 15

You
Section
No ordinary swimming club
lives transformed
or almost 35 years, Mary Arrigan-
Langan has been transforming
F
the lives of people with physical
disabilities through the Octopus
Swimming Club.
Octopus is no ordinary swimming club. It
operates using the Halliwick concept, which
allows people with disabilities, such as
amputees, head injury, spinal cord injury, stroke,
spina-bifida, cerebral palsy, multiple sclerosis,
visual impairment, to become “water free” or
independence in the water.
And as she nears retirement from her fulltime
career as a Clinical Nurse Specialist in
Osteoporosis in Merlin Park, Galway, there’s
no sign of her pulling back from her amazing
volunteer work.
It was this work with the Octopus club that
earned Mary, from Renmore in Co Galway, the
Pride of Ireland award last year.
Mary, the daughter of the late Paddy Arrigan, a
former Irish and All-Army swimming champion
who dominated backstroke events in the 1950s,
breaking records and representing Ireland – was
first introduced to the Halliwick concept when
nursing in England in the 1970s.
The technique means no buoyancy aids are
used to help disabled swimmers. The volunteer
helpers aid those with a disability until they
can become comfortable and, in a lot of
cases, independent in the water. This is done
by developing breathing control, balance and
relaxation techniques.
“I get a great thrill and a sense of achievement
when I see the swimmers progressing. I have an
instinct to hold people with severe disabilities
in my hands. If somebody comes to me with
a severe stroke or an amputated leg, I see the
potential in them,” said Mary.
“If someone is stuck in a wheelchair all day, it is
great to see their reaction when you put them in
the water and see their body move and be free.
And when somebody is completely relaxed, they
can float and eventually they can move and swim.
“Somebody might only be able to wiggle and
arm but, to me, they are swimming.”
Initially, she had intended to do physiotherapy,
specialising in hydrotherapy, but when she
saw the Halliwick method in operation she
immediately knew this was what she wanted
to do. “I like helping people to reach their full
potential,” she says.
When she returned to Ireland in 1981, she
got the opportunity to study the Halliwick
method and then worked tirelessly to set up the
Octopus Swimming Club, the first of its kind in
the country.
At first, she received a lukewarm reception
from the several organisations she approached;
that was until she contacted Ernie Boucher of
the Irish Wheelchair Association. “He said they
would be very interested and asked did we
need a bus. It was such a boost to get that first
positive response,” she revealed.
More than 34 years on, the club is still going
from strength to strength, and its committee
members are mainly made up of people with a
physical disability.
“It is their club,” Mary explained.
She revealed that the club brings a number
of major benefits to members, including social
interaction, a chance to get some exercise and
keep healthy, and respite for family members
and carers.
“We don’t claim to be remedial, what we do
won’t replace physiotherapy. But the swimming
brings so many other benefits that last long
beyond the swimming class. People gain
confidence and a great sense of achievement
and independence,” said Mary.
Mary also earned another plaudit recently. She
was given the award for Promoting Bone Health
in Ireland, with particular interest in disabilities,
at the Annual Osteoporosis Conference.
When she leaves the HSE early next year, she
revealed that she will be able to give more time
over to her volunteer work and also plans to
gather all of her father’s writings together as
part of a project for her whole family.
“I have plenty of plans for my retirement.
There’s still lots to do,” she added.
Mary Arrigan-Langan with members of Octopus
Swimming Club on their Monday night swim in
Kilcornan. Back row - semi circle: Helen O’Connor
(green hat), Joanne Stapleton (red hat), Oliver Kane,
Phil Flatley (blue & white hat), Eva Anselm (blue
& white hat) Shane O’Connor (yellow hat), Bridie
Giles (black hat), Dylan O’Boyle (yellow hat). Front
- semi circle: Michael Howley (blue hat), Niko Lascar
(red hat), Tony Cunningham (no hat), founder of
Octopus Swimming Club, Mary Arrigan-Langan
(blue top). Centre: Sammy Fleming.
16 | health matters | winter 2016

Unique set of visitors to UMHL
Quadruplets join
twins and triplets
he Neonatal Unit at University
Maternity Hospital Limerick
is a busy place at any time of
T
year and has been especially
so in recent weeks with the
arrival in quick succession of quadruplets,
triplets and twins.
Photographer PJ Corbett - who specialises
in newborn portraiture - is a regular visitor
to the unit and was on hand to capture
the moment when the unique 4-3-2-1
combination of premature newborns was
brought together for a photo. It is the firsttime
the Limerick unit has had the privilege
of caring for a set of quads, triplets, twins
and singletons all at the same time.
Lisa Fenton from Caherconlish, Co
Limerick, made a little bit of history when
on October 5th she gave birth to the first
set of quadruplets born in Limerick in 50
years. Other quads from the Mid-West born
in the intervening years had been delivered
in the major Dublin maternity units. Babies
Alexander, Ashley, Maxwell and Kayla are
the first children born to Lisa and her partner
Wayne Downey and were delivered at UMHL
by Prof Amanda Cotter and her team. The
quads have been doing very well in Neonatal
Unit ever since.
Triplets Dáire, Liam and Aisling Cussen
were born on October 27th to parents Olive
and William and will soon be strong enough
to go home to Raheen, Limerick.
Twins Ashton and Leo Mulcahy were born
on October 13th to mum Lydia O’Doherty and
dad Calum Mulcahy, from Annacotty.
And representing the 12 tiny singletons
currently being looked after in the Neonatal
Unit in PJ’s photo is little Maggie Roche from
Charleville, Co Cork, born to mum Mairead
and dad Kieran on October 26th.
Neonatal at UMHL is one of the busiest
such specialised units in the country, with
close to 700 admissions every year. There
are now approximately 4,700 births at
UMHL annually.
The Neonatal Unit at UMHL has 19 cots
but often caters for more babies.It provides
neonatal intensive care, high dependency
and special care to premature and sick
babies of the Mid-West, from 23 weeks of
gestation upwards.
“We have had the pleasure of looking after
quadruplets, triplets, twins and singletons in
the Neonatal Units at various times over the
years but not as far as any of us are aware all
at the same time in Limerick. It is a special
occasion for all of the team working here and
it is a time of great joy for us as well as their
parents,” said Consultant Neonatologist, Dr
Roy Philip.
The team involved in caring for these babies
includes four consultant neonatologists:
Dr Roy Philip; Dr Niazy Al Assaf; Dr Con
Sreenan and Dr Anne Doolan; along with
48 neonatal nurses and midwives under
the clinical leadership of Margo Dunworth,
Deirdre O’Connell and Marie Carroll;
ward attendants; healthcare assistants;
physiotherapists; radiography; laboratory and
clerical staff and others.
According to Clinical Nurse Manager
Marie Carroll: “It was amazing to get all
10 babies together for a special photo. We
are very grateful to PJ, who left his studio
in Adare without hesitation to come in and
take the photo. He clearly is a very talented
photographer to manage to get such a
beautiful image of so many babies at once!
PJ also comes in to us every year to take
photos of Santa with the babies and the
parents in the Neonatal Unit. Christmas has
come early for some families this year. All 10
of them are doing well and should hopefully
be back at home with their families before
December 25th.”
winter 2016 | health matters | 17

You
Section
Change of career
clients ‘cry
with delight’
dental nurse has
branched out
into the world
A
of medical
tattooing,
transforming the lives of many
of her patients.
“To see a client actually cry
with delight when they look in the
mirror and see something there which
they have probably not had before or lost at
some stage due to illness or injury is priceless
and totally fulfilling,” explained Kristen Carroll.
Kristen joined the HSE in 1996 as a dental
nurse. Although she enjoyed her job, she said
that the turning point for came when she
turned 40 a few years ago.
“I felt I needed to re evaluate my working life.
The realisation I had more than 25 more years
of work left in me I needed a new challenge so
looked at where that would lie.”
“I looked into things I would like to learn,
work at and most importantly enjoy giving
to people and recalled seeing a permanent
make-up brow procedure being done some
years ago. I recall thinking it looked like a
really nice job, it brought a lot of happiness
to the person who had it as they had suffered
from alopecia so their new brows changed
their life, literally!
“I did my research and discovered that
outside of the make-up part, there was
a medical aspect to SPMU
(semi-permanent make-up)
- areola/nipple restoration for
ladies who have had breast
reconstruction post cancer,
needling and camouflage for
burn scars and restoration of
symmetry in cleft lip. I knew
then this was for me.”
After earning a diploma of
excellence in SPMU, she decided to get
some qualifications in the medical field
awhere my heart truly lies so completed
her training in areola/nipple restoration with
needling for scars.
She plans to train further in the medical
field in scar camouflage so she can deliver
complete treatments to clients and
patients in both cosmetic and medical
tattoo. She was shortlisted amongst the
top six SPMU technicians in the UK for
Best Technician in May.
Kristen recently treated ladies who
were referred to her by Beaumont breast
clinic for free as part of breast cancer
awareness month .
“I am looking forward to working closely
with them in the future as they try to work
through their waiting list for areola, which I
understand is years long. I’m also working
closely with Alopecia Ireland providing a
service at manageable cost for any of their
kerry to calais
In October 2016, over 700 refugees began
their journey from the Calais camp to
accommodation centres across France. A
humanitarian mission from Kerry to Calais
was set up by locals in Killarney and Dingle
to bring clothes, blankets and suitcases to
prepare those in the camp for the move.
5,000 refugees lived in the makeshift
camp called ‘The Jungle’ in Calais; of that
number, 1022 were minors.
Killarney Community Hospitals were very
much involved in this initiative, requesting
donations and providing the mission with
30 large black bags of clothing, footwear
and bedding which were collected by the
Kerry to Calais volunteers.
Three full vans set off to Calais in
October, along €1,800 to purchase food
and essentials. This trip was filmed by
K-Town media, and was aired on the Irish
TV channel on the evening of November
2nd 2016.
All the staff in the Killarney Community
Hospitals were delighted to have taken
part in this important mission.
members who contact me,” she said.
She still works in HSE dental as a nurse on a
part-time basis and sees clients for cosmetic
tattoo the other part of my week.
“The biggest difference being in dental is not
everyone is happy to see you, even on a good
day. In my current role, everybody is happy to
be here and delighted when I finish my work.”
For more information, see her website at
www.dermartcosmetictattoo.ie
Dental nurse Kristen Carroll, who has branched out
into semi-permanent make-up.
endoscopy unit opens in Roscommon University hospital
Minister for Health Simon Harris pictured at the official opening of the New Endoscopy unit at Roscommon University Hospital with Senator Frank Feighan;
Maurice Power, CEO Saolta University Health Care Group; Dr John Killeen, Chairman, Board of Saolta University Health Care Group; Liam McMullin, Consultant
Surgeon, RUH; Elaine Prendergast, General Manager, RUH and Ursula Morgan, Director of Nursing, RUH. Photo: Joe Travers.
18 | health matters | winter 2016

nursing
pals
face off
in croke
park
wo University Hospital
Waterford trainee nurses took
centre stage at Croke Park in
T
September as they lined up in
opposition with each other in the
All-Ireland Senior Camogie final.
Julianne Malone was the victor on the day
with her Kilkenny side, seeing off the brave
attempts of colleague Laura Treacy’s Cork.
Julianne and Laura are both final year
nursing students at the Waterford Institute
of Technology. They have undertaken their
nursing training for the past three years
together in the same class. They just started
a placement in University Hospital Waterford
(UHW) before the final but insisted on
maintaining their level of training and playing,
recognising the benefits to their academic life.
21-year-old Julianne, from Mullinavat Club,
represented Kilkenny at full forward. She has
been playing Camogie since she was eight
years old with her club. In March of this year,
she debuted as a senior playing in a National
League match. Previous to this, she has played
on the county under-16 and under-14 and
minor teams. Julianne’s most memorable
moment was winning the National League final
earlier this year, beating Galway in Semple
Stadium in Thurles, scoring 1-2.
On the other side, playing since she was
seven years old, 21-year-old Laura, from
Killeagh Club, represented Cork on full back
line. Laura has been on the senior panel since
she was sixteen years old, with this being
her third Senior All Ireland Camogie final. In
2015, she also received a Camogie All Star
Nomination. Laura’s most memorable moment
was winning her first ever Senior All Ireland
title in 2014.
Speaking about the prospect of playing
against her colleague and friend in the final,
Julianne said: ‘‘I have spent my last three
years with Laura at the Waterford Institute of
Technology. We are now undertaking our final
year of training; from now until Christmas
we will be studying for our finals and then
from January 2017, we will both commence
our final 36 weeks internship placement in
I am just so excited
and a little nervous
too about Sunday. It will
be strange playing against
Laura, we are both quite
competitive
University Hospital Waterford.
“We both love the same work and the same
sport and we are now going to compete
at the Senior Camogie Final. I am just
so excited and a little nervous too about
Sunday. It will be strange playing against
Laura, we are both quite competitive. I just
hope we both have a great game and do our
clubs and counties proud.”
Laura added: “Words can’t even describe my
feelings right now. After lots of hard training I
can’t wait to get out there and play on Sunday.
I am very excited to share this moment with
Julianne - even if we are going to play for two
different counties. May the best team win!’’
University Hospital Waterford, Director
of Nursing, Claire Tully, said: “This is such
an unusual situation, two of our students
competing at the Senior Camogie Final
representing two different counties. As the
Director of Nursing I am very proud to see that
it is possible to combine both work and sport at
such high levels. It is a testament to the hard
work that the girls put in both on and off the
pitch. I was delighted to watch the match and
on behalf of the University Hospital Waterford.”
TOP: Laura Treacy and Julianne Malone dressed in
their respective county colours ahead of their All-
Ireland Senior Camogie final showdown at Croke
Park. ABOVE: The pair in their nursing whites at
University Hospital Waterford.
winter 2016 | health matters | 19

You
Section
Prisoners collaborate at Cherry Orchard
benches unveiled
herry Orchard Hospital
occupational therapists Liz
Carey and Linda Penny recently
C
completed a collaborative project
in conjunction with the Irish Prison
Services for the construction of six attractive
outdoor wooden benches on the Cherry Orchard
Hospital campus.
Cherry Orchard Hospital in Ballyfermot,
Dublin 10 is now a residential home for older
people and for young adults with physical and
sensory disabilities.
The campus is spread out, with a large number
of residential units and many other services on
site. New recent construction on the site saw the
opening of a Child and Adolescent Mental Health
Services facility for in and outpatient services.
There are ongoing plans to expand services
on site further. Many older Cherry Orchard
Hospital residents fondly recall that prior to the
construction of the hospital; the 74-acre plot
was a combination of farm land, cherry blossom
trees and fruit trees. A wide variety of mature
deciduous trees still grow around the campus
and each spring everyone particularly enjoys
the emerging blooms of the beautiful cherry
blossom trees.
The Occupational Therapy Department in
Cherry Orchard hospital has been in existence
for many years and continues to strive to help
residents to do the things that they need and
want to do in everyday life. OT aims to enable
residents to achieve maximum independence
and quality of life, and to develop and maintain a
meaningful lifestyle.
A need was identified to assist with residents,
family members and friends when they were
walking or using a wheelchair on the widespread
campus. There were no wheelchair accessible
outdoor benches available that could be used
if they got tired, weak, or simply wanted to sit
and chat.
The Irish Prison Services places a strong
emphasis on the provision of vocational training
activities, including carpentry and joinery, for
prisoners and have workshops with courses
externally accredited by City and Guilds. Fergal
Black, Irish Prison Services Director of Care and
Rehabilitation, formerly the HSE Local Health
Manager in Dublin West, agreed to collaborate
with the Occupational Therapy Department
regarding the provision of benches for the
campus after initial contact was made by
Director of Nursing Fiona Cleary.
The OTs were delighted to be of assistance,
as they focus on the holistic person-centred
service that promotes the well being and rights
of the individual, family and carer whilst Liz and
Linda outlined and recommended the specified
measurements for six outdoor benches to be
made to National Disability Authority standards
in order to ensure they are accessible to
everyone. They advised they also needed to take
into account the surrounding paths, grass and
other walkways.
“In deciding on the location for the benches,
it was deceptively difficult to choose spots that
were accessible, pleasant and sociable,” said
Linda. “In certain spots around this city campus,
the Dublin Mountains are visible, peeking
through units and we were keen to capture this
glimpse of nature. In this regard the Maintenance
Department were invaluable and very patient!”
The Maintenance Department also gave input
on the benches and while they were specified to
be functional, durable and safe for public use,
the OTs particularly emphasised the needs of
wheelchair users on campus during this process.
The design and installation were key in ensuring
that they could access the benches themselves
or sit beside a loved one in comfort and safety.
The project involved various departments from
the campus along its journey including Social
Work, Residents Advocacy Group, Maintenance,
Quality Assurance Committee and others.
“We think this is a good opportunity to highlight
the positive work of all involved on the campus
as it brought a good sense of community
involvement and spirit. The new benches
are placed strategically around campus and
residents and staff tell us they offer a great
opportunity to sit near trees, and engage in
conversation or simply enjoy the view of the
Dublin Mountains,” said Liz.
Linda also explained, “As occupational
therapists we were uniquely placed to provide
the skills necessary to ensure that function and
form merged together in a simple, yet incredibly
effective project.”
Tony Harris, Mountjoy Prison Campus
Assistant Governor, said, “The trainees in the
workshops in Castlerea put great effort into the
benches, especially when they heard who the
recipients would be. The benches are a credit to
the trainees and the staff of Castlerea prison,
and highlights all the positive outcomes that can
be achieved within the prison for the benefit of
the community.”
LEFT:
At the bench on
the Cherry Orchard
campus were back
row l-r: Dr Seamus
O’Dea, Cherry Orchard
Hospital Medical
Superintendent; Joe
Hernon, Cloverhill
Assistant Governor; and
Sean Coen, Castlerea
Industrial Manager.
Front row l-r: Bill Maher,
Cherry Orchard Hospital
Residents Advocacy
group member; John
Flavin, Castlerea
Assistant Governor;
Liz Carey, Senior
Occupational Therapist;
and Linda Penny, Senior
Occupational Therapist.
20 | health matters | winter 2016

Feature
Reflecting our values of care,
compassion, trust and learning
putting values into action
Health service staff at the Values in Action event in Limerick in October.
Health service leaders made a big decision
earlier this year to actively develop a culture
where our values become a way of life and a
visible part of our everyday actions in the
Health Services in the Mid-West .
Bringing our values of care, compassion,
trust and learning to life in the health
services is key to providing better workplaces
for staff and delivering better experiences for
patients and the people who use our services.
A peer to peer approach to this culture change
has begun and we call it Values in Action.
There has been a hugely positive reaction to
Values in Action since it kicked off in the Mid-
West with a two-day workshop in October, for
180 staff and voluntary partners.
HSE Director General Tony O’Brien said: ‘
‘We know that everyday thousands of health
service staff around Ireland live our values
of care, compassion, trust and learning.
Sometimes this is very visible, sometimes it
is not. Values in Action is about shaping our
culture around these values, so that they are
evident every day in every workplace. Values in
Action has translated our values from words
into behaviours (or actions) that we can all
demonstrate. Through Values in Action we
can create a better working environment for
our staff and deliver better experiences to
our patients and service users. This is about
ensuring more and more of us put our values
at the heart of our everyday work.’’
Improving the Culture in the Health Services
Values in Action is based on nine behaviours
that reflect our values combined with a ground
up approach to spreading change. It’s about
all of us, irrespective of role or grade working
together to change our workplaces for the
better. The project focuses on behaviours
which are visible and clearly understood.
We all know what instinctively is meant by
them and everyone can adopt them. We learn
our behaviours by copying those around us.
Values in Action is based on the belief that real
sustainable culture change is shaped by the
behaviours of influential individuals at all levels
across the organisation.
Nine behaviours
The Values in Action team developed nine
behaviours that reflect the three dimensions in
our working lives – us as individuals, working
with colleagues and how we treat patients.
Staff at the workshop were introduced
to the nine behaviours which reflect the
HSE values of care, compassion, trust and
learning. The nine behaviours are practical,
very do-able and cost nothing and will
make a positive difference to patients,
service users and staff.
The 9 behaviours were focus-tested with
staff and patients. They are informed by a
comprehensive review of national and local
patient and staff policies and procedures,
staff and patient/service user feedback, direct
engagements with staff and service users and
patient/service user feedback.
Our Champions
The kick off event which took place in
Limerick in October was for staff who had been
identified as ‘champions’. They were nominated
by at least four of their colleagues and peers in
an anonymous survey as the ‘helpful, wellinformed
and motivating’ people working in the
health service in the Mid-West.
winter 2016 | health matters | 21

Reflecting our values of care,
compassion, trust and learning
putting values into action
Staff at the workshop....Values in Action is based on the belief that real sustainable culture change is shaped by the behaviours of influential
individuals at all levels across the organisation.
These influential individuals are creating a
bottom-up, grassroots movement that will
spread through their peers and colleagues.
Each person drew up a personal plan for what
they are doing to spread the behaviours. They
are looking at and implementing ways to put
the behaviours into practice in workplaces
throughout the Mid-West. They are also looking
at ways to capture stories about the impact the
behaviours are having on staff and patients.
Next steps
The champions are now playing a key role in
actively developing a culture where the values
of care, compassion, trust and learning become
a way of life for all who work in the health
services in the Mid West . Importantly other
people can copy and practice these behaviours;
shaping new ‘norms’ and creating a culture we
can all be proud of.
Leadership for Change
Describing how she fully supports Values
in Action, Colette Cowan, CEO UL Hospitals
Group said: “I am delighted to be partnering
with Bernard Gloster and his team from the Mid
West Community Healthcare, and our national
colleagues, to start an important journey
working together to make the culture in the
health services in the Mid-West one which we
can all be very proud of. I am incredibly proud
of what we have already achieved in the UL
Hospital Group – we have wonderful staff and
a huge programme of development underway
that is going to make our Hospital Group one
of the best in the country. That is why I decided
to make UL Hospital Group the first hospital
group in the country to take on Values in Action.
Primarily because it’s all about people – it’s
based on human behaviour, and whether we like
it or not that is the essence of what the health
services are all about – people, working with
other people, to care for people. ‘’
Bernard Gloster, Chief Officer, Mid-West
Community Healthcare Values in Action said:
‘’What’s unique about this project is the 180
people who are involved as champions – they
weren’t picked by managers. They were picked
by their peers and that says something about
them – they are the people who can lead and
influence change. This project really appealed
to me – it’s based on human behaviour and
our 9 behaviours which are simple, practical,
straightforward and very do-able. They are a
guide for us all on how to be the best version of
ourselves – for ourselves as individuals, for our
colleagues and for our patients.”
The next steps
Health service staff in the Mid-west are now
being asked to get to know and to practice
the nine behaviours. This is about using the
language of these behaviours in interactions with
colleagues and the people who use our services.
It’s about talking to colleagues about the
importance of spreading culture in a way that
will make the health services a better place to
work and giving patients/service users a better
experience. It’s about sharing stories where the
behaviours are being seen and talking about
their positive impact.
If you’re based in the Mid-West then get to
know your champions who attended the twoday
workshop and support them. Highlight it
when your colleagues or the people in your
teams demonstrate these behaviours and call
it out when you see opposite ones. Talk to your
champions; empower and endorse their work
as leaders of culture change so that they know
they have your support. Culture change is a
long-term goal and there will be ups and downs
on the journey but ultimately we are all trying
to improve our workplaces and deliver better
health service experiences to those we serve.
The Values in Action Team
The Values in Action Project Team is made up
of staff from across UL Hospitals Group and Mid
West Community Health Organisation supported
by colleagues from National Communications,
HR, Quality and Patient Safety and the
Programme for Health Service Improvement.
more information
Follow us on Twitter @HSEValues
or see hse.ie/valuesinaction
22 | health matters | winter 2016

INDIVIDUAL
Am I putting
myself in other
people’s shoes?
Am I aware that my
actions can impact
on how patients feel?
Am I aware of my
own stress and how
I deal with it?
Am I being fair to my colleagues? Can I see the
challenges that others have and would I change
my attitude or what I do as a result?
Am I aware of how I am heard and seen?
Am I a good example?
Am I dealing with stress appropriately, for
myself and others? Should I ask for help or
support? Am I doing things that can help
relieve stress at work?
Seeing things from other perspectives and
understanding other peoples role/situation is key
to being able to work effectively with others.
We all have a role to play in the care of our
patients/service users. How can we work together
to solve the problem?
Acknowledge the
work of your
COLLEAGUE
Patients never forget how you make them feel.
We need to be aware that patients are observing
our actions and conversations can be heard by
others. Tensions between staff affect the patient’s
perceptions and their own vulnerabilities.
Ask your colleagues
how you could
Recognising when you are under too much stress
is important as it can have an effect on your
health and wellbeing and on others around you.
Seeking support from a trusted source or doing
things to relieve stress can help.
Challenge
toxic
VIA_behav_all_bigboards.indd 1 18/10/2016 17:05
colleagues
help them
attitudes
Always say thanks and acknowledge the
efforts of team members and colleagues. Treat
everybody as equal, regardless of hierarchy or
role within the organisation
Ask how you can help or offer advice to try
to guide the way. Share your knowledge and
experience with others.
Challenge toxic negativity, defeatism and
cynicism. Address unacceptable behaviours
(abuse, hostility, etc.) where a person is not
being treated with respect
Be supportive of colleagues and tell them when
they are doing a good job. Say thanks. Don’t
be judgemental; a ‘blame culture’ has no place
here. We are all here to make the patient care
experiences better.
PATIENT
Offer a colleague who’s under pressure time to
listen, some advice or a helping hand. We trust
each other to do the right thing. Work together as
a team. Ask yourself ‘Did I say or do something
today to help a colleague.
Do not accept that we can never change or
improve, intervene. Don’t be a bystander when you
see unacceptable behaviours which are contrary to
our values. Acknowledge difficulties, bring balance
to discussions.
Use my name
and/or your
Keep patients
informed – explain
Do an
extra, kind
VIA_behav_all_bigboards.indd 2 18/10/2016 17:05
name the now and the next thing
Introduce yourself and outline your role –
similar to #hellomynameis. Human-to-Human:
turn towards the patient, make eye contact,
smile, low and calm tone of voice
Give information to the patient/service user on
what you are doing now and what the next step
will be. Reduce uncertainty as much as you can.
Explain the known and unknowns in no rush.
Provide small acts of kindness. The small,
unexpected ‘extra thing’ is very human
and powerful
The Values The first in Action few second’s team interaction developed between nine behaviours a that Sharing reflect information the three with dimensions the patient reduces in our working their lives – Very us as often individuals, the small, working unexpected with ‘extra colleagues mile’ and
how patient we treat and patients. a staff member The behaviours sets the tone were of the informed by vulnerability a comprehensive and gives review them a of sense national of control. and local patient and creates staff an policies enormous and sense procedures, of caring. staff and
patient/service whole interaction. user See feedback, the whole person, direct engagements not just with Use staff language and that service the patient/service users and patient/service user will user Small feedback acts of and kindness tested build with trust staff and and respect patients. for
the problem, not just their number. Make the
patient feel as if he/she is unique, the only one.
understand and invite them to ask questions.
Provide a dignified, safe space for your interaction.
staff. You are proud to work for an organisation
that demonstrates such kindness.
winter 2016 | health matters | 23

Feature
Breastfeeding support
Live webchat
service opens
e have recently expanded
our on-line breastfeeding
supports on our website
W
www.breastfeeding.ie to assist
mothers and mothers-to-be.
If you are working with clients who may be
thinking of becoming pregnant or who are
pregnant or if you or a family member are
pregnant you can get support and information
on www.breastfeeding.ie The new supports
include an extended Ask our Expert service with
a live Webchat service provided by International
Board Certified Lactation Consultants (IBCLCs),
a new HSE Breastfeeding Facebook page,
and breastfeeding support videos featuring
health care professionals and parents of
breastfeeding babies.
www.breastfeeding.ie provides answers to
many of the common questions Mums have,
whether they are thinking about breastfeeding,
just getting started or are well on their way
with a growing baby. For those Mums who have
a specific query, there is also the option to email
your question to a Lactation Consultant via the
Ask our Expert service or through Webchat.
The newly launched HSE Breastfeeding
Facebook page provides a community of
support for mothers to join where they can
receive information and tips from the Ask our
Expert Lactation Consultants. The new Irish
breastfeeding videos on www.breastfeeding.ie
provide guidance for mothers on topics such as
positioning and attaching baby; expressing milk
and what to expect in the early days. The focus
is on assisting mothers with information and
enabling them to overcome challenges they
may be experiencing.
Our on-line support is non-judgemental,
respecting mother’s decisions and
encouraging and supporting them. The
website directs mothers to local health
services and breastfeeding support groups, of
which there are over 260 across the country.
All contact details and times are on www.
breastfeeding.ie/Support-search/. Some of
being these groups are facilitated by hospital
and community Lactation Consultants
(IBCLCs), Public Health Nurses, while others
are organised by trained breastfeeding
support volunteers all who are, or have, been
breastfeeding mums. They are a great source
of information, support and friendships. Our
aim is that the new supports will reach more
mothers and improve access to user friendly
breastfeeding help and information.
In Ireland, 57pc of mothers are breastfeeding
their babies on discharge from maternity
hospitals (HSE, 2016). In the first few days
and weeks at home, mothers may experience
challenges which often prompt them to stop
breastfeeding sooner than they planned.
Breastfeeding support is provided by maternity
services by public health nurses, and voluntary
breastfeeding organisations in the community.
Minister Marcella Corcoran Kennedy, speaking
at the launch of 2016 National Breastfeeding
Week, said: “I breastfed my own children,
and I know that there can be challenges in
the early days. Having somewhere to go for
practical information and support is important
for helping all mothers. As time went on, I
found breastfeeding very rewarding and so
convenient. It is important that we all support
breastfeeding as the normal and healthy way
to feed babies, whether through giving practical
support to mothers or ensuring that mothers
are welcome to breastfeed whenever and
wherever they and their babies need.”
Dr Stephanie O’Keeffe, Director of Health
and Wellbeing said: “The evidence in relation
to breastfeeding and health is now stronger
than ever and the potential for improved health
outcomes for women and children in Ireland
is substantial. We are working to promote,
support and protect breastfeeding. We want to
encourage more mothers to start breastfeeding,
and to breastfeed for longer. The on-line service
on www.breastfeeding.ie is part of the range
of the supports available to provide practical
information and support
to help mothers to
breastfeed their
babies.
“The HSE
website www.
breastfeeding.ie
provides answers
to the common
questions mums
have whether they
are thinking about
breastfeeding, just
getting started or
well on their way
with a growing
baby,” said Siobhan
24 | health matters | winter 2016

Hourigan, National Breastfeeding Co-ordinator.
For those mums who have a specific query,
there is also the option to email your question
to a Lactation Consultant via the Ask our
Expert service or through Webchat. The new
HSE Breastfeeding Facebook page provides
a community of support for mothers to join
with input and information from the Ask our
Expert Lactation Consultants. The new Irish
breastfeeding videos on breastfeeding.ie provide
guidance for mothers on topics like positioning
and attaching baby; expressing milk and what
to expect in the early days.
MORE INFORMATION
For more information and LIVECHAT:
www.breastfeeding.ie
ABOVE: Minister of State Marcella Corcoran
Kennedy TD launches National Breastfeeding
Week with baby Sam. Photo: Robbie Reynolds
Photography.
LEFT: Frances Plunkett, HSE Digital Communications
and an expectant mum, supporting the new Ask Our
Expert online chat service.
Parents share
their stories
Mum Bernadette Martyn, Mullingar, Co
Westmeath, who features on the new videos,
gives encouragement to other mothers in the
early weeks. Bernadette says: “The first two to
three weeks were tough but I was determined
to keep with it. A friend of mine gave me
advice, she said ‘don’t give up on your
toughest day’. So I kept with it and it literally
changed overnight, one day it got better and
then the following week, it was like oh gosh -
It went into place really quickly then. Especially
with the other two kids, it’s really handy that I
can just pick him up and feed him when I need
to, and I can put him back down again.”
Mum Lesley Kavanagh, also from Mullingar,
agrees: “There was a lot of cluster feeding
which I now know is completely normal.
Check their nappies, wet and dirty nappies, as
long as there are lots of them, then they are
perfect. It (breastfeeding) is such a brilliant
thing it makes life so much easier.”
Breastfeeding mums Bernadette, Leslie and
Ciara O’Hara describe how they appreciated
the help and encouragement they got at their
local breastfeeding support group. Ciara says
“I just loved the breastfeeding support group,
everybody is so welcoming, everybody is so
friendly. It was so lovely being able to chat to
people, at the time I wasn’t so comfortable
feeding in public so it was a great way of
getting used to feeding in public. It was lovely
having her around other babies.”
The suite of videos also includes videos of
Irish dads sharing their experiences, tips and
supports. Dads Joe and Noel talk about how
their practical help and support helps mum
when breastfeeding. “Definitely go ahead and
encourage her to breastfeed as much as you
can and support her with it. It really worked
for us.”
Noel describes the importance of
breastfeeding for his children’s health.
“I was very happy, very supportive
of (mum) to breastfeed. I think
they (the children) are all
probably a lot healthier
for it, their immune
systems are
strong,”
he said.
winter 2016 | health matters | 25

ACTIVITY-BASED FUNDING
MONEY FOLLOWS THE PATIENT
UNDER NEW SYSTEM
Activity-Based Funding (ABF) is transforming
the way our healthcare services are funded,
bringing with it significant improvements in
levels of efficiency.
ABF means that hospitals are paid for the
actual quantity and care they deliver to patients,
thereby enabling the hospitals to see clearly the
link between money and the work they do.
Maureen Cronin, Assistant Chief Financial
Officer and Head of Acute Hospital Finance
(ABF) and the Healthcare Pricing Office,
explained that the traditional way healthcare
was funded, either on the community side or in
hospitals, was with a block grant.
“That means that in a year, a hospital might
have got €100m in funding but you didn’t have
an explicit link between the work they were
producing and the money they were attracting,”
she said.
The first time ABF was utilised by the HSE
was in 2011 with the advent of the Fair Deal.
“At that time, we had about a billion euro
and 118 public units, as well as a lot of
private providers too. But we didn’t know in
the public unit with 30 beds whether or not
they had 12 clients or 30 clients in the unit
in a particular month. So we couldn’t link the
product or the production at that unit with
the money they were spending. There was no
link,” she explained.
“So, in a way, that is a disincentive for people.
They were getting the same amount of money
whether they have the 12 clients or the full 30,
while the local hospital could be overflowing
with people in leading care and they weren’t
able to move them on. Now most people would
be very professional and would not do that but
that was what was possible under the block
grant system.”
Since the Fair Deal went live on billing on
January 1st 2012, there has been a marked shift
in behaviour from nursing homes.
“There’s no doubt that has changed
behaviour. People in the public hospital system
have told me that units are much more keen
to take the patients because if they don’t
have full occupancy, then they don’t get
their full funding.”
What Maureen and her team did under
the new scheme was create a link
between the number of beds and the
number of clients being treated with the
money for the first time.
“If a unit had a €105 million budget
then we would take that €105m off
them and divide it by the number of
beds they had, say 30, and say ‘well
that is what it is costing you that per
week per client’. We said will give
you back that €105m but only on
the basis that every month you
had to have 30 clients in the
beds,” said Maureen.
“At national level, that gave us for the first
time visibility. For that billion, we literally had
a list of 23,000 people who we could see their
name and photograph and see what we were
getting for our money.”
But bringing ABF to the acute hospital setting
is a much more complex process, with Maureen
describing it as ‘Fair Deal on speed’.
“Fair Deal is a very simple model. We have
in simple terms a bed in a unit and we have
a person in it. That is the product is being
produced. There’s no product differentiation,”
she said.
“You have to decide what the equivalent of the
product is in the hospital setting. In hospitals,
we have about 16,000 possible diagnoses
and 8,000 possible procedures which we
classify under the Classification of Diseases 10
Australian Modified (ICD10-AM).
“Because you couldn’t work with that huge
number, we use a grouper and that groups
those different procedures and diagnoses into
diagnosis-related groups (DRGs). The DRG
is the product. We have 7/800 products for
inpatients and about 350 or 400 for day cases.
Whereas we have loosely 1000 products in the
hospital settings, we have just one in the Fair
Deal, highlighting the huge challenge of bringing
ABF to the hospitals.”
The foundation stones of the system have
been laid since the 1990s when Brian Donovan
and his team started collecting the cost data
from the hospitals since then. Deirdre Murphy
and her team provide the other vital cog in the
ABF system – the classification system.
“You need the same concept as the ‘€105
million for the 30 beds’ from the Fair Deal for
the hospitals. You need to be able to say, what
is the cost of doing this work, and how do you
measure how many products you are producing.
“There are two systems basically. Deirdre
and her team running the classification system,
which people would know as the HIPE clinical
coding system, and Brian and his team have
been conducting the cost collection for many
years. What we do then is join the two of them,
and that effectively becomes the cost of each of
our products.”
There are statisticians and very elaborate
statistical models that allow them to merge
those two very large data sets. There are 1.6
million discharges a year in the hospital system
26 | health matters | winter 2016

The ABF team: Deirdre Murphy, Joe Sheeky, Maureen Cronin and Brian Donovan.
and all diagnoses, all procedures are grouped
into those products.
“The 1.6 million has to be merged with the
money,” explained Maureen.
Brian said that, for example, they get all the
costing data for treating Alzheimer’s patients
and then set the average.
“Efficient hospitals end up getting more money
and inefficient hospitals get less,” he explained.
“We have relative values for each DRG. The
average case costs €5,000 and each DRG is
given a weighting relative to the average case.
An ICU case could have relative value of 28 and
a normal birth would be 0.6. We weight each of
the DRGs depending on how many resources
they consume and we pay then based on that.
“In the old way when we were measuring
activity based on discharges, then an ingrown
toenail measured the same as a head
transplant. It didn’t make any sense. You had to
acknowledge the complexity of the cases.
“If one hospital gets funding of €100m but
overruns by €1m, then under the previous
system, they were doing badly. Another hospital
could have received funding of €100m too and
managed to come in €1m under budget and
looked good. You could have even looked at
the under-budget hospital, seen that they had
performed 20,000 procedures and thought that
they were doing even better.
“But that hospital could have dealt with
20,000 ingrown toenails while the other
hospital dealt with 10,000 head transplants. So
when you weight them, the first hospital is doing
much better. ABF now can show us that the
over-budget hospital was far more efficient.”
The challenge now for the Healthcare Pricing
Office, under Maureen’s leadership, is to get
good enough data to be able to implement
ABF fully.
“First of all, the costs that we are producing,
we know they are wrong, because hospitals
don’t have good enough systems in place to
capture all the things that we would like them
to capture. We first need to refine and get our
costs better,” said Maureen.
This year Brian and his team will be
implementing across the country new patient
level costing (PLC) software to capture data
from all the feeder systems such as labs,
radiology and theatre.
“The PLC is basically like a hotel bill for your
stay in hospital. It will show how many days you
spent in it, what tests you had, all that would be
on your bill,” said Brian.
Maureen explained: “We need to put a greater
worth on clinical coders. During the recession,
many coders were taken out not replaced.
Clinical coding didn’t take centre stage due to
the pressures people were under. Now we have
the National Office for Clinical Audit and the
clinical programmes looking more at clinical
coding and telling clinicians, ‘this is your data,
your staff is putting it in, make sure it is good’.
For example, if somebody has a catastrophic
stroke but a coder is brand new or the clinical
notes are appalling and it is coded as a minor
stroke, we might pay out €1,900 instead of the
€23,000 is actually cost to treat.”
Deirdre said a coder’s job is to open a patient
file every day and extract the information as
given by the clinician.
“They will give us that picture of the activity
in the hospital and play a critical role in giving
us the 1.6 million pictures - some simple, some
complex – and helping to identify and group
those. It is a massive role and they are vital to
the hospital.”
FURTHER information
For further information: www.hpo.ie
winter 2016 | health matters | 27

Feature
National review of clinical care
national office
of clinical audit
ational clinical audit is a cyclical
process that aims to improve
patient care and outcomes by
N
systematic, structured review and
evaluation of clinical care against
explicit clinical standards on a national basis.
The aim of the National Office of Clinical
Audit (NOCA), established in 2012, is to provide
a national measure of inputs, process and
outcomes of care provided against national and
international best practice standards. National
audit data can also provide a repository of
reliable data for service planning, strategic
development and research.
NOCA is based on the campus of the Royal
College of Surgeons (RCSI) and is funded by the
HSE Quality Improvement Division (HSE QID).
The team is led by Collette Tully, Executive
Director and Ken Mealy, Clinical Director.
Each audit is managed by an Audit
Coordinator and Clinical Lead, with
governance provided by a National Clinical
Audit Governance Committee and the NOCA
Governance Board. Each audit is also supported
by a Statistician and Information Manager.
National audits are well established
internationally including HQIP in England, ISD
Scotland, the Swedish National Audit Office
and the Australian Orthopaedic Association,
National Joint Replacement Registry.
National audit reports identify areas of
excellence as well as concern and include key
findings and recommendations to improve our
healthcare system.
NOCA currently manages the following
national audits:
• Irish National Orthopaedic Register (INOR)
was established in 2013 to improve and
maintain the quality of care for individuals
receiving joint replacement surgery in Ireland.
The register will collect information from
all elective hospitals in Ireland undertaking
joint replacement surgery and will support
early detection of implant performance and
improve the efficiency of the recall and review
process. The register is currently live in South
Infirmary Victoria University Hospital, Cork and
will be implemented across all public elective
orthopaedic hospitals by 2019, with private
hospitals to follow.
• Irish Hip Fracture Database (IHFD) is
live in all 16 hip fracture trauma receiving
hospitals across Ireland. Every year in Ireland,
over 3,000 people are hospitalised with a hip
fracture. International evidence has shown
that care standards, audit and feedback can
drive measurable improvements in hip fracture
outcomes. Quality of hip fracture care is
assessed against the six standards in the British
Orthopaedic Association (BOA) and British
Geriatrics Society (BGS), 2007 ‘Blue Book’: Care
of patients with fragility fracture.
• Major Trauma Audit (MTA) is live in all 26
trauma receiving hospitals across Ireland. Major
trauma is recognised as the leading cause
of death and disability in older children and
adults of 44 years and younger. MTA uses the
internationally recognised the Trauma Audit and
Research Network (TARN) methodology. This
audit assesses the quality of care against clinical
guidelines from National Institute of Clinical
Excellence and system level KPIs.
• Irish National Intensive Care Unit Audit
(INICUA) measures the quality of care in ICU by
benchmarking outcomes to the internationally
recognised standards of the Intensive Care
National Audit & Research Centre (ICNARC) in
the UK. The National ICU audit is currently live
in five public hospitals and seven units – Mater
Hospital Beaumont Hospital, Tallaght Hospital,
Lourdes Hospital, Drogheda and UH Limerick. It
will be implemented across all public ICU units
by 2019.
• National Audit of Hospital Mortality (NAHM)
is live in 44 acute hospitals across Ireland.
NAHM explores hospital mortality patterns and
produces a standardised mortality ratio (SMR).
The SMR compares the observed to the expected
number of deaths within diagnostic groupings in
a hospital setting adjusting for factors that may
influence their outcome such as age, admission
source and type, pre-existing illness etc. SMRs
are only one indicator of quality of care. Hospitals
have access to reports via the NQAIS NAHM tool
that supports the national audit.
NOCA also provides assisted governance for
the National Perinatal Epidemiology Centre
(NPEC) who conduct the following audits:
• Severe Maternal Morbidity
• NPEC Perinatal Mortality
• Planned Home Births
There will be three NOCA audit national
reports published by the end of 2016. The Irish
Hip Fracture Database National Report 2015
was launched recently at the 5th National Hip
Fracture Conference.
The Major Trauma Audit National Report
2014- 2015 is the inaugural report for this
audit and will be launched December 8th at the
National Patient Safety/Clinical Effectiveness
Conference.The inaugural National Audit of
Hospital Mortality Report will be launched on
December 15th.
All reports will be available via the NOCA
website www.noca.ie/publications
more information
If you have any queries, please contact us on
014028577, auditinfo@noca.ie or Tweet us
@noca_irl
28 | health matters | winter 2016

Introducing @HSELive
‘Hello, we’re the health
service. How can we help?’
ABOVE: Geraldine Charman, HSELive; ABOVE LEFT: Lorcan Power, Communications; Lorraine
Reaburn, HSELive and Sarah Kelly HSELive; BELOW LEFT: Geraldine Charman and Geraldine
McCarville, HSELive
We know that it’s not always easy for our
service users and clients to know where
to turn to for guidance or support when
navigating the healthcare system. They find it
confusing and have many questions about our
health system, often during times of emotional
distress when they or their loved ones are ill.
As well as this, public expectations have
changed in recent years and are constantly
changing in this digital age. People expect
to be able to engage with an organisation
directly – to ask questions, get consistent
responses, and support in a timely manner.
Think about your car or house insurance,
even your hairdresser or dentist will send you
text reminders.
The ways in which the public chooses
to engage directly with organisations
has widened. More people are now using
LiveChat, social media and email to interact
with organisations to ask questions, find
information or solve problems. Globally and in
Ireland, phone / voice is the fastest reducing
medium of communication as more and more
people turn to digital channels.
This is why we are launching @HSELive
– a new multi-channel information service to
answer questions and be a guide to the Irish
health system. The purpose of this change is
to deliver an improved responsive customer
service platform with staff who can provide
consistent responses, to the public across
phone, email, Livechat on HSE.ie and via
social media.
The service has been designed with the end
user at the heart of the service, to provide
information and signposting on health and
health services for the public on a channel of
their choosing.
In addition to significantly enhancing the
public face of health services, this digital
transformation also, importantly, gives us an
opportunity to use data to drive improvement.
Every contact with @HSELive signals that the
public are experiencing a problem somewhere
in the health system. The new customer
relationship management tool and data
systems will enable us to focus our energies
on fixing the root cause of the contact or
problem, ultimately using public feedback to
drive improvements, thereby ensuring better
health service experiences to those we serve.
HSELive will bring a renewed focus on
customer service in information provision in
the health services in-line with our values of
care and compassion.
Speaking about the launch of @HSELive,
Geraldine Charman, @HSELive Team Leader
said, “We are looking forward to being able to
deliver an improved service to more peope in
the way they want the service delivered. The
@HSELive team has really embraced these
huge changes and has welcomed the new
technologies, which is fantastic.”
Here’s all the ways you can talk to us
Callsave 1850 24 1850
Livechat on HSE.ie
Tweet us @HSELive
Email hselive@hse.ie
We’re here Monday – Friday 8am to 8pm,
Saturday 10am to 5pm.
winter 2016 | health matters | 29

specialist team providing integrated community care
service helps reduce
unnecessary hospital stays
A key principle of our health service is to provide
patients with the most appropriate care and
service in the most appropriate location provided
by the appropriate health care professionals.
Patients should not have to attend hospital
unnecessarily with all the added stresses and
possible complications that such attendances
involve for them and their families.
A Community Intervention Team (CIT) is a
specialist, nurse-led health professional team
which provides a rapid and integrated response
to a patient with an acute episode of illness who
requires enhanced services/acute intervention
for a defined short period of time. This may be
provided at home, in a residential setting or in
the community as deemed appropriate, thereby
avoiding acute hospital attendance or admission,
or facilitating early discharge.
The CIT, through its fast-tracked provision
of services enhances the overall primary care
system, providing access to nursing and home care
support, usually from 8am to 10pm, seven days
per week. It is available to all patients regardless
of eligibility once they meet the referral criteria.
Referrals are accepted from hospitals, GPs and
other community sources and each person’s
referral is assessed to ensure it meets the criteria
for safe care in the person’s home or in a CIT clinic.
These clinic locations are more convenient
for patients compared with attending an acute
hospital setting. The CIT works in partnership with
the referring clinician and agrees a plan of care for
the patient .
The range of services currently provided by
CITs include:
• Administration of IV antibiotics
• Wound dressings
• Acute anticoagulation management
• Urinary related care (urinary catheter care and
patient education)
• Ostomy Care
• Medication Management
• Enhanced Nurse Monitoring
• Care of patients with respiratory illness
• Male/ female urethral/ supra-pubic
catheterisation
• Palliative care/ end of life care
• Diabetic care and blood sugar monitoring
• Central venous catheter care
• Chemotherapy Pump disconnection
• Physiotherapy and Occupational Therapy
services (Louth)
Key to the service are the working relationships
with both hospital based and community based
health professionals, as all are working together to
support and care for patients living at home with
chronic diseases.
GPs may refer to CIT for interventions such as
subcutaneous fluid administration.
One such case is a lady in her 80s living at home
with carers in South Dublin. She has a medical
diagnosis of Parathyroid adenoma with high
calcium levels and a past medical history of CVA
(stroke). She previously had multiple admissions
to hospital for treatment for dehydration and high
calcium levels, (3 admissions of approximately
10 days each in a 3 month period). In December
2015 her GP referred her to the local CIT for the
administration of subcutaneous fluids twice weekly
to maintain hydration and decrease calcium levels.
CIT has been visiting this lady in her own home,
as requested, twice weekly and administering
fluids as prescribed, usually a litre of normal
saline over 24 hours. Since the GP referral to
the CIT in December 2015, this lady has had
no hospital admissions for dehydration or high
calcium to date (patient has given permission to
document her treatment .
Another example of this collaborative working
relationship is where a patient is referred to CIT
from an Emergency Department with a minor soft
tissue injury sustained after a fall. In this case,
when the CIT nurse assesses the patient on a
home visit, she may note that while previously this
patient had been independent with care at home,
the patient may now require community services
and a Geriatrician review.
The CIT works closely with PHN services, and
may transfer care to the PHN when an acute issue
has been resolved and the patient has ongoing
needs or where the CIT accepted a referral for a
nursing service during out of hours. The PHN may
refer to CIT following discussion with the patient’s
GP, where there is a new acute need or if a patient
requires a service out of hours which the PHN
service cannot provide.
An example is where a PHN visits an elderly
patient for a planned leg ulcer dressing and
determines that the patient is acutely unwell
but does not require hospital care. The PHN may
contact the GP in relation to the need for a home
visit and referral to CIT.
Referrals for administration of home IV
antibiotics (Outpatient Parenteral Antimicrobial
Therapy) (OPAT) are made by hospital consultants
with input from the local Infectious Diseases
30 | health matters | winter 2016

Contact Details for CIT
Dublin South – 01-4987100,
Fax 01-4987132
Dublin North – 01-7044444,
Fax 01-7044497
Meath/Kildare – 01-4276000,
Fax 01-4276099
Louth – 042-9364210,
Fax 042-9389864
Sligo – 01-4688279, Fax 01-6865153
Galway – 01-4270000, Fax 01-4276099
Limerick – 061-483660/483679,
Fax 061-483902
North Tipperary – 067-46472,
Fax 067-46490
Clare – 065-6863260,
Fax 065-6863262
Carlow/Kilkenny, Wicklow, Waterford/
South Tipperary – 0818-300030,
Fax 059-9133968,
Ereferrals available in this area
Cork – 1890-837427, Fax 021-4840093
To discuss the clinical details of
a patient you should phone the
relevant CIT and fax the referral to
the appropriate number outlined
above. Please note that you must
await confirmation of acceptance of
referral by CIT.
In the event of you experiencing
any service difficulties please call
the CIT/OPAT Management Control
Centre at 01 4276000 which provides
a national co-ordination role for
these services.
specialist or Clinical Microbiologist.
This helps to ensure that patients are suitable
for treatment at home and that they are receiving
the appropriate antibiotic treatment. It is assumed
that each day on the OPAT programme equates
to a bed day saved as the patient would otherwise
have remained in hospital. This programme saved
26,307 bed days in 2015 (17,031 on the nurse
administered service HOPAT, and 9,276 where the
antibiotic is compounded in a device and patients
taught to self administer SOPAT). This equates to
72 beds each day.
The OPAT programme has developed a
protocol for the management of cellulitis in the
community including appropriate oral antibiotics/
criteria for prescription of IV antibiotics by the GP
if indicated/ criteria for referral to hospital. This
IV service is currently available for GP referrals
for patients living in Dublin, Kildare, Wicklow,
Louth and Meath. Plans are underway to roll out
to the other CIT teams.
The CIT is a valuable acute nursing service
that can rapidly respond to acute nursing care
needs in the community. It provides a very
patient centred service within the primary care
framework and audits have reported high levels
of patient satisfaction.
Thanks for participating in the Health
Sector National Staff Survey 2016
Thank you for your response to the
2016 Health Sector National Staff
Survey, Your Opinion Counts.
The survey ran for just over
five weeks from Wednesday,
September 28th until Friday,
October 28th and staff
participated from all parts of
the country.
More than 19,000 completed
surveys were received.
The purpose of the Survey was to
access current staff opinions in order to
identify opportunities for improvement which
will help build a better health service for all.
Rosarii Mannion, National Director of Human
Resources, expressed her appreciation to all
of the staff who participated
“Thank you for your participation and
sincerity. Your feedback is an invaluable tool
for the success of the health sector. It is very
much valued. Staff who have good workplace
experiences deliver better care to patients.”
Libby Kinneen, HR Lead on Staff
Engagement, said there were many positive
aspects about the way the Survey was carried
out this year.
“We tried to do something different this
time. We wanted the Survey to be a vehicle
for staff engagement. Therefore we tried to
get as many people to participate as possible.
“We were assisted by 200 staff around the
country who acted as Survey Champions
encouraging colleagues to complete the
questionnaire. Our Survey Champions were
the human face of the Survey and helped to
explain what it was about and why we were
doing it by holding briefings and meetings
around the country.
“In addition we received a lot of feedback
from staff which will be very useful in
informing the 2017 Survey process.”
What’s Next?
Ipsos MRBI has the completed surveys and
has been compiling the results. An overview
of the results is due to be presented to the
HSE Leadership Team this month (December)
and a Communication to all staff will follow
outlining the main findings.
The need for systematic follow up in the
period following staff surveys has been
identified as a very important part of the
whole process.
With this in mind, we plan to hold a series of
workshops across the health sector including
Hospital Groups and Community Health
Organisations in the week beginning January
23rd next.
In the spirit of staff engagement these
workshops will be attended by a
proportional representation of
staff who will plan actions for
their area to address issues
which have been identified in
the Survey.
The workshops will provide
opportunities for staff at
all levels to get involved in
actions which will ensure local
ownership.
Look out for opportunities to give
expressions of interest to participate in
a workshop in your area.
Thanks again for your valued participation!
We on the Project Team really appreciate
your participation and the effort you made to
make time to do the Survey.
Your feedback will help to make the Health
Sector a better place to work.
FURTHER INFORMATION
Further information please contact:
nationalhr@hse.ie
winter 2016 | health matters | 31

Feature
Valuing staff knowledge and creativity
HEARING
STAFF VOICES
hey say there’s nothing as
powerful as being heard and
University Hospital Kerry (UHK)
T
have taken this message to heart
- from sharing their ideas for
quality improvement at staff listening sessions
to acting on those same ideas using an approach
called Front Line Ownership.
In 2015, 69 staff from all disciplines in
University Hospital Kerry participated in
listening sessions designed and facilitated
by the Quality Improvement Division. Before
beginning this work, the Executive Management
Board (EMB) agreed to support and act on the
top three suggestions for improvement.
The key feedback from staff at these
sessions was:
“Helping make a difference in the lives of
those who use our services and working
collaboratively with our colleagues are the
greatest positives of our work. Please ensure
we have sufficient staff to do our jobs safely
and well.
Help us to continue to learn so that we can
continue to improve service delivery. Help us
Principles of Front Line Ownership
• Go slow to go fast
• Invite the unusual suspects
• Work with those who want to work with you
• Participation is voluntary
• Nothing about me without me
• Change can spread bottom up, top down,
and sideways
• Make the invisible visible
• Act your way into a new way of thinking
commit to a culture of mutual respect, kindness
and compassion.
To improve services, improve
communication - keep us informed, listen to
us and value our opinion.
Ask us - we can help reduce waste and
improve processes. Introduce flexible working.
Happy staff - happy patients. And finally
recognise the work of staff - say thank you and
acknowledge us when we do a job well.”
In a follow on action planning session
with staff and management which included
engagement with patients, staff formed five
teams: Communication, Culture, Flexible
Working, Waste and Training and Education.
Using a Front Line Ownership approach,
Dr Michael Gardam and Leah Gitterman,
Ignite Consulting, coached approximately
50 staff members during three on-site visits
and through regular coaching calls on these
themes. A member of EMB acted as a sponsor
for each of the group to raise issues at board
level if required. The Quality Manager who
was also a member of the EMB provided
coaching and leadership support locally. Four
HSE staff shadowed this work to sustain and
spread the learning.
FLO is an internationally recognised and
successful quality improvement approach
which encourages staff to acknowledge their
own capacity and potential to improve service
delivery and make creative sustainable changes.
Some challenges included having time to meet
together. One group utilised ‘What’s App’ and
Twitter to communicate regularly. The methods
used to communicate and engage with other
hospital staff included informal get togethers,
canteen focused events, and conversations
with staff. Coaching via teleconferencing was
more feasible than videoconferencing due to IT
restrictions and access.
32 | health matters | winter 2016

So what happened?
The Communications team introduced the
‘Hello My Name’ is initiative, completed
a social network mapping exercise and
established a UHK choir ‘The Frontliners’!
The Waste team established a pilot for
recycling in theatre and outpatients, provided
recycling awareness training for staff,
introduced patient menu cards to reduce
food waste by introducing portion sizes (also
meeting HIQA Nutrition standards).
The Culture group introduced ‘Happy
Mondays’ and social events to improve staff
culture, held a free staff draw with prizes from
local businesses, improved car parking, raised
awareness of staff uniform policy- clerical
staff now have a standard uniform and staff
outdoor seating area provided.
The Training, Education and Flexible working
time completed a review of mandatory
training and flexible working was agreed; with
staff self rostering systems in place in most of
the wards.
Today the teams continue to work on new
ideas and with new and original members.
Majella Daly, worked as the Quality Manager
in Kerry at the time and she described the
experience (see right).
ABOVE: Pictured at the sessions were Grainne
Rohan, CNM2, Emir Murphy, Speech and
Language, Majella Daly, Quality Manager and
Amanda Brolly, Intensive Care Nurse.
BELOW: Staff celebrating the success of the work in
University Hospital Kerry.
more information
Further information please contact:
Maureen Flynn, Director of Nursing and
Midwifery, Quality Improvement Division,
Lead Governance and Staff Engagement for
Quality maureena.flynn@hse.ie 01-6352344
Juanita Guidera, Quality Improvement
Division, Lead Staff Engagement juanita.
guidera@hse.ie 087-06423 08
Majella Daly, Interim Primary Care Manager
Majella.Daly@hse.ie
For more information,
see www.qualityimprovement.ie
in brief with
majella daly
#hellomynameis Majella Daly. I worked as
Quality Manager in UHK and was the local coordinator
for the front line ownership initiative
in the hospital.
The hospital has almost 300 beds and over
1000 staff delivering services across wide
range of specialities such as maternity services,
orthopaedics, oncology, palliative care, acute
medicine as well as a very busy Emergency
department and outpatient services. So you
can imagine the span and scope of issues and
problem facing staff and patients. This is why I
feel we are really benefiting from being part of
the frontline ownership initiative.
Firstly the staff listening session held in
May/June 2015 offered staff the opportunity
to identify first-hand what their main issues
of concern was. The National QID team
supported this work, provided the final report
and worked with myself and staff to prioritise
the top five issues to address. My role was to
encourage staff to continue their engagement
after the listening session to actually sign up to
join working groups to progress improvements
in the five themes and keep FLO on the
Management team agenda. The role of the
local co-coordinator is key in moving into the
stage of improvement as otherwise we could
fail to walk the talk!
Support staff, management and different
professions were keen to become engaged
in making changes. They signed up to join
working groups and attended training in
Frontline ownership methods - to be honest
staff and I weren’t really sure what Frontline
ownership and liberating structures methods
were all about but we adopted an open mind
and ‘suck it and see’ approach!
We were still learning and having fun! For
me I had to unlearn some of my traditional
QI methods such as PDSA as Frontline
ownership and liberating structures is more
about listening helping staff you work with
think in a different way, ask questions, drill
down to find out why and then come up with
solutions together which staff can try. It’s okay
to fail with the solutions, you just learn, and
try a different approach.
The liberating structure tools provide
different ways to ask the questions, seek the
solutions but most importantly allow staff
themselves to come up with those solutions
and own the implementation of them. So it
has been liberating for me in my role! I no
longer feel I have to be the doer/come up
with the solutions; staff can do this themselves
with the techniques- they’re the best people
to do it. We’ve even started involving some of
our volunteers in the hospital. I believe this
approach will build a sustainable approach to
QI in the hospital now and in the longer term.
winter 2016 | health matters | 33

A Patient Safety Initiative
Introducing the Individual
Health Identifier
– your own “digital key”
When you visit a healthcare practitioner, you
embark upon a journey. This may be a brief trip
to the GP for some advice and perhaps a medical
prescription or it might turn into a lengthier
journey with referrals to different parts of the
healthcare system.
Whoever your healthcare practitioner is, and in
whatever setting you are seen, one of the most
important things in order to deliver the right care
at the right time is that you, as the patient, are
uniquely identified.
This is the key function of the new Individual
Health Identifier (IHI). Your IHI is generated by the
HSE using information about you as set out in the
Health Identifiers Act 2014. This information will
include your name, address, date of birth, etc. The
IHI will not hold any of your health information
and should not be confused with an electronic
health record (EHR) which would gather all of
your health records into one file; the IHI is there
to identify you.
Existing information systems in the Irish health
and social care services need the IHI to help them
identify you as a unique individual. At some stage
future IT connectivity and new developments, for
example the proposed Electronic Health Record
(EHR), will rely upon the IHI as the cornerstone
for unique and safe identification of patients.
This means the risks of information not following
you from your GP to the hospital, will be greatly
reduced; the chances of using the wrong patient
record, delivering the wrong care, prescribing
the wrong medicine or performing the wrong
procedure will be minimised.
The development of the new IHI required
legislation to protect everyone’s data and ensure
the security of the system. The Health Identifiers
Act 2014 was the first step in the creation of an
IHI for Ireland and describes exactly what the
IHI record for every person who uses the health
services is allowed to contain.
The HSE has been given the job of building
and operating the IHI Register of unique health
identifiers that will be used across health and
social care services in the State. Personal data
will be held safely and securely in the IHI Register
and only used within the health and social care
system to accurately identify you, using data such
as your name, date of birth, mother’s maiden
name, etc.
The IHI record itself contains no medical data,
just personal data to uniquely identify you as an
individual. IHI records will be created, stored and
used with the utmost confidentiality and security.
Your individual personal data is private and will
not be shared with anybody outside of the health
and social care system. IHI records will only be
seen by the relevant healthcare staff at the point
of patient care.
An IHI will be generated and assigned
automatically to your existing health and social
care records. In time, the IHI will be connected to
the Maternity and Newborn Clinical Management
Systems (MN-CMS) which will allow for the
IHI to be generated at birth. The IHI number
will be used in the background to identify you
34 | health matters | winter 2016

and enable healthcare systems to identify your
unique records so that we can provide healthcare
services to you at the right time, giving safe and
timely treatment. You will never need to know or
have your IHI to access services as it is just an
identifier within the health and social services
(but it can be provided upon written request to
the IHI Business Service). The IHI programme is
committed to keeping your information safe and
secure and an IHI Privacy Impact Assessment
was opened to public consultation earlier in
2016 (the results of which can be seen on www.
ehealthireland.ie/Strategic-Programmes/IHI/).
As the IHI is implemented in existing and new
healthcare information technology systems
across Ireland’s health and social care services in
the coming years, it will allow you to be identified
uniquely and will increase patient safety benefits.
What does this mean for me, as a health service
staff member?
At the point where a patient registers with
a health or social care provider, the IHI will
become a key process for patient identification.
Patient administration systems will be tailored
to incorporate automatic look-up of the IHI for
each new or return patient who presents to
your service. In the event that a patient is not
automatically allocated an IHI, this will not
prevent their access to health or social care
services. The IHI Business Service will process
the new request in the background to generate a
unique IHI for that patient.
It will take several years for the IHI to be
fully implemented in Ireland. There are many
thousands of points where patients connect with
health and social care services and the IHI Project
will be implemented in each location over the
course of time. Each site will be supported to
identify and communicate with staff that need to
use the IHI number for their patients. Initial pilot
sites will start in both community and hospital
based locations through 2016 / 2017 and, building
upon the experience from these pilots, the rollout
will continue in a managed way across the
entire health and social care system. Already
most European countries, along with Australia,
Singapore and the United States, are benefitting
from this system and we can learn from their
experiences, of how best to introduce the IHI for
maximum patient safety benefits.
As the IHI implementation spreads across the
Irish health and social care system, staff will
begin to see IHI numbers appearing on patient
records or correspondence between healthcare
providers. The subsequent implementation of
the IHI in existing national systems such as
HealthLink / eReferrals, National Integrated
Medical Imaging System (NIMIS) and the National
Laboratory Information System (MedLIS) will
spread the use of the IHI across the services.
Local systems such as GP practice management
systems and hospital patient administration
systems will be added on a continual basis as
we work through the phased roll-out. The IHI
is a cornerstone of the eHealth strategy across
public (both statutory and voluntary), and private
health and social care services. With each phase
of the roll-out careful consideration will be
given to existing work practices of health
service staff who are involved in patient
identification, in order to minimise
any extra workload.
In most cases, the IHI will
be automatically added to
patient records without
requiring much, if any,
intervention from staff. The
pilot approach adopted by
the IHI Project will ensure
that staff training materials
are offered wherever needed.
We are embarking on
a programme of work
that is estimated could
take several years to
be fully embedded
in every health and
social care service.
We are taking
a programmed
approach and adding
locations continually.
We look forward to
working with staff, GPs,
and key agencies to
build the IT platform
FURTHER information
that will improve the safety of our services.
From our patient’s perspective the IHI will be
transparent, working away in the background
to assure health and social care staff that our
patients are correctly and uniquely identified. Our
patients will not need to know their IHI any more
than they need to know other internal health
service reference numbers such as their Medical
Record Number (MRN). However as mentioned
earlier, anyone can apply in writing to get a copy
of their IHI number, the IHI Business Service will
gladly provide an individual with their IHI.
The IHI is a key to the success of safe,
integrated health and social care for tomorrow
and the future. We will keep you updated on new
pilot programmes and progress over the coming
months and years.
Further information, including YouTube video is available at:
www.ehealthireland.ie/Strategic-Programmes/IHI/
winter 2016 | health matters | 35

HSE and e-HEALTH IRELAND
HEALTH TECHNOLOGY
IMPROVING CARE FOR PATIENTS
The HSE and eHealth Ireland recently
showcased the current innovations in Health
as well as innovations from the future in Trinity
Science Gallery in Dublin.
This two day event was part of the eHealth
Innovation week which started with a Hackathon
to deliver solutions for patients with Bi-Polar
disorder. This event was the first of its kind, and
featured a host of health innovation exhibitions,
demonstrations, presentations and devices which
can enable innovations in healthcare today and
into the future.
Speaking at the event, Tony O’Brien, Director
General of the HSE, said, “This event provides
a timely opportunity for the HSE and eHealth
Ireland to showcase the innovations currently
being developed and delivered within the
Health Service and the innovations that will
be available to us in the future with the help of
digital technologies. These innovations are part
of building a better healthcare service for the
patients we serve now and into the future.”
The EH2030 exhibition included exhibits
from suppliers, SMEs, start-ups and a new
HSE initiative -the QIC Programme - which
encourages clinically led innovation. This
is an eHealth Ireland led internal innovation
programme, facilitating the ability to deliver
disruptive technologies and innovative platforms
capable of transforming the Irish healthcare
system by 2020.
Richard Corbridge, HSE Chief Information
Officer, said, “Disruption in digital health is here.
Digital Health is a driving force in healthcare
reform. Mobile technologies and elements
like Internet of Things solutions will be the
dominant platforms to access and create
digital information. Research suggests that
83pc of businesses will be digital by 2020 we
need to work with SME’s and the public to be
ABOVE: Richard Corbridge, Chief Information
Officer , HSE (left) and Tony O’Brien, HSE Director
General, pictured together experiencing the virtual
Reality headsets during the HSE / eHealth Ireland
Innovation Showcase held in the Science Gallery,
Trinity College Dublin. Pic. Robbie Reynolds.
technology bringing assisted living into the 21st century
When people hear the words ‘assisted living’,
chances are they will think of the traditional
pendant alarm that can be worn around the neck.
If you or someone in your family wears one of
these devices, there is a good chance that Tunstall
Emergency Response is the company monitoring
the device and any alerts it sends out.
“We are the largest provider of ‘telecare’ services
in Ireland,” explains Tunstall MD James Doyle.
“We have a 24/7 monitoring centre, which fields
about 450,000 calls per annum – so we’re very
experienced in this area.
“The traditional assisted living device would be
the pendant alarm that people are familiar with
– but the technology is evolving all the time, and
new innovations can really benefit the people we
help care for.”
Tunstall has recently joined forces with another
Irish company, Motech Group, to provide a nextgeneration
assisted living experience – through a
device called the CareClip, designed by Motech.
The CareClip is a matchbox-sized device, worn by
the user. This is supported by a secure web portal
and a mobile app that provide the family member
and/or carer with instant, accurate data as to their
loved one’s wellbeing.
The CareClip has two-way communications
to allow for instant contact from a person in a
response centre, a family member or carer. The
family member and/or carer can use the app to
assure themselves of their loved one’s safety and
wellbeing at any time.
“The CareClip uses the most innovative and
secure technologies available,” says Paul Flavin,
CEO of Motech.
“Traditionally an ‘assisted living’ monitoring
service would be restricted to the home or
residential care unit, due to the technology
available. Motech wanted to extend this level of
service and support, to allow people get the same
reassurance 24/7 – wherever they are,”
he explained.
James from Tunstall continues: “We get
approached on a regular basis by companies who
have new pieces of technology. Motech’s CareClip
36 | health matters | winter 2016

innovative and agile in our projects to provide the
appropriate healthcare that citizens need.
“This is the first time that a Health Innovation
Week has been hosted in the EU. The Health
Innovation Showcase is part of the Health
Innovation Week currently being hosted in Dublin.
The HSE and eHealth Ireland welcome this global
event to Ireland and see it as an important step on
the path towards building a better health service.”
To learn more about the events of the Health
Innovation Showcase or Health Innovation Week
visit www.eh2030.com.
Epilepsy and
technology
– Bridging the Gap
Taking the care of an individual from
the hospital into the community is not a
new concept. However, the sharing of the
most relevant and up to date information
between tertiary and primary care has
often been delayed and fragmented,
requiring the way in which we communicate
relevant information to change.
The electronic patient record (EPR) was
designed to share all relevant patient
information between members of the
multi-disciplinery team both in the hospital
and the community setting at the touch of a
button, in an effort to enhance patient care.
The opportunity and necessity to use
healthcare data/information intelligently
has never been greater.
The technology is now available to
healthcare professionals
to allow the delivery of
a variety of epilepsy
services to multiple sites
to include maternity care.
The use of the EPR
in maternity services has
enhanced the sharing
of information between
obstetrics, primary care,
neurology services and
the patient.
The information gathered
on the EPR is readily available
allowing the various clinicians on site
to make prompt informed decisions in
caring for the woman with epilepsy. The
woman with epilepsy is then more likely
to have a greater awareness of her own
condition, thus allowing her an influence
into her care.
is the best device that we’ve seen. It does exactly
what we would want it to do.” The CareClip works
while a person is at home and also while they are
out and about, therefore allowing both physical and
social interaction with the community.
“This is achieved by combining the best mobile
communications with GPS satellite technology and
rigorous adherence to data security and privacy.
The CareClip allows the wearer to send an alert
if in need of assistance, and it provides automatic
fall detection. It also allows for highly accurate
location identification in the event of an alert – it
will display where the person is instantly (accurate
to within 5m).
The CareClip will even alert if the wearer is out of
a ‘safe zone’ or entering a ‘non-safe zone’, giving an
increased level of reassurance and independence.
James says: “Motech’s device has been
comprehensively field-trialled, and its ability to
roam across all the different networks is one
aspect that we’re particularly delighted with. We’ve
taken it to known black spots, where there is very
poor phone signal coverage, and it has worked
every time.”
The CareClip has two-way communications
to allow for instant contact from a person in a
response centre, a family member or carer.
The family member and/or carer can use the
app to assure themselves of their loved one’s
safety and wellbeing at any time. Both James
and Paul explain that what the CareClip really
offers is peace of mind to families, carers and
wearers themselves.
“Technology can never be a panacea,” says
James, “but technology such as this can be
an enabler – it’s an enabler for promoting
independence and hopefully giving increased
quality of life to both the wearer and their family
or carer.”
FURTHER INFORMATION
To find out more call 1850 247 999 or
go to www.tunstallemergencyresponse.ie
winter 2016 | health matters | 37

NEW QUALITY
AND SAFETY GUIDES
QUALITY and Safety Committees perform
an essential role in our health services by
providing a forum to consider, monitor and
improve the quality and safety of care we
provide, said the HSE National Director for
Quality Improvement, Dr Philip Crowley.
“The committees provide much needed
space to stand back and consider the quality
and safety of care we provide, to monitor this
on a routine basis, and to provide respectful
challenge and act to improve care,” he said.
“To help this process the National Quality
Improvement Division has just updated
guidance and produced templates for HSE staff
who are looking to establish and review Quality
and Safety Committees.
This guidance forms part of a toolkit to
support staff in applying the Framework for
Improving Quality in our Health Service which
was published by the HSE recently.
Quality and Safety Committees address
issues like:
• How do you know what good care is?
• How do you know you are getting better?
• Do you have the appropriate measures?
• Have you confidence in the relevant data?
• Do you know where you stand relative to
the best?
• How do you demonstrate that you are a
learning organisation?
• How do you keep in touch with the front line
reality of service delivery?
• How do you ensure you hear the voices of
patients, families, service users and frontline?
“The guidance and templates are provided
ready for adaptation to the specific context of
each of our services.
These include acute services, mental health,
primary care, social care, health and wellbeing
and the national ambulance service and are
valuable tools for all of us to continue in improving
the care that we deliver,” said Dr Crowley.
more information
The Quality and Safety Guidance is available
to download at www.qualityimprovement.ie
Please contact Karen Reynolds at karen.
reynolds@hse.ie or 086 8394929 for more
information or any questions about the Quality
and Safety Committee Guidance document.
38 | health matters | winter 2016

Claimsure claims system
efficiency and
accuracy boosted
he deployment of Claimsure, a
private health insurance claims
management system, across
T
the acute public hospital sector
is having a positive impact on
the efficiency and accuracy of private health
insurance claims management. Claimsure
has been successfully implemented in all
hospitals by HBS Finance - Income Reporting
and the Office of the Chief Information Officer
in partnership with Claimsure Slainte Ireland
and local hospital resources.
There are 48 public acute statutory and
voluntary hospitals in Ireland which generate
almost €640m worth of income from
privately insured patients. In 99% of cases
hospitals have a direct payment agreement
between Private Insurers / Occupational
Health Schemes and the Hospitals.
Prior to 2012, the majority of hospitals had
their own way of managing this process, so
there were no national standards or national
claims management systems in place.
With the introduction of Claimsure, the
HSE is now in a stronger position when
negotiating changes in business terms at a
high level. There is now national visibility
and hospital uniformity when reporting
on the level / status of private insurance
debt. The direct pay agreement allows
the hospital to directly bill the Private
Insurers on the patient’s behalf and seek
reimbursement from Insurers via Claimsure.
Claimsure now electronically manages
all aspects of a hospital’s claim from
patient admission to discharge, including
e-submissions to health insurance providers.
It replaces the existing paper processing of
claims and integrates with the Hospital’s
admissions systems, patient billing systems
and any external 3rd party consultant
billing services. Patients can electronically
sign insurance forms via an e-pad or tablet
device. Consultants can access an electronic
secure list of their claims via their HSE
approved device, and can electronically sign
appropriate claims.
Claimsure has enhanced claims reporting
at both hospital and national level, increased
efficiencies in claims handling and query
management. Most notably it has enabled
the HSE to agree a significant Memo of
Understanding with the VHI which was
introduced in November 2015 by way of a
Heads of Agreement and adopted fully from
March 1st 2016.
A significant project to provide a national
centralised reporting facility based on
Claimsure is under development by HBS
Finance - Income Reporting. This initiative
will allow for further streamlining and
standardisation of national reporting and is
due for completion by the end of Q4 2016.
HBS ON THE ROAD TO SUCCESS
Health Business Services, the business division of the HSE,
has achieved significant success in its first three years of
operation, Tony O’Brien, Director General of the Health Service,
acknowledged recently.
Mr O’Brien, who is also Chair of the HBS Governance Committee,
was speaking at a senior management forum for HBS leaders in
Castletown House, Co Kildare.
He said HBS was a central part of improving and reforming the
health service.
“There has been significant success in the first three years which
demanded great effort, huge hard work and tremendous cooperation,”
he added.
“The theme and focus for the event centred around the
development of a new Strategy for HBS for the next two years
(2017-2019). The development of the Strategy was discussed in a
series of workshop sessions and feedback discussions.
Director of Health Business Services, Jane Carolan said the
engagement was very successful helping to shape and inform the
approach for progressing the HBS global business services model.
“I am confident that HBS is delivering a world class model for
shared services and that we will see more and more success in
terms of the new Strategy of 2017-2019,” Ms Carolan said.
HBS Management Team with Tony O’Brien, Director General.
winter 2016 | health matters | 39

Feature
Fewer errors and better outcomes
Communicating
ommunicating is something
that happens every day in the
health services. How well we
C
communicate is determined not
by how well we say things but by
how well we are understood.
Research has shown that there are fewer
errors and better treatment outcomes when
there is good communication between patients
and their healthcare providers, and when
patients are fully informed and educated about
their treatment and medication (World Health
Organisation 2012).
How we choose to communicate also
influences our relationships with colleagues
and impacts on the experience of our patients
and service users when they interact with the
health service.
Patients and service users expect us to be
clear when we give them information about
their health. When we explain things clearly and
with care and compassion, people have more
confidence and trust in us, take our advice,
and follow medical guidance. They are better
informed and more likely to ask us questions so
that they can take better care of their health.
“39pc of Irish people ask that healthcare
professionals use more understandable
language and less medical jargon” (National
Adult Literacy Agency, 2015).
The HSE Communications Division supports
effective and consistent communications by
everyone who works in our health and social care
services. On that basis, the Communications
Division is developing a suite of tools for all staff
to assist in effective communications. These are
aimed at supporting HSE staff in communicating
more clearly with service
users and their families
and with colleagues.
Kirsten Connolly,
Deputy Director of
Communications, said,
“We want to assist
staff in thinking
about how they
present information in a way that ensures they
are fully understood. This in turn ensures that
patients, clients and the public in general can
make informed choices, access appropriate
services and take better care of their or their
families, health. We also want to support
staff in reflecting the values of the Health
Service, particularly care and compassion, in
how we all communicate. Through our daily
interactions, we have an opportunity to shape
the kind of communication culture we want in
the health service.”
The Communications Division team has
developed a practical guide to encourage the
use of plain language – using both the written
and spoken word. Quite simply we wanted to
give everyone a succinct and informative guide
to how we communicate in the HSE. We set
out the language and norms we use to ensure
we communicate clearly and are understood.
In a very practical way, this guide has been
developed to support everyone in the health
service adopt plain language in their work
environment. The guide is aimed at all staff and
is applicable for our daily interaction with adult
service users and colleagues.
To develop the Communicating Clearly Guide,
we brought together the larger communications
team and explored what plain language really
means in various contexts and settings in health.
We shared examples of where plain language
worked really well and identified what was
distinctive about the use of language in these
instances. All of this was underpinned by a
key principle; that we reflect our values in
language we all use.
The project team created this guide as
the first in a suite of plain language tools to
be developed over the coming months. The
team was made up of Kirsten Connolly, Deputy
Director of Communications; Norma Deasy,
Campaigns Manager; Ann McLoone, Deputy
Head of Press; Sarah Woods, Communications
Manager, NOSP; Sandra Eaton, Deputy Head of
Digital; Sheila Caulfield, Client Director Health
and Wellbeing; Ross Cullen, Communications
Manager, CHO2; Ciara McWeeney, Office of the
Chief Officer, CHO6.
Entitled ‘Communicating Clearly with
Patients and Service Users’, the guide outlines
how patients and service users ask us to be
clear when we give them information about
their health. It stresses that “clear and
compassionate communication makes for better
outcomes and a better experience for the people
in our care”.
40 | health matters | winter 2016

Clearly
To achieve clarity we have taken an accessible
and simple approach.
The pointers we provide are:
We introduce ourselves by saying:
“Hello, my name is...”
We speak clearly and with empathy:
“How can I help you?”
We put ourselves in our patients and service
users’ shoes when talking to them:
“Is there anything else you need to know?”
We use plain language to explain complex terms:
“Let me explain....”
We listen to what they have to say and respond
kindly:
“I am here to help you understand everything.”
We give contact details for more information:
“In case you want more information...”
To support staff in “writing so that those we
care for can understand our letters and advice,”
we provide further pointers:
• We use clear language and everyday words
• We write it as we would say it, using plain
language
• We avoid using jargon, abbreviations and
acronyms
• We use a font that is easy to read, such as
Helvetica or Arial
• We clearly explain the purpose of our letters
and documents
• We ask non medical staff to check that our
letters and documents are easy to understand
• We use ‘I’, ‘we’ and ‘you’ to personalise our
letters and documents
• We use short sentences and paragraphs
• We give our contact details so that the reader
can contact us for more information.
Over the coming weeks, we will be distributing
hard copies of ‘Communicating Clearly with
Patients and Service Users’ guidelines, which
encourages us all to communicate clearly and
show empathy when talking and writing
to our patients, clients and service
users. These guiding principles, which
have been endorsed by the HSE’s
Leadership team, are designed to
make us all stop and think on how we
communicate. They will assist us to be
more compassionate with our spoken
and written word. They encourage us to
use a clear, narrative and plain language
that is suitable and easy to understand,
and to focus our communications on
the needs of those with whom we are
communicating. Give them a try and see if
it makes a difference in your day.
further information
See www.hse.ie/communicatingclearly
Hard copies available to order from
www.healthpromotion.ie
winter 2016 | health matters | 41

Feature
s you walk in the door of the
Blackrock Hospice, you are
welcomed warmly by Andrea,
A
the soothing scent of essential
oils and the calm that permeates
the building. Then you look left and the choice
of books from ‘Saying Goodbye to Daddy’ to
‘Finding a way through when someone close
has died’ reminds you why people come here.
In Galway, when you enter the spacious
atrium, motivational messages catch your eye,
there are people everywhere and instinctively
you feel that each person has a purpose
– some are waiting for news over a cup of tea,
others on a mission to attend appointments
or visiting loved ones. The one connecting
point for these two diverse settings is that the
staff in each look after people at their most
vulnerable, hear intimate thoughts and share
their time with patients what are often their
greatest joys and sorrows.
In healthcare, there is great privilege in
this work yet when we help families hold
it together, who holds us? Who cares for
the carers?
The Quality Improvement Division
in conjunction with the Point of Care
Foundation (PoCF), is currently working
with Our Lady’s Hospice & Care Services
- Blackrock Hospice and University Hospital
Galway to test the introduction of Schwartz
Rounds in an Irish context.
What are Schwartz Rounds?
Schwartz Rounds are monthly meetings for
all staff working in a health care organisation.
The Rounds provide an opportunity for staff to
reflect on the emotional aspects of their work.
The focus is on the human dimension of care.
Each round is based on the story of a
particular patient or a theme and is briefly
presented by 3 or 4 members of staff.
This is followed by a facilitated discussion
which involves the wider audience and is an
opportunity to listen, share and support.
Schwartz Rounds provide a framework which
helps to improve staff wellbeing, resilience
and support which ultimately has an impact on
improved patient centred care.
What are staff saying in Ireland about
Schwartz Rounds so far?
The feedback from staff so far has been
really positive – staff are telling us:
ENCOURAGES INSIGHT
“Amazing insight into other professional’s
experiences”
“Felt glad that multidisciplinary from cleaner
to consultant was emphasised”
“These rounds help break down barriers
between all the different members of the
hospital staff ...”
“Takes time out to my day to see the patients
on my waiting list but is a good way to focus on
caring for ourselves”
Schwartz Rounds
who cares
Reaffirms values
“Brings caring and kindness back into the
workforce”
“Helps us remember why we are in a caring
profession”
positive feeling
“Feel-good factor - positive effect overall”
“Incredibly moving and human”
“Stunning - made me very proud to work
with such compassionate, sincere and expert
people”
“Well worth taking the time to attend despite
a very busy schedule”
HIGHLIGHTING IMPORTANT ISSUES
“Highlighted other issues like open
disclosure”
“Very positive and potent reinforcement
of how an individual can impact on patient
care through non-clinical means - smiles,
compassion, greetings”
“Very thought-provoking about what we do
well and when things go wrong”
For more information about Schwartz
Rounds, please see
www.qualityimprovement.ie
A mentor’s experience of
Schwartz Rounds by Nicki
Power, Schwartz Round
Mentor
I have facilitated, mentored and evaluated
more information
If you have any queries about Schwartz
Rounds, please contact:
Maureen Flynn, QID Lead Governance and
Staff Engagement for Quality, maureena.
flynn@hse.ie 01-6352344 or
Juanita Guidera, QID Lead Staff Engagement
juanita.guidera@hse.ie 087-0642308.
Useful Resources
www.qualityimprovement.ie
http://www.theschwartzcenter.org
http://www.pointofcarefoundation.org.
uk/schwartz-rounds/
http://www.kingsfund.org.uk/publications/
schwartz-center-rounds-pilot-evaluation
Schwartz Rounds since 2014 in the UK,
working both within the National Health
Service and with the Point of Care Foundation,
who have supported the development of the
Schwartz Round pilot in Ireland. For me, the
power of Rounds is that they advocate for
vulnerability as a strength, and see bravery
in the emotions we display and acknowledge
the positive impact of our human connections
in a professional context. I have heard a
choke in the throat of a ‘tough’ consultant as
they talk about the guilt of making a mistake,
seen tears in the eyes of audience members
connecting to their own unforgotten patients
and also, heard the silence of an audience
engaged completely in listening to the story of
a colleague, a human being.
Before coming to Ireland to mentor the
42 | health matters | winter 2016

for the carers?
staff at Blackrock Hospice and University
Hospital Galway, I had not considered that
storytelling is innate in Irish culture and
how this might impact on Schwartz Rounds.
As an emigrant, resident in the UK, my
cultural identity is obvious as soon as I speak
– I am Irish. People often ask me why I’m
passionate about Schwartz Rounds. I used to
absentmindedly say that I have always liked
stories and hearing people share their unique
perspectives, but I had not linked this to my
cultural heritage until now.
Ireland offers a unique context in which
to apply this model of staff support – one
where storytelling is already valued and
culturally relevant.
A Schwartz Round at
University Hospital Galway
The reception at University Hospital Galway
invites all those who enter to take care of
themselves before caring for others. This
is communicated through art work which
invites visitors and professionals to reflect
on the toll of caring. It sent a message to me
that the organisation was already engaged
in caring about its staff. The Schwartz Round
I attended, entitled “Behind Closed Doors”,
gave staff from the intensive care unit an
opportunity to share their experience of
treating patients and caring for families in a
high pressure and critical environment where
outcomes routinely involve life or death.
The openness of the audience discussion
struck me immediately. Staff members not
only shared their work related experiences,
but connected to their personal lives. People
spoke about the palliative care of their parents
and the critical care of their children by other
caring professionals. One woman said: “they
carried myself”, referring to the emotional
support she received from healthcare staff.
This short statement has stayed with me
since. There are few jobs where training
equips staff with practical skills but the
demands of the role go far beyond completing
tasks and being effective in the job. Wherever
we work in healthcare, from facilities provision
to wards or therapy rooms, we work with
people who are distressed.
The staff spoke about the needing to be kind
to each other and to themselves. They spoke
about the difficult power of knowing too much
from a professional point of view and having
to find a common language with families to
communicate caring in these most difficult
of circumstances. They also shared their
vulnerabilities through expressing feelings of
helplessness; when the helping profession
cannot help, when death is imminent or when
pain cannot be cured.
A Schwartz Round at
Blackrock Hospice
Blackrock Hospice is tucked away on a
back lane, a light-filled care setting which
offers respite from the City as well as
from life-limiting illness. Here, I felt the
community of staff, cover had been arranged
so that as many staff as possible could
attend the Schwartz Round. The theme was
“What a patient taught me” and four staff
shared their learning from patients for the
benefit of the audience.
The depth of the audience discussion was
what struck me here. Staff spoke about the
times when words fail, when only silence
will suffice to acknowledge the needs of
the patient. Courage was needed by staff
to trust that at times the patient knows
best. A senior colleague said: “don’t just do
something, stand there”. By inverting this
common saying the power of being with a
patient or family member, without the need to
act was recognised. This message, heard by
all staff present communicates the value of
a supportive culture which acknowledges the
human moments of care.
The staff present were able to recognise
their personal limitations as professionals, in
that death cannot be prevented but a ‘good’
death is a privilege for the staff to facilitate
for the families and people who cross the
threshold of the hospice. As well as the
challenge of absorbing strong emotions in the
work, the positives of patient care surfaced,
a nurse spoke about feeling renewed and
energised through her work.
TOP: The Schwartz Rounds facilitators in Galway
pictured in front of some of the artwork there.
winter 2016 | health matters | 43

Feature
Single Assessment Tool
technology helps
assess care needs
ssessing the health and social
care needs of older people is
key to ensuring they receive the
A
appropriate care and support. A
new IT-based assessment beinig
introduced in our health services is enabling staff
to better assess and better plan beople’s care.
Health professionals are now using the
‘Single Assessment Tool’ (SAT) to carry out
comprehensive geriatric assessment of older
people who apply for support under either
the Home Care Package (HCP) Scheme or
the Nursing Home Support Scheme (NHSS),
also known as ‘A Fair Deal’. Using SAT, the
assessment process is the same for everyone,
regardless of where they live or who carries
out the assessment, ensuring it is fair and
equitable. The system is secure, user-friendly,
person-centred, intuitive and informs more
comprehensive care and service planning.
Better care planning
Trained assessors in hospital and community
settings are now using computer Tablets with
specially designed software, SAT Information
System – SATIS, to gather all of the necessary
information from the older person.
There are 20 different sections in the
assessment e.g. functional performance,
cognition/mental health, social life, clinical
issues etc., all of which must be completed.
Each section has a number of questions with a
drop down menu of ‘codes’, one of which must
be selected, as well as options to add additional
information to capture a fuller account of the
person’s holistic needs.
When completed, the system automatically
generates a number of reports which can
be used to determine areas of risk, potential
for improvement, current health status, and
prioritisation of service need e.g. risk of adverse
outcomes such as falls, pressure ulcers and
increasing frailty. This detail enables staff to
develop a care plan that is tailored for the
older person in consultation with their family
representative. The SAT, which will replace
the current paper based ‘Common Summary
Assessment Report’ (CSAR), adds significant
value as all the relevant health and wellbeing
information about the older person is gathered in
one assessment process, rather than through a
battery of individual tests.
SAT also enables staff involved in the older
Ciara Blair, OT and
trained SAT assessor,
with Colette Murphy,
patient at Tallaght
Hospital.
person’s care to easily exchange relevant
information (with the older person’s consent) as it
securely stored electronically.
Specially designed software
The SATIS software enables the use of the
interRAI (International Resident Assessment
Instrument) Home Care assessments that
are designed to assess older people at
home, in hospital or other community-based
settings. interRAI is a world renowned non
profit organisation that provides royalty-free
licenses of its assessment instruments to
help improve the quality of life of vulnerable
persons - www.interrai.org
The SAT is currently being introduced on a
phased basis but the results to date are positive.
Dr. Natalie Vereker, Specialist in Services for
Older People and SAT Project Manager said,
“The SAT is new to the Irish health system but
we know its potential and are already seeing the
opportunities for better use of the information
gathered about older people’s care needs.
The system is intuitive and along with enabling
a comprehensive care needs assessment, it also
identifies opportunities for improvement as well
potential areas of decline.
The SAT will not only benefit older people and
their clinicians but the wider health system as it
has enormous potential to facilitate the delivery
of targeted services, quality initiatives and future
service planning.”
Phased implementation
Since May 2016, Beaumont Hospital,
Tallaght Hospital and University Hospital
Galway have started a trial implementation
of SAT. Multidisciplinary staff in each hospital
were nominated to become SAT assessors
and were trained to use the HSE tablet device
and software.
They also completed the SAT Education and
Development Programme with mixed methods
of training and support involving four days
classroom-based training, practice assessments
with direct feedback, one to one support as
needed and eLearning modules leading to a
mandatory competency evaluation.
Professor Shaun O’Keeffe, Consultant
Geriatrician, University Hospital Galway said,
“The approach for assessing older persons has
now been standardised for clients entering our
services. The introduction of the SAT is a change
in how assessments are completed but this has
been worthwhile. We now have a comprehensive
SAT assessment which will ensure services
for clients are allocated in a fair and equitable
manner based on their care needs.”
44 | health matters | winter 2016

Members of the
SAT National
Implementation
Team
SAT assessments are completed by the
assessors with older people in the hospitals
and are then available to all staff who
are directly involved with the care of the
person with onward referrals being made
as appropriate. These assessments are
also considered by members of the Local
Placement Forum who make a determination
about entry into long term care based on the
older persons wishes and assessed need.
Integrated care
THE implementation of SAT also promotes and
facilitates the continuity and integration of care
between acute and community sectors. In line
with their nearby hospital colleagues, staff in the
community areas of Dublin North, Galway and
Dublin South West are also implementing SAT.
Following an evaluation of the implementation
process in these locations, SAT will then be
implemented nationally on a phased basis
throughout 2017.
JJ O’Kane, Manager of Services for Older
People, Galway CHO 2, “I am looking forward
to the roll out of SAT in the community.
This comprehensive assessment will bring
consistency to the way older people are
assessed for Home Care Services and will
assist us in decision making when allocating and
prioritising services.”
Michael Fitzgerald, HSE Head of Operations
and Service Improvement for Older Persons
Services and Chair of the SAT Project Team said,
“It is best practice nationally and internationally
to advocate for a standardised care needs
assessment. Implementing this project is
a substantial undertaking but in striving to
continuously improve our services we know that
the SAT technology will better support us to
ensure the most appropriate care in the most
appropriate setting for older people.
“We look forward to rolling this out further and
working with the acute and community sites
coming on stream throughout 2017.”
more information
Further information about SAT is available
from: www.hse.ie/SingleAssessmentTool
or email the SAT National Office, Single.
AssessmentTool@hse.ie
patient given due recognition
Trained SAT assessor
Ciara Blair, Senior
Occupational Therapist
in Tallaght Hospital, one
of the SAT Pilot Sites,
shares her experiences
of the new tool
The Single Assessment Tool is new to Ireland
but has been used internationally for over 20
years. The SAT is a much more detailed and
comprehensive assessment tool than the
paper-based CSAR. It captures information,
not just about medical diagnosis, medication
and a broad overview of care required to look
after the patient but more specifics about
personal activities of daily living eg bathing,
dressing, toileting, functional transfers,
eating etc and medication management,
transportation, pressure ulcer risks and
managing household related tasks. It also
acknowledges the importance of a patient’s
mental health and mood.
The SAT system also automatically
generates clinical alerts that trigger
the assessor to ensure further in depth
assessments may need to be done, for
example on cognition, and provides guidance
to the assessor on evidence-based care
planning. The assessment covers in greater
detail information about the patient’s abilities
and capabilities as well as things they need
assistance with.
It also gives the person being assessed a
‘voice’ and recognition as a vital person in
the process of organising long term care
for them by seeking their opinion about how
they are coping, managing and feeling. This
fits in well with our approach in Tallaght
hospital of ‘people caring for people’ so we
are delighted to be one of the first places to
use the SAT system.
We have been using the SAT system for
a number of months and, as with anything
new, it has taken staff some time to get used
to the SAT assessor approaching them for
information with a computer tablet in their
hand instead of a paper based assessment.
Ward staff have said they prefer the SAT
system as they are consulted in completing
the person’s assessment and it has taken
extra paperwork tasks away from them,
such as the CSAR. It does take a little
longer for the SAT assessor to complete
the assessment than the CSAR would
have taken. However, the benefits of such
a comprehensive assessment for the older
person is a far greater advantage to them and
our organisation in the longer term.
winter 2016 | health matters | 45

Feature
Children First:
Guidelines for
child protection
hildren First: National
Guidance for the Protection
and Welfare of Children,
C
(2011) is currently being
reviewed to reflect the pending
implementation of the Children First Act 2015
which is scheduled for January 2017. The most
critical message in the revised Guidance and
Legislation is that we are all responsible; we
are all required to act and we are all required
to report to the Child and Family Agency any
concern we have which suggests that a child
has been harmed or may be at risk.
What is Children First?
Children First aims to promote the safety
and wellbeing of children. It is intended to
assist people in identifying and reporting child
abuse and neglect, and to deal effectively with
concerns.
It states what organisations such as the HSE
need to do to keep children safe, and what
different bodies, and the general public should
do if they are concerned about a child’s safety
and welfare. The Children First Act 2015 places
a number of statutory obligations on specific
groups of professionals, such as health and
social care staff providing services to children.
These obligations extend to mandatory
reporting and mandatory assisting when the
Children First Act 2015
is fully enacted from
January 2017.
Children First
National Office
A Children First
National Office has
been established and
is staffed by a Director
and fifteen training
and development officers nationwide. Their
role is to support the Community Healthcare
Organisations (CHO’s); Hospital Groups (HG’s)
and regional and national services in achieving
full compliance with Children First. In addition,
there is a National Oversight Committee
supported by Divisional and local area
committees to progress the programme of work.
Child Protection and Welfare
Policy 2016
The HSE has developed a Child Protection
and Welfare Policy to assist staff in
understanding the corporate responsibility
of the HSE and the individual responsibility
of each staff member as to their role and
responsibilities. The policy also addresses
the legal frame work for child protection in
Ireland and the legislative protections for any
individual reporting a child
protection or welfare concern
in good faith and in the best
interests of a child.
Resources
The Children First National
Office has produced the
following resources to assist
staff:
• Child Protection and Welfare
Policy, 2016 (leaflets, a briefing
paper and presentations)
• A foundation e-learning programme called
“An Introduction to Children First” available on
www.HSELanD.ie. This e-learning programme
is mandatory for all staff and is in line with the
HSE Child Protection and Welfare Policy, 2016
• The HSE Children First website www.
hse.ie/childrenfirst which has a number
of resources to support HSE staff and
HSE funded organisations in meeting their
responsibilities under Children First
• A generic e-learning programme is
available at http://childrenfirst.hseland.ie/ for
interested people/ bodies/organisations with
an interest in this critical area.
The Children First National Office welcomes
comments or queries at childrenfirst@hse.ie
Record numbers participate in Ageing Well group
Recently, the Primary and Community
Care Occupational Therapy Department,
based in St Finbarr’s Hospital, Douglas Road,
Cork, started an eight-week Ageing Well
group in the local community.
The need for the group arose as part of the
Cork Integrated Falls Service.
One of the strands of this service
is a community strand which includes
developing opportunities to stay healthy and
well as we age..
Record numbers contacted the department
to book a place on the course and, due to
demand, the group is now booked out for
2017 already.
Topics covered included maintaining
physical and mental wellbeing, energy
conservation, safety around the home and
Some of the group participants on their outing.
dealing with finances.
The group was run in the local library in
Ballyphehane, Tory Top Library and it was an
ideal location in the middle of the community
for people to be able to access.
The group had an outing on November 8th
to put some of the principles discussed over
the weeks into practice and excessive wind
and rain did not stop them from enjoying
the occasion.
46 | health matters | winter 2016

linn dara gives warm welcome
ailed for providing a welcoming
and reassuring domestic
ambience, the Linn Dara Child
H
and Adolescent Mental Health
Inpatient Unit won the Best
Universal Design at RIAI Annual Awards.
The unit for children and adolescents with
acute mental health illness opened recently on
the Cherry Orchard Campus. It provides mental
health services for children and adolescents
up to 17 years in Dublin and Mid-Leinster. This
is an in-patient building for acutely ill patients
who reside here for up to six weeks. It includes
a school, a gym hall and an apartment for
family use.
For many of the children and adolescents, this
is the first time spent away from family. The
building plan stems from the brief and wraps
around secure courtyards. The courtyards share
a curvy wall faced with ceramics designed by
artist Diane Jamesion of birds and leaves and
trees. The courtyards are not enormous, but
large enough for play, or to sun yourself on the
grass, or site under the covered ‘shed’ area.
There are two wards, Hazel and Rowan,
and the artwork picks up these themes in the
wardrobe doors and the glass screens. The
bedrooms are grouped around a small planted
courtyard, with the coloured staff bases always
in view. The staff base is round and blue (or
green). The top glows gently, so at night you can
keep it in view if you wish. All residents have a
single room and ensuite bathroom.
There is a small wardrobe and a worktop
for a dressing table or to work. One wall is
painted with white ‘blackboard’ paint – you can
draw on it, and then wipe it down. There is a
large cushioned chill out area nearby, and a
worktop with computer access for games or
for homework if you need company, or you can
move away and sit in a recess beside the planted
courtyard, or go into your room.
There are a variety of living rooms, large and
small, well-furnished and homely, with coloured
carpets or flooring. The living rooms all get
sunshine at some time during the day and
several have direct access to the courtyard. It
all allows for a variety of activities and gives the
staff plenty of options for therapy.
The essential supervision of activities
is achieved within a complex plan in a
subtle manner. It avoids an over stimulated
environment and allows the residents privacy
as well.
At the front entrance there is a waiting area
and office – it is bright and light, a bit quirky, you
can see in and out. It leads to a coffee/meeting
area with a view to planting outside and to the
artworks on the wall. It is calm and spacious.
Beyond the entrance is the school. The
residents leave their unit and make a short
journey across the hall, past the outdoor ball
area and into school. Going to school is normal
and can even be a pleasurable distraction. There
are several classrooms, an art room with access
to the garden and a view of the mature trees on
the campus, a small home economics room and
the occupational therapy room. There is also a
large, bright gym/activities/playroom which the
staff find useful for all kinds of activities.
The staff offices and meeting rooms are
upstairs. There is a small apartment for family
stayovers where required.
Externally, the building elevation is broken into
a number of smaller blocks with large coloured
blocks at the corners. Double volume spaces at
these nodes ensure both wards (two different
orientations) receive sunlight, cross ventilation
and the spaces provide variety in a building of
small domestic sized rooms. Contrasting shapes
and colour reduces scale and adds interest.
Colours were selected to visually compliment
Linn Dara’s outpatient building nearby.
The gardens are landscaped and it is in
harmony with the remainder of the grounds of
Cherry Orchard which is characterised by large
mature trees, brick walls and more recent low
level planting.
“Dealing with mental health issues is tough
when you are very young. The intention is that
this building is welcoming and reassuring and
homely and allows the staff to treat and care for
the residents in a safe and robust environment,”
said one of the staff members.
The project team consisted for: HSE Estates
Dorota Nieznanska, Pat Fogarty; Linn Dara
CAMHS – Brendan Doody and his team.
The design team was: Wejchert Architects;
Varming Consulting Engineers; Civil & Structural
Engineers - O’Connor Sutton Cronin; Quantity
Surveyors - Mulcahy McDonagh and Partners.
The coffee/meeting room at Linn Dara.
winter 2016 | health matters | 47

Feature
thousands of incidents reported
id you know that several
thousand employee health
and wellbeing incidents are
D
reported through the HSE’s
incident reporting system
(National Incident Management System
- NIMS) every three months?
Little is said about the success stories,
about how the application of simple controls
and a dedication by managers and their staff
to the preservation of employee health and
wellbeing can, and does, save people from
horrors such as that described above.
You are the HSE’s most important asset in
the delivery of high quality health and social
services and the HSE has a strong desire
to safeguard your health and wellbeing. In
order to support you in the implementation
of your Safety Management Programme
(SMP), the National Health and Safety
Function is pleased to launch the following
National Occupational Safety and Health
Policies and Guidelines:
HSE Policy on Statutory
Occupational Safety &
Health Training
Training is a key component of the HSE’s
health and safety management programme.
This document sets out policy and
provides advice and guidance on statutory
Occupational Safety and Health (OSH)
Training, i.e. training that is either explicitly
required in legislation or deemed by the
organisation to be necessary to ensure, so
far as is reasonably practicable, the safety,
health and welfare at work of employees
and others.
In summary:
1. The policy applies to all employees and
others working in the HSE
2. A systematic training needs assessment
must be carried out locally, underpinned by
risk assessment
3. Employees should be facilitated in
attending statutory occupational safety
and health training - Statutory Training is
Mandatory for the identified employees
4. Employees must attend statutory OSH
training
5. Records of statutory training required and
attended must be kept at each management
level
HSE Policy on the Prevention
of Sharps Injuries
More than one million sharps injuries are
estimated to occur in the European Union
each year. This document sets out policy and
provides advice and guidance on the sharps
risks and their management.
In summary:
• This policy applies to all employees
and others working in the HSE including
temporary employees, agency employees,
students, volunteers, contractors and any
employees contracted to provide services for
the HSE
• The HSE acknowledges the risk of
exposure to sharps in the workplace
• The HSE is committed to eliminating or
reducing the risk of exposure
• All hazards associated with exposure to
blood and bodily fluids from sharps injuries
must be identified, the risks assessed, control
measures identified and implemented
Guideline on the Safe
Handling and Use of
Cytotoxic Drugs
Cytotoxic drugs are a group of medicines
that contain chemicals which are toxic to
cells. Their toxicity means that they can
present significant risks to those who handle
them and Occupational exposure can occur
when control measures are inadequate. This
document provides advice and guidance
on the management of risks presented by
cytotoxic drugs.
In summary:
• The document applies to all employees
working in hospital departments where work
activities may involve risk of occupational
exposure
• The HSE undertakes to ensure the
protection of employees from the risks related
to exposure to cytotoxic drugs
The guideline does not deal with patient
care, except in the context of workplace
health and safety
Further information can be found on the
National Health and Safety Function website
or through our helpdesk
more information
Log your health and safety request at:
http://www.hse.ie/safetyandwellbeing.
Alternatively contact the National Health &
Safety Helpdesk on 1850 420 420 between
10.30 and 12pm and 2pm and 3.30pm Monday
to Friday.
Launch of new tobacco-free implementation guide
Health service staff from a variety of
backgrounds, as well as delegates from
Malta and members from the International
ENSH-Global Network for Tobacco Free
Healthcare Services attended a recent
‘Tobacco Free Health Service Programme
Conference’ organised by the HSE’s Tobacco
Free Ireland Programme.
The conference also saw the formal launch
of the new tobacco-free implementation
guide ‘How to Implement HSE Tobacco
Free Campus Policy’. This document aims
to support the implementation and ongoing
management of Tobacco Free Campus policy.
The implementation guide was developed
using the updated ENSH-Global Network
for Tobacco Free Health Care Services
Standards 2015. For more go to www.hse.
ie/tobaccocontrol
Pictured are (l-r) Dr Fenton Howell, National Tobacco Control Advisor, Department of Health; Dr
Stephanie O’Keeffe, National Director, Health and Wellbeing; Martina Blake, National Lead Tobacco-
Free Ireland Programme; and Mirian Gunning, HSE Senior HPO for Tobacco. Photo: Paul Connor
48 | health matters | winter 2016

Naloxone Demonstration Project
how to save a life
he HSE has published an
evaluation report on the
Naloxone Demonstration
T
Project which has been running
for 18 months in a number of
sites across the country. Naloxone blocks
or reverses the effects of opioid overdose
including extreme drowsiness, slowed
breathing, or loss of consciousness. It is
used to treat a narcotic overdose in an
emergency situation.
The most recently published data on
overdose mortality rates in Europe is
estimated at 18.3 deaths per million
population aged 15–64. The highest rates are
reported in Estonia (113 per million), Sweden
(93 per million) and Ireland (71 per million).
In 2014, the World Health Organisation
recommended that countries expand naloxone
access (opioid antidote) to people likely to
witness an overdose in their community, such
as friends, family members, partners of people
who use drugs, and social workers. In most
countries, naloxone is accessible only through
hospitals and ambulance crews.
In 2015 the HSE followed that WHO
recommendation with the development
of a demonstration project to introduce
naloxone into local communities. The HSE
commissioned an external review of the
Naloxone Demonstration Project and the
Minister for State Catherine Byrne launched
the evaluation of the report on International
Overdose Awareness Day.
“I’m glad to have the opportunity to raise
awareness of overdose and to speak about
reducing the stigma of drug-related death. I
very much want to recognise and acknowledge
the grief felt by families and friends whose
loved ones have died or been badly injured as
a result of overdose. The number of drugrelated
deaths in Ireland is a matter of serious
concern to me, and this project is an important
element in the Government’s efforts to tackle
the issue,” said Minister Byrne.
Denis O’Driscoll, Chief Pharmacist for
HSE Addiction Services, said, “Overdose
awareness and training has been developed
and made available to drug users, their peers
and families. Training in the use of naloxone
is available nationally to drug users, their
peers and their families and is available to all
staff working in statutory and community/
voluntary Addiction Services. To date we
have trained over 600 people in the use of
naloxone and we look forward to rolling out
more training in 2107 as we work to expand
the service.”
At the launch Melanie Froud, Crosscare
homeless services staff member who availed
of the training, described her experience of
using naloxone while a client of her service
was overdosing. It brings into sharp focus
the value of having naloxone available for
when it is needed. “The main thing was
seeing someone who was unresponsive
and fading in front of me, thinking they
were gone, then regaining consciousness,
breathing and moving.”
Project Partners include: Ana Liffey Drugs
Project, Merchant’s Quay Ireland, Uisce, Novas,
McGarry House, National Family Support
Network, Crosscare, National Ambulance
Service and SafetyNet
For the report please log on to: www.hse.
ie/eng/services/publications/SocialInclusion/
addiction/Naloxonedemoproject.pdf
Naloxone Project Photo Exhibition
To mark International Overdose
Awareness Day and the completion of
the Evaluation Report, our Drug Services
held a photographic exhibition in Temple
Bar, focusing on family members, drug
workers and partner agencies to highlight
the importance of Naloxone. Tim Bingham,
a dedicated Drug Service staff member
took some very evocative photos of family
members who had lost a loved one, others
who were supporting a loved one with
an opioid addiction, drugs workers and
voluntary agencies. All of the photos can be
seen on www.drugs.ie/naloxone
winter 2016 | health matters | 49

Feature
Alternative option to respite
the Home
away from home
ome Sharing in intellectual
disability (ID) services has
been an alternative option to
H
the traditional residential and
respite care offered to people
with intellectual disability and their families
for many years.
The Home Sharing model of support is
divided into three categories:
• ‘Short Breaks’ families - A Home Sharing
family in the community offers a placement
in their home to a person with intellectual
disability for short breaks and cares for that
person as a member of their family.
• ‘Contract’ families - ‘Contract Families’
are specialist carers from within the
approved Home Sharing families who provide
short breaks to children and adults with
more complex and more challenging needs.
• ‘Shared living’ families - A ‘Shared Living’
family provides full-time care in their home
to a person with intellectual disability
similar to a fostering placement. The shared
living family makes their home available to a
person with intellectual disability on a fulltime
basis as a member of their family.
Home Sharing has been developed and
fostered by the National Home-sharing
and Short-breaks Network (NHSN) which
was established to promote uniformity and
high standards amongst disability service
providers throughout Ireland.
In line with the programme of reform
within disability services, the HSE’s
Social Care Division committed to further
developing Home Sharing as a personcentred
and community inclusive type of
support. A National Expert Group including
healthcare professionals, representatives
from the HSE, TUSLA, Federation of
Voluntary Bodies, CEOs from the nonstatutory
sector service providers and
members from the National Home-sharing
and Short-breaks Network (NHSN) was
established to review the service. Their
report, ‘Home Sharing in Intellectual
Disability Services in Ireland’ (HSE, 2016),
has recently been published and, as set out
here, provides for the future development
and the safe governance and management
of Home Sharing.
Home Sharing – a positive
option
It is held internationally, nationally and
indeed from the experience of intellectual
disability service providers in Ireland that
there are many advantages to Home Sharing.
Dr Donal Fitzsimons, HSE National Disability
Specialist and Chairperson of the National
Expert Group spoke about the report findings,
“Home Sharing strives to empower people
with intellectual disability to have dignifying
relationships and to be included meaningfully
in the life of their communities.
The uniqueness of Home Sharing is that
families provide support from their own
homes. People with intellectual disability
enjoy the opportunity of developing
new relationships and being part of new
communities whilst enjoying a short break or
full time support.”
Families are also advising service providers
that one of the supports they need to enable
them to continue to care for their family
member at home is short breaks. Short
breaks give families a break from their role
as carers and it also provides their family
member with an opportunity to be with
others while benefiting from new experiences.
Families have also reported that close
SIUN’s STORY
Siun is a 16- year-old girl who has cerebral
palsy, a profound intellectual and physical
disability. Siun is extremely medically frail.
Attendance at school is sporadic due to poor
health and frequent hospitalisations. Siun
requires 24- hour care and receives all her
nutrition through a peg tube. Her natural
family are overwhelmed and exhausted
with this relentless cycle of caring for their
daughter. A Home Sharing family provides
two overnight breaks per week to Siun. Her
natural family have described this support as
a ‘lifeline to them’. Significant training was
provided to the Home Sharing family by the
clinical nurse specialist with the support of
the paediatric hospital. Regular contact is
maintained with the Home Sharing family
by the clinical nurse manager and the social
work team leader.
and trusting relationships have developed
between them as carers, their family
members and their Home Sharing families.
Challenges to be addressed
While recognising the advantages of
Home Sharing for people with intellectual
disability, there are strategic and
operational challenges in the delivery of this
model of support within an Irish context. A
legal framework for the regulation of Home
Sharing in Ireland is required to underpin
the governance and management of the
service. As Home Sharing has developed
‘piecemeal’ over the years, additional
resources should also be allocated to
the monitoring, management and further
development of Home Sharing nationally.
Dr Fitzsimons said, “Notwithstanding
these challenges, the National Expert
Group advocate for statutory recognition
of Home Sharing and its continued
development as a model of support.
It requires a commitment and further
investment by the HSE and Government
departments for it to continue and for
its future development. This report
provides the blueprint for resolving these
challenges.”
50 | health matters | winter 2016

Making a difference
copd services
ercy University Hospital
(MUH) COPD Outreach Service
is a Cork city based service
M
that aids in the early discharge
of patients who present
with an “exacerbation of COPD” to Mercy
University Hospital.
Once a patient is discharged and meets
certain criteria, the COPD Outreach Team will
perform home visits to patients. International
best practice guidelines suggest that such
a ‘hospital at home’ programme is a safe,
effective and efficient approach to the
treatment of patients with COPD.
One patient explained the benefits they got
from the service, saying, “No-one wants to
stay in hospital, the COPD Outreach Team
helped me to get discharged from hospital
earlier than usual – I am delighted with this. I
have also learnt so much about my condition
and how to manage it better.”
The team consists of Consultant Respiratory
Physician Dr David Curran; Clinical
Nurse Specialist Una Lehane; and Senior
Physiotherapist - Ciara Hanrahan.
Main aims
The main aims of the COPD Outreach
programme are to:
• Aid in the early supported discharge of
patients
• Optimise patient care in the comfort of their
own home
• Reduce the number of admissions and
re-admissions related to COPD
How it works
All patients admitted to Mercy University
hospital with an exacerbation of COPD are
assessed by the COPD Outreach Team
regarding suitability for inclusion in the
programme. The service involves a member
of the COPD Outreach Team visiting a
patient’s home. Depending on the patient’s
length of stay in hospital, a patient will
receive between two to four visits over the
two-week period following discharge.
A visit from one of the COPD Outreach
Team members entails:
• Advice and education on management of
COPD
• Vital signs check
• Spirometry (breathing test)
• Smoking cessation advice
• Provision of a home exercise programme
• Education regarding airway clearance
techniques.
Both outreach and in-reach access is now
offered as part of the COPD Outreach service.
This is available to GPs and their patients
who are known to the service. If possible a
member of the COPD Outreach Team can
offer support in relation to the patients COPD
and help to determine the optimal treatment
for the patient at that time.
The hospital-at-home service provided
by the COPD Outreach Team appears to be
making a positive impact on the patient’s
journey through MUH. The journey is
becoming more seamless and the feedback
from our patients is overwhelmingly positive.
The outreach service has also lead to a
reduction in the average length of hospital
stay for a patient with a COPD exacerbation,
thus easing pressure on bed capacity.
Overview
Chronic obstructive pulmonary disease
(COPD) is a common progressive disease
of the lungs characterised by airflow
obstruction. COPD is a major cause of
morbidity and mortality for patients in this
country. At least 1,500 patients die each
year of this disease and over 15,000 patients
are admitted to hospital with COPD.
Tobacco smoking is the most important
risk factor for the development of COPD.
Other factors that may contribute to the
development of COPD include: genetic
predisposition especially in individuals with
α1-Antitrypsin Deficiency, occupational dust
and fume exposure, exposure to outdoor and
indoor air pollution including tobacco smoke,
recurrent childhood respiratory infections
and bronchial hyper responsiveness.
A person with COPD may present with
chronic cough, sputum production and
shortness of breath. Patients with severe
disease may suffer frequent exacerbations
requiring medical attendance, potential
hospitalisation and severe disruption of their
quality-of-life. An exacerbation is typified
by deterioration in a patient’s symptoms
resulting in an increased cough, sputum
production and shortness of breath.
The establishment of the National
Clinical Programme for COPD, within the
Clinical Strategy and Programmes Division,
facilitates an improvement in the care of
people at risk of, and those who have COPD.
In 2012, the COPD Outreach service was
rolled out in 12 centres throughout the
country as part of this National Clinical
Care Programme.
winter 2016 | health matters | 51

Feature
Medical Card plan
priorities
set out
he HSE National Medical Card Unit
recently published its Strategic
Plan 2016-2018.
T
Anne Marie Hoey, Assistant
National Director PCRS outlined
the work undertaken to develop the plan.
“The development of our three-year strategic
plan was a key recommendation of the Medical
Card Process Review undertaken by the HSE in
2014. In developing the plan, we engaged with a
wide range of customers, staff and stakeholders,”
she said.
“We held a public consultation process on our
five key priorities set out in the strategic plan.
Between March 21st 2016 and April 6th 2016,
more than 200 individuals and organisations
responded to us with submissions providing
valuable input to the completion of the Strategic
Plan.” The feedback from two major customer
surveys, with over 2,000 respondents, also
provided valuable insights and key contributions to
the development of our Strategy.
“We are extremely conscious of our responsibility
to provide an excellent public service to individuals
and families throughout the country who require
eligibility under the General Medical Services
(GMS) and the Community Drugs Schemes
to enable them to access GP care, medicines,
dental and optical services. On September
1st 2016, the number of people with Medical
Card eligibility was 1,709,957. In addition
460,427 people had GP Visit Card eligibility,”
said Anne Marie.
“Our mission is to deliver a first-class
service in a consistent, transparent and
compassionate way to everyone that
engages with us. With the dedication and
commitment of our staff, applications and reviews
of eligibility will be processed in a timely manner
and any engagement with our customers and
stakeholders will be open, respectful and trusting.
“I want to acknowledge the preparation,
planning, and analysis involved in bringing this
strategy to fruition. With the determination and
support of the managers and other colleagues
within the National Medical Card Unit, I am
confident that the implementation of the priorities
in this Strategic Plan will position the National
Medical Card Unit at the forefront of quality
service delivery.”
more information
The National Medical Card Unit Strategic Plan
2016-2018 can be downloaded from
www.hse.ie/publications
National Medical Card Unit Strategic Plan
2016-2018 - Five strategic priorities
A little goes a
long way…
HBS Procurement has partnered with
Health and Wellbeing division supported
by HBS Communications to assist in the
successful promotion of public health
campaigns.
Jane Carolan, Director of HBS, said she
was delighted with the success of this
pilot and the reaction it has received. “This
initiative is a prime example of the synergies
that exist between Health Business Services
and its customers and the mutual benefits
that can be realised by working together.
Brian Long, Head of Logistics and
Inventory Management, said, “With over
30 trucks on the road each day, we saw a
great opportunity to have campaign artwork
displayed on the sides of our vehicles.”
The Logistics and Inventory Management
function of HBS Procurement currently
operates a fleet of HSE delivery vehicles
daily between the National Distribution
Centre in Tullamore to Limerick, Sligo,
Brian Long, Head of Logistics and Inventory Management; Finn Ryan, HBS Business Relationship
Manager; Jane Carolan, Director of Health Business Services; Dr Stephanie O’Keeffe, National Director
of Health and Wellbeing. Photo: Brian Gavin Press 22
Letterkenny, Cherry Orchard and Naas, with
plans to extend to Tralee, Cork, Wexford,
Drogheda and Galway.
For this pilot, artwork from the Little
Things Mental Health and the Under The
Weather campaigns were chosen to feature
on selected vehicles which are well placed
to further enhance delivery of HSE campaign
messages in an innovative approach.
Speaking of this initiative Dr Stephanie
O’Keeffe, National Director Health and
Wellbeing said, “This initiative is about taking
the Healthy Ireland agenda to the highways
and byways of Ireland, in collaboration with
HBS and National Communications, to
improve the impact of our campaigns and to
realise more from our collective investments
and assets.”
52 | health matters | winter 2016

General
News
odti delivers training course
FORTY-FIVE staff working in the field of
Organ Donation and Transplant services
throughout Ireland including Transplant
Surgeons, Anaesthetists, ICU leads and
consultants, and organ donor nurse
managers, recently came together in Dublin
to undertake the internationally recognised
Intermediate Training Course in Transplant
Procurement Management.
The course was presented by Transplant
Procurement Management (TPM), a formal
training initiative based in Barcelona which
has been working with international experts
from around the world to provide training in
transplant procurement management for over
25 years.
The course was organised by HSE Organ
Donation Transplant Ireland and welcoming
the TPM delegation and course participants,
Professor Jim Egan CEO ODTI said, “There are
two key pillars to developing organ donation
in Ireland, namely training and having key
personnel on the ground to work and support
donors, families and recipients.
“Irish people are very supportive of organ
donation and our very simple but important
message is that organ donations save lives.
“Since April 2015 Organ Donation and
Transplant Ireland (ODTI), HSE, has taken the
lead in enhancing the infrastructure in place
to improve organ donation and transplantation
rates for Ireland.”
Opening the course Dr Jeanne Moriarty, Dean
of the Joint Faculty of Intensive Care Medicine
of Ireland, added, “We can make great progress
in organ donation in the Irish Healthcare
Network by applying a nationally recognised
process around organ donation that involves the
identification of the potential donor, discussions
with families and donor management.
“As a training body the Faculty of Intensive
Care Medicine is working towards making this
course in Transplant Procurement Management
mandatory for all our trainees.”
In 2015, a total of 266 people received a
life-saving organ transplant in Ireland, 81
families donated the organs of their loved
ones and 33 people donated their kidney to a
family member.
Nuria Masuou, Ignation Martin Loeches, Jeanne
Moriarty, Jim Egan, Lars Nolke, Catherine
Motherway and Alan Gaffney attending the Train
for Trainers seminar at Castleknock Hotel in Dublin.
HSE Drugs and Alcohol Helpline and Email Support Service
The Drugs and Alcohol Helpline and Email
Support Service, deals with questions or concerns
from the public related to drugs or alcohol use
and provides information and support in relation
to these substances and their effects. The
Helpline also directs people to support services
that are available if needed.
Aileen Dooley, Manager of the Helpline
explained the service they provide. “We offer
non-directive support, information, guidance
and referral to anyone with a question or
concern related to drug or alcohol use. We
receive a diverse range of queries and provide an
opportunity to explore a concern in confidence
with onward referral when necessary. The
Helpline and email support service are run and
funded by the HSE and are accessible throughout
the Republic of Ireland for free.
“Our Helpline staff aim to support callers and
people emailing to talk about their situation,
explore their feelings and how their lives are
being impacted by alcohol/drug use. We facilitate
service users to explore what their options are
and to consider their own personal needs. We
offer information, guidance and support. To date
we have dealt with over 75,000 calls and emails.”
What should a member of the
public expect from contacting
the helpline?
Those who contact the helpline can expect
to be listened to by a professional staff; to
be supported; to have their unique position
considered and to be offered space to explore
how they want to proceed.
Helpline staff are trained to listen in a nonjudgemental
way to what each service user has
to say and offers the space to identify what they
want from the call/email. Staff support callers
and as appropriate offer information to help.
Is the service confidential?
Calls and emails are anonymous and
confidential. The service does not retain any
identifying information on callers or those
who email.
Aileen describes some of the calls and emails
they receive to the service.
“Lately we have been receiving an increasing
number of calls and emails about alcohol. We
dealt with 349 calls and emails about alcohol in
2013; 471 in 2014; 516 in 2015 and as of early
November 2016, we already have dealt with
542 people concerned about alcohol. People are
starting to think about their alcohol consumption.
“We also receive calls from people who are
worried about someone else close to them and
want to know how they can help the situation.
Where appropriate, people are given information
on services and supports such as self-help
supports, counselling, support groups, residential
programmes etc.”
Who contacts the Helpline?
We regularly receive calls/emails from people
with a concern in relation to themselves, but also
many contacts are from family, partners, friends,
professionals and students doing research.
Those working within the health services can
avail of the service also, either to discuss their
own drinking or that of clients or family members.
The service is confidential and free to all.
Ways to contact us:
Freephone: 1800 459 459
Email: helpline@hse.ie
www.hse.ie/go/drugshivhelpline
www.facebook.com/drugsalcoholandhivhelpline
winter 2016 | health matters | 53

General
News
Patients impressed with service IN
Injury Units across the country
As part of an ongoing Injury Units public
awareness campaign, we recently sought
feedback from patients who had attended
an Injury Unit for treatment and care. The
main purpose of the survey was to help
guide our public communications on Injury
Units by finding out what patients knew
about the services provided by Injury Units,
where they were getting this information
from, if they wanted to find out more
information and how they would like to
receive information in the future.
Following on from the public views and
feedback gathered from the initial Injury
Units Advertising campaign on Facebook
, the patient survey went one step further
to seek feedback from the patients who
had used or engaged with the Injury Unit
services directly.
900 surveys were distributed to 10 Injury
Units in Bantry, Mallow, Cork, Nenagh,
Ennis, Limerick, Dundalk, Monaghan,
Dublin and Roscommon. 586 completed
surveys were returned by mid September
representing an extremely high response
rate of 65pc.
For 46pc of respondents it was their
first visit to the Injury Unit while 54pc had
previously availed of the services there.
75pc of respondents (435) stated they were
attending as a patient, 10pc said they were
there with an adult patient while 15pc were
attending with a child.
48pc of respondents had been referred
to the Injury Unit by their GP while 52pc
presented directly. 34pc of patients stated
they incurred their injury while playing
sports, 30pc said the injury happened
at home with a further 36pc stating the
injury happened elsewhere such as a work,
outside, because of a fall etc.
When asked how they heard about the
Injury Units most respondents selected
friends and family 44pc and the GP 49pc as
the source of the information. 65pc stated
they would like to know more about the
injury unit and when asked to select the
way in which they would like to receive this
information 23pc mentioned HSE website,
Social Media 24pc, Local Radio 25pc Local
Newspaper 24pc and 26pc leaflet.
pcWhen asked to rate the Injury Unit
Service on a scale of 1-5 from very poorexcellent,
70pc of respondents (403)
selected Excellent, 25pc Very good( 141)
and 5pc good.
The survey also invited patients to
leave a comment and this is where it
got really interesting. Over a quarter of
respondents chose to write a comment.
While some comments were very similar
to the Facebook comments about service
access and availability, the majority of
the comments focused on the quality
and timely care provided by caring and
compassionate staff working in the Injury
Units. These are some of the comments
received;
Staff are lovely and very short wait time”
“Excellent service long may it continue”
“5 Star”
“Everybody is very nice to me Thank You”
“Met with lovely friendly smile from
receptionist”
“Thanks for always putting me back
together”
Superb service to have in our area brilliant
staff and care”
“Impeccable service given to all by staff,
the premises are spotless”
“We are so fortunate to have this service”
“You can’t get better than that”
“We were in and out of the hospital in one
hour excellent service”
Nurses extremely understanding, helpful,
also reception lady extremely friendly
Great Care very clean unit staff very
professional
I was treated with respect and concern
While the survey feedback will help
us to shape the Injury Unit Campaign
for 2016/17, it has also provided us with
some really great insights into patient’s
appreciation for the service that Injury
Units provide and the gratitude that
patients have to the staff who work in
these Units across the country.
MORE INFORMATION
For further information on the Injury Units visit
www.hse.ie/injuryunits
The Injury Unit Public Awareness campaign will
continue throughout 2016/17. The campaign is
sponsored by the HSE Acute Hospitals Division
and the Emergency Medicine Programme
54 | health matters | winter 2016

Da Vinci brings cutting-edge
technology to midwest
A state-of-the-art art Da Vinci Xi robotic
surgical platform has been installed in
Operating Theatre 7 at University Hospital
Limerick, the first such installation in Ireland.
A similar system was recently installed at
The Royal Marsden Hospital and at Guy’s
Hospital, London.
Since its installation, the team involved have
pioneered robotic colorectal and urologic
surgery in Ireland. Some 25 robotic assisted
cases have been conducted in University
Hospital Limerick. These include surgery for
colon and rectal cancer, inflammatory bowel
disease and cancer of the kidney. On average
at least three cases are now conducted
weekly in University Hospital Limerick.
Robotic surgery represents the highest
international standard of surgery worldwide.
It is the most advanced form of “key hole”
or “laparoscopic” surgery. Until recently,
patients wishing to avail of this type of
surgery had to travel to private health
institutes, or leave Ireland. The introduction of
the robotic surgical program in the UHL Group
has meant the highest international standard
of care is, for the first time, available to all
patients in the Midwest.
Already the teams involved have seen their
patients recover faster and with minimal postoperative
discomfort.
“Following major surgery for colon or rectal
cancer, recovery in three to four days was
the exception rather than the rule. With
robotic surgery we have seen this reversed,
and now this kind of recovery is becoming the
rule rather than the exception,” said Prof J
Calvin Coffey, Colorectal Surgeon, University
Hospital Limerick and Professor of Surgery,
UHL and the University of Limerick.
During robotic operations the surgeon is
seated at a consol and operates the robotic
instruments. The level of control, accuracy
and versatility these provide is unsurpassed
and approaches that possible with the human
hand. The program for robotic surgery
is funded by the HSE, the Mid-Western
Development Trust, and the Graduate Entry
Medical School at the University of Limerick.
The surgeons involved include Professor J
Calvin Coffey (colorectal surgeon), Subhasis
Giri, (urologist) and by Colin Peirce (colorectal
surgeon), who recently completed his training
at the Cleveland clinic. The programme
initially focused on bowel and kidney cancers,
but as it expands, cancers in other areas of the
body including the ovary, uterus, head, neck
and endocrine glands will also be treated.
ABOVE: Subhasis Giri, Consultant Urology Surgeon
with the Da Vinci Xi; TOP: The Da Vinci Xi Team:
Fiona Darmody, Dara Walsh, Technical Support,
UHL , Dr Peter O’Leary, Subhasis Giri, Consultant
Urology Surgeon ,ULHG , Greg Hilton, Prof J Calvin
Coffey, Consultant Colorectal Surgeon, ULHG, Dr.
Seosamh O’Riain, Maura Tully, CNM2, Prof Michael
Larvin, UL, Ursula Morby, Dr Patrick Dillon, Kevin
Hickey, Consultant Gynaecology Surgeon, ULHG.
winter 2016 | health matters | 55

General
News
Tullamore hospital staff
give initiative a very big hello
Midland Regional Hospital Tullamore
(MRHT) launched the ‘Hello My Name
Is’ campaign with more than 1,000 staff
signing up. This patient-centered initiative
encourages staff and healthcare workers
to introduce themselves to both patients
and staff.
The campaign was founded by the late
Kate Granger, a doctor from the UK who
was diagnosed with terminal cancer and the
campaign has become a resounding success
worldwide with the initiative being introduced
in hospitals in Ireland, UK and USA.
Last March, Katherine Kenny (Director
of Nursing), Mary Jane Burke, (Assistant
Director of Nursing) and Claire Foley, (Nurse
Practice Development) from Midland Regional
Hospital Tullamore were fortunate enough
to meet with Dr Kate Granger at the HSE
Masterclass in Communication where Dr Kate
Granger was speaking. They were struck by
her emotional story, her unrelenting passion,
and the simplicity of the concept that they
felt compelled to introduce the initiative into
the hospital.
Director of Nursing at MRHT, Katherine
Kenny, is one of the leaders and champions
behind the campaign. Speaking at the launch,
she said: “Personal interaction between
patients and staff is the basis for an effective
therapeutic relationship. The simple act of
introducing yourself to a patient instantly
creates a rapport and allows the patient, and
indeed their families, to be more at ease.
“Since meeting with Kate Granger last
March, we have been determined to
continue her important legacy and bring
her story to the attention of our team.
Indeed, I am delighted to say that more
than 1,000 of our staff have pledged their
support to the campaign.”
The MRHT hellomynameis committee have
been preparing to launch ‘Hello my name
is’ since March this year. This has included
assigning campaign champions from all
disciplines across the hospital, and creating
new name badges for all staff to include the
‘Hello my name is’ logo. The name badges
were kindly sponsored by Friends of the
Hospital, Tullamore. The launch proved very
successful with over 450 staff members
attending on the day to have their photo taken
to display in the hospital foyer where there
was a great positive atmosphere. All staff
who pledged to this patient-centred initiative
were entered into a raffle for sponsored
prizes from local businesses. This launch
comes in the aftermath of Kate Granger’s
untimely passing in July and staff will ensure
her legacy lives on in Midland Regional
Hospital Tullamore.
ABOVE: (l-r) Mary Jane Burke, Assistant Director
of Nursing; Orlagh Claffey, General Manager;
Katherine Kenny, Director of Nursing; Sean
Johnston, Clinical Director. BELOW: (l-r) Trish Fox,
Senior Radiographer; Claire Foley, Nurse Practice
Development; Paula Duignan, ED Shift Leader;
Katherine Kenny, Director of Nursing; Mary Jane
Burke, Asst Director of Nursing; Orlagh Claffey,
General Manager at the #hellomynameis launch.
56 | health matters | winter 2016

virtual dementia tour
offers unique insight
A unique interactive training experience aimed
at bringing greater understanding and empathy
for people living with dementia is being piloted
by HSE Donegal.
With the support of the Nursing and Midwifery
Planning and Development Unit (NMPDU) and
the cross border partnership (CAWT), the Virtual
Dementia Tour® mobile simulated training was
at St Conal’s Campus, Letterkenny, for two days
in October. It was an exciting opportunity for the
HSE as it will be the first time this type of mobile
simulated training was delivered in Ireland.
International evidence suggests simulated
training in this field is effective and engages
managers, clinical professionals, carers, family
and friends with the experience of what it is
like not only to live with dementia, but to also
sense it. In addition, this type of training helps
us to understand what we need to change in
order to improve the quality of care that will
support families to keep their loved ones at
home longer. The Virtual Dementia Tour® mobile
simulated training will be delivered to a total of
72 healthcare personnel and family carers from
across the entire range of hospital, community
and voluntary services.
The Virtual Dementia Tour® saw health and
social care staff and family carers undergo
specialised training designed not just to show
people what it is like to live with dementia, but
to actually experience it for themselves. As
part of the experience participants wear items
such as gloves, glasses and headphones so
that their vision, touch, sound and pain sensors
are impacted in a similar way to someone with
dementia. This enables participants to gain a
closer appreciation of the physical and mental
challenges facing those with dementia.
One of the organisers responsible for bringing
the initiative to Donegal, Dr Randal Parlour,
Assistant Director NMPD, commented: “Our key
objective, within this process, was to develop an
infrastructure that will fundamentally support
both staff and carers to increase their awareness
around dementia. Following independent
evaluation, we anticipate that this training will
also have real potential with other public service
staff such as An Garda Síochána, Irish Fire
Services etc.”
He added: “Ultimately we anticipate this
initiative will complement measures within the
Irish National Dementia Strategy designed to
promote person-centred practice, raise public
awareness, address stigma, and promote the
inclusion and involvement in society of those
with dementia.”
Edel O’Doherty, Chief Officer of CAWT,
outlined the cross border partnership’s support
saying: “CAWT’s role is to foster and develop
practical cross border health and social care
activity and is delighted to support this cross
border initiative.
“We know the increase in the number of
people with dementia in the coming years will
be significant. This training is timely in enabling
health and social care services staff to reflect
on and improve the care they currently provide.
“We also hope that this initiative will be a
valuable training experience for the carers of
those with dementia.”
At the unit are, from left, Dr Randal Parlour,
Assistant Director NMPD, Martina Conway, Sadie
Toye, Iris Alcrorn, Frank Morrison, Anne Gallen,
Tom McBride, Grace Kelly, Dympna Wynne,
Michelle Baldrick, Pat McDaid, Catriona McIntyre,
Tina Gardiner, Elizabeth Breslin and Sadie Bergin,
CAWT. Photo Clive Wasson.
healthy IrelAND plan will support staff and patients
As part of the delivery of the Saolta Healthy
Ireland Implementation Plan 2015-2017, the
Saolta Hospital Group has developed a new
resource to support the health and wellbeing
of staff and patients and build capacity to
implement health and wellbeing activity.
It is hoped that the Saolta Health and
Wellbeing Training Plan will contribute
to the three goals of the national Healthy
Ireland Implementation Plan of improving
staff health and wellbeing, reducing the
burden of chronic disease and reforming the
health services.
The plan offers a wide range of staff
supports for physical and mental health. It
provides many health and wellbeing training
opportunities for staff within the hospital
group and in the community.
The plan also lists a range of health and
wellbeing services available for patients.
This section in particular will be helpful
to staff in identifying health and wellbeing
supports for patients.
Staff from the National Health and Wellbeing Division, with HSE National Health and Wellbeing Director,
Dr Stephanie O’Keefe and Saolta Group Health and Wellbeing Lead, Greg Conlon.
winter 2016 | health matters | 57

General
News
one in four people still smoke
Almost a quarter of Irish people are
still smokers, while close to a fifth of the
population is exposed to second-hand smoke
on a daily basis, according to the second
annual Healthy Ireland Survey.
The survey of 7,500 people aged 15 and over
living in Ireland gives an up-to-date picture
of the health of the nation and reports on
many lifestyle behaviours such as smoking,
alcohol consumption, physical activity, diet
and mental health. A number of new topics
have been included in this year’s survey,
which examine additional aspects of health
behaviours and issues such as multiple risk
factors and knowledge and attitudes about
health behaviours.
Some new findings in this
year’s survey results include:
• While 90pc of respondents know that
alcohol is a risk factor for liver disease, only
27pc of women are aware of the increased
risk of developing breast cancer as a result of
heavy drinking.
• The majority (55pc) of men who drink
consume six or more standard drinks
(“binge drink”) on a typical drinking occasion
while fewer than 1 in 5 (18pc) women drink
to this level.
• Fewer than 1 in 10 women takes a folic
acid supplement with just 18pc of women
aged 25 to 34 doing so.
• 18pc of the population in Ireland is exposed
to second-hand smoke on a daily basis.
• While only 54pc of people living in
Ireland said they would be willing to live
with somebody with a mental health
problem, 83pc of people said they would
be willing to carry on a relationship with a
friend who developed a
mental health problem.
• People spend 6
hours and 36 minutes
sitting on an average
day and while men
generally spend longer
sitting than women,
younger women spend
more time sitting than men of
the same age.
• Most people (63pc) would like to be more
physically active although many say that time
pressure due to work or caring is a barrier
Speaking at the launch, Minister Marcella
Corcoran Kennedy welcomed publication of
the Report. “The new findings in the second
Healthy Ireland Survey add very useful
evidence about key lifestyle issues affecting
people living in Ireland.
Despite seeing some very positive results in
this Survey, some groups still have a risk of
poor health due to lifestyle behaviours.
“These results will help us in the
Department of Health, as well as in other
Departments and agencies, to focus actions
to promote and improve health and wellbeing
by targeting at-risk groups and those
experiencing health inequalities.
“The Government has made a very clear and
unambiguous commitment to implementing
Healthy Ireland, especially in the recent
Budget, with €5m specifically allocated to
kick starting cross-sectoral engagement, and
I look forward to focusing on specific actions
and initiatives in the coming months.”
The Healthy Ireland Survey showed that
of the four types of unhealthy behaviours
under consideration, the most
common was that almost threequarters
(73pc) of the population
eat fewer than five portions of
fruit and vegetables daily.
Between a fifth and a third of the
population have each of the other
three behaviours – binge drinking
(28pc), sedentary behaviour (26pc) and
smoking (23pc).
Some of the other important
findings include:
• 84pc of people living in Ireland say their
health is very good or good although 28pc
indicate that they have a long-standing illness
or health condition.
• 23% of the population are current
smokers.
• Three in five eat snacks every day with
42pc of the population eating 6 or more
portions daily.
• Just 27pc eat five portions of fruit and
vegetables daily.
• 14pc consume sugar sweetened drinks
daily, rising to 22pc of those aged 15 to 24.
• 37pc of drinkers indicate that they drink six
or more standard drinks (“binge drinking”) on
a typical drinking occasion.
• While 19pc of people living in Ireland
smoke on a daily basis, recruitment of new
smokers continues at a high rate with 20pc of
those aged under 25 currently smoking.
• 67pc of men and 39pc of women aged
under 25 binge drink on a typical drinking
occasion.
• Approximately half of the people living in
Ireland have had some experience of people
with mental health issues.
Search for new digital health technologies at NDRC
Medimorpho Micro Blood Lab was selected
as winner of the digital health technologies
pre-accelerator at NDRC. Led by founder
Joseph O’Brien, Medimorpho is a GSM enabled
small, portable blood lab.
Run in partnership with e-Health Ireland,
the aim of the pre-accelerator was to bring
together health and technology experts
to find digital solutions to healthcare
challenges. Thirteen entrepreneurs won a
place on the programme, based in NDRC,
with ideas that ranged from digital diagnostic
tools to assistive technology.
The idea owners were linked with over
100 volunteers with backgrounds in health
and technology.
The HealthTech pre accelerator is
sponsored by eir Business and Bank of Ireland.
Gary Leyden, Commerical Director, NDRC; Joe O’Brien, Director, Medi Morpho; and Richard
Corbridge, Chief Information Officer, HSE. Photo: Shane O’Neill Photography.
58 | health matters | winter 2016

Safeguarding Older People
in Residential Services
A seminar on safeguarding older people in
residential services took place in September.
Hosted as a joint initiative between the HSE and
Nursing Homes Ireland, the aim was to build
on previous safeguarding training which was
collaboratively delivered to staff in residential
care settings for older people.
Minister for Mental Health and Older People,
Helen McEntee TD, opened the seminar
and highlighted the role that everyone has
to play in safeguarding, both as individuals
and collectively. The Minister reiterated that
the rights of vulnerable persons to live full
and meaningful lives in safe and supportive
environments must always be upheld.
Michael Fitzgerald, Head of Head of
Operations and Service Improvement for Older
People addressed attendees and spoke about
their crucial role in promoting the principles
that prevent abuse. Mr Fitzgerald said, “Today’s
seminar is about promoting knowledge of what
constitutes good care and what helps to prevent
abuse and/or neglect. It demonstrates how we
can all learn from each other and support each
other in promoting a positive culture and in
combating abuse.”
A new ‘Train the Trainer’ initiative for non-HSE
sector nursing homes was launched at the
seminar; an important development in ensuring
that a consistent safeguarding message is
delivered and in providing a foundation for the
future delivery of safeguarding training to staff.
Mr Fitzgerald welcomed the initiative
reiterating that Safeguarding is everyone’s
responsibility, regardless of their role in
the service, “This collaborative approach
ensures that the information being delivered
to HSE and non HSE staff through the
training is the same regardless of the
setting; whether it be residential or day care,
community care, in disability services or in
services for older people.”
Since the publication of the HSE’s
‘Safeguarding Vulnerable Persons at Risk of
Abuse – National Policy and Procedures,’ in
2014, a number of structures and resources
have been put in place including 9 Safeguarding
and Protections Teams have been established,
one in each Community Healthcare Organisation
(CHO); a National Safeguarding Office has been
created to implement the Policy, a National
Safeguarding Committee has been established
and Safeguarding and Protection Committees
have been established in CHOs. Also, a
standardised safeguarding training programme
has been developed for all staff with a target of
8,000 staff to be trained by year end.
hse volunteer sTAFF JOIN DUBLIN AIRPORT
AUTHORITY IN EMERGENCY EXERCISE
The HSE was involved in an Emergency
Exercise with Dublin Airport recently.
Members of the Department of Public
Health and the Ambulance Service were
involved in the exercise, which focused on a
public health incident originating on board an
incoming aircraft.
In conjunction with the activity in Dublin
Airport, two other exercises were undertaken.
The Mater Hospital tested its response to
the airport incident by conducting a table top
exercise in relation to the National Isolation Unit.
Seconly, in conjunction with the airport
exercise, the Voluntary Emergency Services of
Order of Malta, Irish Red Cross and St John’s
Ambulance conducted a mobilisation exercise
to examine their response capabilities in support
of the HSE.
A large number of HSE staff and volunteers
were involved on the night as participants in a
number of locations. A lot of learning was taken
from the exercises, which were coordinated by
the Emergency Management Office.
ABOVE:National Ambulance Service take part in
the Emergency Exercise at Dublin Airport.
RIGHT: HSE staff in action during the Emergency
Exercise.
winter 2016 | health matters | 59

General
News
‘flu jab helped keep me alive’
The flu vaccine service has ‘helped keep
people like me alive and healthy’, said
RTE correspondent Tommie Gorman
as he launched the annual campaign in
Community Health Organisation (CHO)
Area1 Cavan, Donegal, Leitrim, Monaghan
& Sligo). Tommie was joined in An Clochar,
Health Campus, Ballyshannon by HSE staff
and representatives from various agencies
associated with the HSE.
“For several years, the flu vaccine service
has helped to keep people like me alive
and healthy. I have what’s described as
a chronic illness and I am one of the
many people who are strongly advised
to get the flu vaccine jab. So for obvious
reasons I am delighted to be involved in the
launch of this energetic campaign in our
region. Seeing is believing - at the launch,
here in Ballyshannon, I’m availing of the
opportunity to get my injection.”
Flu can be a very serious and sometimes
deadly disease, with potentially 1,000 flu
related deaths in Ireland during a severe
flu season. Flu is very infectious and can
cause potentially serious illnesses especially
for older people, those who have a chronic
illness, those with weakened immune
systems and pregnant women. Seasonal
flu vaccine can be given at any stage of
pregnancy and also protects the baby. The flu
vaccine cannot give you the flu as it does not
contain any live flu virus and all those at risk
should get vaccinated as soon as possible this
year to make sure that they are protected.
The following groups of at-risk people
should be vaccinated against seasonal
influenza:
• Everyone aged 65 years and over
• Anyone over six months of age with a long
term illness requiring regular medical followup
such as chronic lung disease, chronic
heart disease, diabetes or those with lower
immunity due to disease or treatment
• Pregnant women
• Residents of nursing homes and other
residential care services
• Healthcare workers
The HSE provides the flu vaccine free of
charge for all those in the at-risk groups.
The vaccine and consultation are free
for those with a Medical Card or GP Visit
Card. Those without a Medical Card or GP
Visit Card will be charged a consultation
fee. Those aged 18 years or older in the at
risk groups may attend either their GP or
pharmacist for vaccination and those under
18 years should attend their GP.
“This is the first year we have had a CHO1
wide flu vaccine campaign and I would like
to take this opportunity today to highlight
the importance of increasing the uptake of
the flu vaccine among the at risk groups
and among my colleagues in CHO1. The
flu vaccine is a safe, effective way to help
prevent flu infection, avoid hospitalisation
and reduce flu related deaths and illnesses.
Therefore I urge all those in the at risk
groups to avail of the flu vaccine,” said John
Hayes. Chief Officer, CHO1.
Dr Louise Doherty, Specialist in Public
Health Medicine, spoke at the launch, stating,
“It is important that all those working in
frontline healthcare including doctors, nurses,
therapists and carers protect themselves
from getting the flu and also to prevent
spreading the flu to vulnerable patients. Older
and at risk patients may not get sufficient
protection from the vaccine themselves,
so people who care for them need to be
vaccinated. The flu vaccine is available
free to healthcare workers from their local
Occupational Health Department and in their
workplace from nurse peer vaccinators.”
Delegates at the launch were entertained
by the Markievicz Minstrels, a choir consisting
of HSE Sligo/Leitrim staff who sang a
song especially for the occasion about the
importance of getting the flu vaccine. A
series of posters and fliers were unveiled
targeting the at risk groups and conveying
the message to get vaccinated. These
posters will be displayed in HSE facilities
throughout CHO1. The HSE’s Occupational
Health Service also provided a clinic at the
launch where those attending could avail of
the vaccine.
rugby stars do the right thing
Members of the Connacht rugby squad joined staff from the Saolta University Health Care Group and
HSE to launch the Group’s flu vaccine campaign at University Hospital Galway. This year, the Saolta Group
and the HSE are particularly requesting health care workers to get the vaccine to protect themselves, their
families and their patients. (l-r) James Cooney, Connacht Rugby player getting his flu vaccine from Teresa
Canniffe, CNM 2, Occupational Health Department with fellow teammates Sean O’Brien and Rory Parata.
peer vaccinators
The Peer Vaccination Programme
is a National programme to allow
Nurse Peer Vaccinators to vaccinate
their fellow staff with influenza
vaccine during the influenza season.
The purpose of the programme is
to improve the uptake of seasonal
influenza vaccine among staff, by
making it easier for staff to receive
the vaccine.
Peer Vaccinators would also be seen
as Influenza vaccine champions in
their areas of work. These Nurse Peer
Vaccinators have been provided with
training under a medication protocol,
which is being produced nationally.
A total of four Peer Vaccinators were
trained in St Finbarr’s Hospital, Cork
and seven clinics have been planned in
varying departments on site, to cater
for night staff and day staff. The first
of the Peer Vaccinator Clinics got off
to a great start with a fantastic local
response seen, where a total of 27
staff received the vaccine.
60 | health matters | winter 2016

Baby Box
Project
aims to
reduce
incidence
of infant
mortality
UNIVERSITY Maternity Hospital Limerick
(UMHL) launched a major initiative aimed at
reducing the incidence of infant mortality and
raising awareness through educating parents
on how to care for newborns.
The Baby Box programme – a national first
- will see mothers who complete e-learning
modules provided with a free baby box for
their infant to sleep in. The online education
element is inclusive and accessible; easy
to follow and available in 17 languages,
reflecting the growing diversity of Irish
maternity hospitals. Women booking in at
ante-natal clinics will be given details on
how to sign up for the e-learning at the Baby
Box University.
Sudden Infant Death Syndrome (SIDS), also
known as cot death, is the sudden unexpected
death of an apparently well infant and for
which there is no explanation. About nine out
of 10 cases occur in the first six months of
life, with a greater risk for premature and lowbirth-weight
babies.
The use of Baby Boxes has been credited
with helping reduce infant mortality rates in
Finland, where they have been in use for over
75 years. The tradition has contributed to
reducing the infant mortality rate in Finland
from 65 infant deaths per 1,000 births in 1938
to 2.26 per 1,000 births in 2015. Ireland’s
infant mortality rate is 3.7 per 1,000 births.
Other countries, including the UK,
Canada and USA, have begun to introduce
this concept to their families. UMHL—in
partnership with The Baby Box Co. - is the
first Irish maternity hospital to embrace
the idea. New mothers in Limerick will
be presented with a Baby Box, containing
clothing and other goods as well as
educational materials.
The Baby Boxes, which are made from a
durable cardboard, can be used as a baby’s
bed for up to the first eight months of their
life. Replacing the need for the traditional
Moses basket or cot, it is thought the small
size of the Baby Box prevents babies from
rolling onto their tummies, which experts
think can contribute to SIDS.
The Baby Boxes come with a firm foam
mattress, waterproof mattress cover, cotton
sheet - and education materials with advice
from healthcare professionals in the Mid-
West on reducing risks to baby, improving
parental bonding and making the transition
to parenthood. The theme chosen for the
Limerick initiative is ‘Celebrating Life,
Celebrating Family’.
“The Baby Box programme is a proactive
approach to improving the health and
safety of the newborn child and parents.
We are combining tradition with current
technology and supporting the newborn
child’s family with online educational
material covering a broad range of
essential topics on ante and postnatal
care,”said Dr Mendinaro Imcha, Consultant
Gynaecologist/Obstetrician, UMHL.
Margaret Gleeson, Chief Director of
Nursing and Midwifery, UL Hospitals
Group, said education was a central
element of the project, arising from which
up to 5,000 boxes would be distributed to
the families of babies born at UMHL over
the year of the programme.
“The Baby Boxes designed by one of our
patients are a thing of beauty. Then there
is the invaluable education element of
the initiative which makes it truly patientcentred,”
said Ms Gleeson.
“That education involves brief video
tutorials delivered by local healthcare
professionals addressing the most common
concerns of parents with newborn babies.
A number of these videos were made in our
hospital with our specialists. We think all of
our staff here at UMHL are stars and they
were delighted - along with their colleagues
in public health nursing and community and
primary care - to make videos advising new
parents in critical areas like breastfeeding,
nutrition, perinatal mental health, neonatal
resuscitation, postnatal community support,
postnatal checkup, immunisation, VTE and
sepsis,” added Ms Gleeson.
The Limerick Baby Box has been designed
by Tipperary-based tattoo artist and
expectant mum Karen Smith.
“The whole meaning behind the design is
rebirth. I thought the butterfly was the perfect
symbol for the Baby Box. It is a symbolic
creature in many cultures. It sometimes
represents Beauty itself, or metamorphosis,
and at other times the transitory nature of
happiness and indeed all of life. They lend
themselves to all manner of colourful and
fanciful adaptations, in our case our beautiful
Baby Box,” said Karen.
Jennifer Clary, the CEO of The Baby Box
Co., which is supplying UMHL with the Baby
Boxes and Baby Box University memberships
for participating parents said: “We are
delighted to expand the Baby Box programme
to Ireland and look forward to an impactful
collaboration here at University Maternity
Hospital Limerick.”
winter 2016 | health matters | 61

General
News
Programme in Sexual Health
Promotion off to flying start!
By Moira Germaine and Martin Grogan Health
Promotion & Improvement Officers, HSE South
The Foundation Programme in Sexual
Health Promotion (FPSHP) is concluding
its first year as a national programme
under the aegis of the National Sexual
Health Strategy. The 2016 target of
100 participants has been dramatically
exceeded with 184 completing the training
and a healthy waiting list established for
the 2017 courses.
Originating in HSE South in 2009, the 10-
day FPSHP was developed as a response
to the need for sexual health training that
not only addressed knowledge but also the
comfort levels of participants in addressing
a topic that has historically been taboo.
This approach was taken on foot of a review
of national and international literature,
which revealed that two major blocks to
the promotion of sexual health were the
discomfort of professionals in addressing
the subject and the conscious and
unconscious impact of professionals’ own
attitudes and values in dealing with their
clients. As a result, the FPSHP programme
takes a broad, holistic approach to sexual
health and utilises the principles of adult
learning and experiential methodology to
increase participants’ knowledge, skills
and self awareness. In addition, because
training is only one facet of capacity
building, participants and their organisations
are offered on-going support in order
to implement sexual health promotion
activities within their organisation.
In 2013, an external evaluation of the
FPSHP - funded by Sexual Health & Crisis
Pregnancy Programme and carried out by
the School of Nursing and Midwifery, Trinity
College Dublin - assessed the programme
favourably for its capacity building impact
on participants.. It was on the basis of this
that the FPSHP was then adopted as a
national programme. Following a pilot in
Galway in 2015, the FPSHP was expanded
out of HSE South and is now being delivered
in 10 different locations throughout Ireland.
This work will continue in 2017 with a
further three locations being added to the
training list.
Participants on the FPSHP come from
the Health, Education, Community and
Youthwork sectors and the range of
professions represented is vast including
doctors, nurses, psychologists, occupational
therapists, social workers, social care
workers, teachers, lecturers, counsellors,
people working in the areas of substance
misuse, homelessness, mental health,
intellectual disability and Acquired Brain
Injury. Eligibility for inclusion is simply
dependent on the person’s capacity to
integrate sexual health promotion into their
core work and their personal compatibility
with the learning style of the programme;
both of these are established during a
20-minute interview with each prospective
participant before places are allocated on
the course. Priority is given to personnel
working with the most disadvantaged and
those whose employers have identified an
organisational goal in relation to sexual
health promotion. All groups include a range
of agencies and disciplines to promote
networking and cross- sectoral working.
Anyone interested in further detail on
the Foundation Programme in Sexual
Health Promotion should contact Martin
Grogan- Acting FPSHP Co-ordinator martin.
grogan@hse.ie
The group of staff in Athlone who completed
the Foundation Programme in Sexual Health
Promotion (FPSHP).
What past participants have to say
Participation in the FPSHP in 2012 was the perfect foundation
on which to build a tailor-made programme for our service
users. It also gave me the confidence to facilitate the sessions
and eased any concerns I may have had in covering somewhat
delicate issues in relation to sexual health.
Carol Kelly, Keyworker with Aspect (Autism Services)
In the course of my work with Mental Health Ireland, I have
used the skills and knowledge I acquired in the FPSHP on a
regular basis. Many mental health problems or issues are, in
fact, based in fears around sexual identity and sexual health.
The course has enabled me to explore these very sensitive
issues because I feel confident and grounded in this area
following the course.
Linda Thorpe, Development Officer, Mental Health Ireland
I loved the FPSHP. It opened my eyes that sexuality is from
birth to death, and that all persons, regardless of gender, age,
health and disability, are entitled to explore their sexuality. As a
midwife, it increased my confidence to talk to new parents about
sexuality; as a parent to young children it reinforced my belief
that communication about sexuality can begin in the early years.
I would highly recommend this course.
Claire Bulfin, Midwife, Waterford Regional Hospital
62 | health matters | winter 2016

South East
intercultural
healthcare
project
shortlisted for
national award
An intercultural health pilot project for
the South East based in Waterford and
South Tipperary was one of six finalists
for the overall Health Management
Institute of Ireland, Leaders Awards,
which were presented at a ceremony in
Dublin recently.
The aim of Social Inclusion in
HSE South East is to “support the
development and implementation of
appropriate initiatives that enhance
healthcare delivery to ensure equitable
health outcomes for vulnerable
Minority communities” and this
particular project was highlighted as a
prime example.
The HSE’s Social Inclusion Services,
working in partnership with the
Integration and Support Unit (ISU),
the HSE’s Primary Care Leads, Health
Promotion, Primary Care Social Work,
Tulsa, Mental Health, Homeless and
Substance Misuse Services, sought to
enhance health information and access
to services for vulnerable members of
new communities.
Aileen Colley, Chief Officer of the Area
5 Community Healthcare Organisation,
congratulated all those involved in
the Waterford based healthcare pilot
project and said it was a model for
how things could be done in other
communities around the country.
In illustrating the co-operation
between the HSE and the ISU, Anne
Nolan, Manager of the ISU said,
“The HSE and the ISU initiated a
pilot phase in 2014/15, in which we
focused on the health outcomes of
asylum seekers living in the five ‘direct
provision’ centres in the South East,
four are based in Waterford and one in
South Tipperary. Key areas of health
concerns were identified through the
ISU’s work and research. Namely,
these were sexual and mental health.
Thereafter, a training programme was
designed and delivered to up-skill
‘Peer Community Knowledge Workers’
(CKWs) resident in the South East and
who had lived in direct provision and/or
were members of vulnerable minority
groups. Information sessions were
delivered to staff in health and social
care settings.”
Medical Careers Day
Almost all of the attendees who gave
feedback on the most recent Medical
Careers Day felt the day was beneficial and
would recommend the event to others.
Over 300 medical students and interns
attended the fourth annual Medical
Careers Day “Building Your Future”
with the view to learning more about
postgraduate training opportunities in
Ireland.
Held at the Royal Hospital Kilmainham,
Dublin, the focus of the day was to provide
practical information about postgraduate
training structures in Ireland and specific
information about specialty training.
Over 95pc of the attendees felt that
The Minister for Health Simon Harris
attended the event, and described it
as “not only a great opportunity for
networking with peers, it enables
participants to explore different career
paths through the medical profession”.
Minister Harris also officially launched
the NDTP Strategic Plan for the period
2016-2020. This is the first strategic plan
for the unit since the three functions of
medical education and training, medical
workforce planning and the consultant
post approval process were centralised
in NDTP in November 2014. NDTP has a
statutory remit outlined in the Health Act
2004 and the Medical Practitioners Act
2007. For more information on NDTP go to
www.hse.ie/doctors
the presentations, walks and workshops
provided relating to working and training in
13 broad specialty areas were appropriate
and relevant to their needs.
Some 90pc of those in attendance felt
that the information provided by the
postgraduate training bodies was useful.
Feedback received from attendees will be
incorporated into the planning for the next
Careers Day, to be held in September 2017.
TOP: Prof Eilis McGovern, Director National
Doctors Training and Planning (NDTP) with some
of the attendees at the 4th Medical Careers Day.
BELOW: Prof McGovern with Minister for Health
Simon Harris.
chance to explore new career path
winter 2016 | health matters | 63

General
News
Irish use of psychoactive
drugs continues to rise
A new information campaign aimed at
students has been developed by the Union of
Students of Ireland in partnership with Drugs.
ie and the HSE. The information campaign
focuses on harm reduction and is aimed at
young adults and students who use new
psychoactive substances (NPS).
New Psychoactive Substances’ (NPS) are
designed to mimic established illicit drugs
such as cannabis, cocaine, methamphetamine,
MDMA and LSD. Manufacturers of these
substances develop new chemicals at an
alarming rate to replace those that are banned
in order to stay ahead of the law.
As the availability of new substances
has increased, so have the serious harms
associated with their use particularly acute
poisonings sometimes resulting in death.
These substances also cause other unwanted
physical and psychological side effects. The
increase in these substances and the wide
variation in strength and purity requires a
strong public health response.
The use of psychoactive drugs in Ireland
among the 15-24 year age group is the highest
in Europe (22pc lifetime use). Data suggests
that the purity or potency of most illicit
substances is increasing and that the market
for substances is becoming more varied
and accessible. This phase of the campaign
focuses on two specific drugs MDMA (ecstasy)
and Ketamine (K); this is the first step of an
ongoing campaign to provide harm reduction
information for students. Two posters have
been designed along with Facebook ads and a
social media campaign to give harm reduction
advice and information on accessing support.
Dr Eamon Keenan HSE National Clinical
Lead for Addiction services, added, “The HSE
is partnering with the Union of Students in
Ireland to target students and young people
with an appropriate Harm Reduction message.
Harm Reduction refers to policies, programmes
and practices that aim to reduce the adverse
health, social and economic consequences of
the use of legal and illegal psychoactive drugs.
“Harm reduction benefits people who use
drugs, their families and the community. It is
always safer not to use illegal drugs and we
advise people not to use, however we have
a duty to reduce harm and protect young
peoples’ health.
The key messages that we need to get to
people is to Stay Safe and to be aware of the
strength of the drugs they are taking.”
MORE INFORMATION
There is information, support and help
available through www.drugs.ie or the
Drugs Helpline HSE Drug/Alcohol helpline
Freephone: 1800 459 459 9.30 - 5.30 Monday
– Friday or Email support: helpline@hse.ie
innovative webinar launched to improve quality of services
A new and innovative web based seminar, or webinar – QI Talktime
- has been launched for everyone with an interest in improving the
quality of services we deliver.
The one-hour webinar will be hosted by an exciting mix of local,
national and international speakers and will be held every three weeks
from November 2016, explained Roisin Breen, QI Talktime lead from
the HSE Quality Improvement Division.
“The webinars are open to everyone across our health and social care
services and will provide a forum to share learning and experiences
of service redesign and improvement. They will also be a great way of
connecting with others interested in Quality Improvement (QI)”.
“It’s free and easy to join, all you need is an internet connection. We
would encourage people to get together in their workplace and log
on as a group to help in building your own local QI networks. However,
people can of course join individually as well.”
All links to the webinars will be available on the HSE QI web page of
the HSE website and archived talks will also be available after they
have taken place. Check out the web page to see the range of topics,
speakers and dates.
Please contact Roisin (roisin.breen@hse.ie) who will be happy to help
with any queries and follow QI Talktime on twitter for regular updates
on @QITalktime
64 | health matters | winter 2016

special needs preschool
gets a garden revamp
The Ballaghderg HSE special needs preschool
provides a service for children with moderate
to severe intellectual disabilities and complex
care needs in the Letterkenny area.
The service strives to provide a holistic and
therapeutic environment for the children
in partnership with families and the early
intervention team where each child learns
to develop and grow through play in a
specialised setting.
Over the past five months Fintan
Houston volunteered to lead the project to
revamp the sensory garden with the help
of local volunteers and sponsorship from
local businesses.
The garden was reopened by Fintan
recently and all those involved including
families and friends were invited to celebrate
this special occasion.
Speaking at opening, Catherine Kelly, HSE
Clinical Nurse Manager at Ballaghderg, was
full of praise for the effort given.
“The HSE intellectual disability services
would like to take this opportunity to thank
Fintan Houston and all the volunteers who
kindly gave up their free time to redecorate
and clean up the garden area,” she said.
“We would also like to express our gratitude
for all donations received from local sponsors,
which funded the cost of visual images, new
plants, an all-weather proof wheelchair
accessible swing and to the St Conal’s Garden
Centre team who designed a bird man that
attracts birds into the garden area. The
sensory garden has many benefits for the
preschool children from stimulating their
senses to providing a safe and calming place
where they can learn about their environment
and have endless hours of fun and enjoyment.
Commenting on the re-vamped garden,
Eugene McElroy HSE Donegal Intellectual
Disabilities Business Manager said, “The
garden is an important element of service
provision and the works carried out on the
garden will enhance the experience of children
attending the Preschool.”
BELOW: Fintan Houston cuts the ribbon at the
opening of the HSE Ballaghderg Special Needs
Preschool Garden after its revamp with front, from
left, Veronica Kilpatrick, Senior Human Capital
Specalist Optum United Health Services; Malachey
Dunleavy, Eunan Carol, Sarah Jane O’Connor,
Optum Engagement Team; Catherine Kelly HSE
Clinical Nurse Manager; Orson Sterritt, Optum
Engagement Team; John Burke; and Laura
Campbell, Optum Engagement Team.
Photo: Clive Wasson.
We must work together, conference told
A large crowd attended the Connecting For life Donegal
Conference organised by Donegal County Council held in Buncrana
recently. The aim of the conference was to build connections and
share good practice in suicide prevention. Connecting for Life
Donegal is a countywide suicide prevention action plan which
calls on individuals and organisations to work together to realise
‘a county where fewer lives are lost through suicide and where
communities and individuals are empowered to improve their
mental health and wellbeing’.
The audience heard the personal story of Emma Lawrence who
spoke movingly about her own experiences and the help she received
from the HSE, Child and Family Mental Health service when she
struggled with her mental health as a teenager.
Anne Sheridan, Suicide Resource Officer with the HSE outlined and
complimented the good work being done by numerous organisations
and groups. “We need to keep working together year on year - the
HSE, the County Council, schools, youth, community and voluntary
organisations and groups as every single organisation has an
important part to play in reducing deaths by suicide.”
Other speakers outlined the issue of suicide among the Traveller
Community, individuals struggling with debt, the burden of alcohol
and a new Crisis Suicide Assessment Nursing service working
alongside GPs. Finally, Dr Kevin Malone, UCD complimented Donegal
on leading the way in suicide prevention at a local level and said that
the cumulative grief resulting from suicide deaths and road traffic
accidents was an issue which should be considered.
winter 2016 | health matters | 65

General
News
5,000 people die in Europe
from bugs that are resistant
to antibiotics and someone
2
somewhere in the world dies
every 10 minutes because
antibiotics don’t work, the HSE Clinical Lead
for the Prevention of Healthcare-associated
Infection, Dr Robert Cunney has warned.
“Antibiotics are a precious resource that
saved millions of lives. They are very specifc
drugs designed to kill bacteria. However
using antibiotics when they are not needed
eg for viral infections is a waste of time and
money, puts your health at risk, and makes
it more difficult to fight against infections
in the future. Using antibiotics needlessly
allows bugs that cause infections to build up
resistance against antibiotics and renders
them useless over time. Most infections
children and adults get are caused by
viruses and will get better by themselves ,”
said he said.
“Very few new types of antibiotic are being
developed, which means that we must make
sure that the ones we have remain effective
against infections for the sake of our own
health and future generations. If somebody
develops an infection that antibiotics can’t
kill because it has built up resistance to the
treatment then that person will become
very unwell and may die. This person could
have been cured if the infection had not
become resistant to antibiotics. Examples of
antibiotic resistant infections include MRSA
and C.difficile.
“The more antibiotic prescriptions a person
receives, the higher the likelihood that the
antibiotics won’t work the next time they get
an infection due to the infection developing
resistance to the antibiotics. Antibiotic
consumption is falling in most European
countries but not in Ireland although there
have been improvements in hospitals and
certain age groups in the community.”
The HSE, in partnership with the Irish
College of General Practioners and the
Irish Pharmacy Union, has developed a new
website which gives practical, common sense
advice and information on dealing with many
common illnesses like colds, flu, earaches,
sore throats, tummy bugs and rashes.
www.undertheweather.ie provides the
sound advice that we all need to give us the
confidence and skill we need to take care of
ourselves and our families at home without
resorting to antibiotics, according to the HSE
National Director for Quality Improvement, Dr
Philip Crowley.
“The website tells you how long common
illnesses should last, what to expect,
and what you can do to cope with, and
recover from, these illnesses. The site
includes a series of videos featuring GPs
and pharmacists who offer their expertise
on dealing with these common illnesses,
under the
weather
practical remedies, and advice on when to
seek help from either a pharmacist or a
doctor,” he said.
Dr Nuala O Connor, ICGP lead advisor on
antibiotics, said research has shown that a
lot of people still believe that antibiotics can
help to treat common illnesses, like colds, flu,
earaches, tummy bugs and rashes. We know
in fact that antibiotics are useless against
most of these infections, which are caused by
viruses, and antibiotics don’t work on viruses.
“Learning how to manage common illnesses
with confidence and common sense is a great
life skill and improves our understanding of
when we need antibiotics and when we don’t.
It’s something that we learn from our parents,
friends, doctors, from our own experience and,
more and more, from the internet. Under the
Weather has been developed in response to
this, to support the public in accessing trusted
and reliable health information, developed by
the HSE with expert knowledge and advice
from GPs and pharmacists,” she said.
“The Under the Weather campaign is about
ensuring that we only use antibiotics when
we really need them. Using antibiotics when
they’re not necessary creates stronger, more
resistant infections that can make us very ill.
“Antibiotic resistance is a global health
threat, and one that is being tackled on a
range of fronts, in Ireland and internationally.
We need to ensure that we preserve
antibiotics for when they are really needed
– for everything else, your common cold
and nasty cough - the best advice is on
undertheweather.ie.”
more information
www.undertheweather.ie
Get advice and get better
66 | health matters | winter 2016

support for parents
of preterm babies
A new booklet and on-line information on
breastfeeding for parents of premature babies
has been launched at the National Maternity
Hospital for World Prematurity Day. The day
aims to raise awareness of the issues facing
babies born prematurely and highlights supports
for parents of premature babies
A number of organisations have come together
to develop the information resources for
parents - the HSE, the Association of Lactation
Consultants in Ireland, Irish Premature Babies,
the National Maternity Hospital and Our Lady’s
Children’s Hospital, Crumlin.
Breast milk is vital for premature babies to help
them grow and develop and to prevent infections
and illness.
Speaking at the launch, Master of the National
Maternity Hospital, Dr Rhona Mahony said, ‘Our
babies that are born preterm are particularly
vulnerable. Breast milk is not only nutrition for
premature babies, every drop of breast milk
is protecting your baby’s health. Everything
that we can do to support parents of preterm
babies is important. This practical information
launched today is part of the range of supports
to help mothers.”
Elaine McGovern gave a mum’s perspective,
noting, “So many emotions hit you when you have
a baby that’s born early. You can feel helpless so
it is really good to know that there is something
that you can do as a mother to protect your
baby’s health, by giving breast milk to your baby.”
Irish Premature Babies is a charity dedicated
to supporting parents of preterm babies. Their
website is www.irishprematurebabies.com
“Each year over 4,500 pre-term babies are
born in Ireland, every 116 minutes a pre-term
baby is born, in one of Ireland’s maternity
units. Irish Premature Babies delivers front line
services to families and support the work of
the neonatal intensive care units around Ireland
by providing vital equipment towards the care
of pre-term babies,” said Allison Molloy of Irish
Premature Babies.
National Breastfeeding Co-ordinator Siobhan
Hourigan said, “Mother’s own milk makes such
a difference to premature babies. We want to
support and help mums to provide breast milk for
their babies. The booklet and online information
and videos www.breastfeeding,ie talks parents
through this and gives step by step tips and
photos on expressing milk, kangaroo care, and
lots more’.
MORE INFORMATION
For further information log on to the HSE
website www.breastfeeding.ie/Getting-
Started/Premature-or-ill-baby/
Caitriona Garde and baby Grace attending the
launch at the National Maternity Hospital for World
Prematurity Day. Grace was born at just 30 weeks
and breastfed until she was just over a year.
New Dedicated Paediatric Area opens in UHG
The newly developed dedicated paediatric area
within the emergency department at University
Hospital Galway opened its doors to paediatric
patients in June, reducing wait times and
improving patient flow.
The new paediatric area was reconfigured
from an existing space to facilitate the
development and will accommodate all
paediatric patients from 0 – 16 years of age
and will cater for both medical and surgical
patients. The emergency department
at University Hospital Galway sees
approximately 17,000 paediatric patients
per annum, this accounts for approximately
20-25pc of all presentations to the ED. The
new paediatric ED comprises of 6 cubicles,
2 isolation rooms, a separate waiting area
from the adult waiting area and a separate
access door into the paediatric ED. It is fully
compliant with the national HSE charter
ensuring complete audio-visual separation
from the adult ED area. Children will no
longer have to share the same waiting area as
adults. The separate area is compliant with
the Children First hospital policy, ensuring the
safety and privacy for all paediatric patients
presenting to the department.
Dr Ethel Ryan, Clinical Director for Women’s
and Children’s Directorate & Consultant
Paediatrician, UHG stated, “The new paediatric
ED area benefits the paediatric patients and
their families by providing a safe and secure
environment for them to be reviewed in, with
complete separation from the adult area. This
new area provides them with full privacy and
safety as per the National Children First Policy.
With the increased number of clinical cubicles,
paediatric patients will be seen quicker which
improves patient flow through the department
and reduces their waiting time to be seen.”
winter 2016 | health matters | 67

Lifestyle
The public sector has a target to improve its energy efficiency by 33pc by 2020 and the HSE is well on
its way to achieving this ambitious target. As part of its energy efficiency programme the National Health
Sustainability Office (NHSO), in partnership with the Office of Public Works (OPW), is currently running a
staff energy awareness campaign called Optimising Power at Work which will rolling out in twenty sites
over 2016 and 2017. The initiative aims to change staff behaviour towards energy use and reduce the
amount of energy we use in our buildings. Cathryn Buckley, Office Coordinator in the National Health
Sustainability Office looks at simple ways that you can save energy at home and at work.
Energy Efficiency at
home and
in work
nergy is essential to nearly all
aspects of our daily lives - but
we rarely stop to think about
E
how or why we use it. As the
darker evenings approach and
the weather gets cooler we can all do our
part to avoid wasting energy. This will save
money and also benefit our health and the
environment. Every change no matter how
small can make a difference.
The World Health Organisation supports
the argument that the burning of fossil fuels
and the emission of Green House Gases is
not only detrimental to the environment but
also to people’s health. For example, policies
supporting cleaner transport, energy-efficient
buildings and better waste management reduce
emissions of CO2 and pollutants, contributing to
the mitigation of climate change. These policies
also reduce key sources of air pollution leading
to improved cardiovascular and respiratory
health of the population. Policies encouraging
sustainable transport can promote physical
activity by encouraging low carbon modes of
transport such as cycling and walking.
Remember these three easy steps to avoid
wasting energy - plug out equipment, switch off
lights and only use what you really need.
Top tips for saving energy
at home
• Turn down your thermostat - if yours is above
20ºC turn it down as lowering your thermostat
by just 1ºC will knock 10pc off your heating bill.
• Turn the lights off when leaving a room or
when there is enough daylight.
• Switch appliances off rather than leaving
them on standby - this will save up to 20pc of
your appliances’ energy use.
• Take a shower rather than a bath - a typical
shower uses only one fifth of the energy of a
bath.
• Use energy efficient light bulbs – they use
80pc less electricity than
ordinary bulbs to produce
comparable light and they last
eight times as long.
• Buy A-Rated appliances
when possible - all appliances
now need an energy label so
check them for one.
• Insulate your attic and
walls – this could save you 30-
40pc on your home heating
bill. SEAI provides grants for
upgrading your insulation
through the Better Energy
Homes scheme.
• Replace your boiler and
improve heating controls
- the Better Energy Homes scheme will also
grant aid for high efficiency boilers and heating
control improvements.
For more information on saving energy
in your home and the grants available
for energy improvements check out the
Sustainable Energy Authority of Irelands
website www.seai.ie.
Top tips for saving energy
at work
• Switch off computers and non-essential
equipment each evening, at weekends, and
before holidays - this will save up to 20pc of your
appliances’ energy use compared to leaving
them on standby.
• Activate the power saving functions on
computers, printers and photocopiers /fax
machines.
• Report any dripping taps, leaking pipes or
broken toilets – saving water also saves energy.
• Keep it on the screen – only print when
necessary which saves paper and energy.
• Ensure windows and outside doors are kept
closed when the heating or air conditioning is on.
• Use the stairs instead of the lift and if
you can, consider walking, cycling or public
transport when travelling to work – this saves
energy and is also good for your health.
More information on sustainability in the
Health Service, including energy efficiency,
water conservation, waste prevention and
sustainable transport, is available at www.hse.
ie/sustainability or you can contact the National
Health Sustainability Office – nhso@hse.ie
National Health Sustainability Office
www.hse.ie/sustainability
Useful links
www.hse.ie/sustainability
www.opw.ie
www.seai.ie
www.seai.ie/Grants/Better_energy_homes/
68 | health matters | winter 2016

www.HospitalWalks.com
Get Up!
Get Out!
Get Active!
F you were offered a daily pill
that could reduce your risk of
Type 2 diabetes, cancer, heart
I
disease and stroke, give you a
healthy dose of vitamin D, help
you lose weight, tone up and increase your
stamina, would you take it? The answer is
sure to be “yes” but before you search for this
new wonder drug, here is the best bit: the
benefits are all yours with a brisk daily walk.
Even if you are physically inactive now, just 30
minutes of brisk walking five days a week is
enough to lower your risk of suffering an early
death by up to 30pc.
A new website was launched in early
September to highlight accessible walking
routes for staff, visitors and patients in
Galway City Hospitals.
By changing the work environment to
include accessible walking routes, we can
help to raise awareness of the many benefits
of physical activity to one’s health and
wellbeing. Walking is a great way for nonexercisers
to begin an activity programme, as
it is free, accessible and we already know how
to do it.
This is the reason Health Promotion and
Improvement and the Saolta University
Health Care Group identified and highlighted
various internal and external accessible
walking routes on both hospital sites in
Galway City, on the grounds of GUH and
Merlin Park University hospitals.
In early September, to coincide with the
hospital step challenge for staff and ‘Culture
Night’, a new website was launched called
www.HospitalWalks.com These hospital
walks are coloured coded and measured in
relation to step count, distance in kms and
duration-walking at a modest pace.
The website clearly highlights interactive
maps, slide shows and photos of all the
routes, to ensure clarity and accessibility
for all. The website also contains links to
Get Ireland Active, Get Ireland Walking and
other relevant websites to support staff,
patients and visitors to become more active,
more often.
It is hoped that the website and promotional
material will support all hospital staff,
patients and visitors to avail of opportunities
at work and while visiting the hospitals to
integrate more physical activity into their
daily routine by engaging in short physical
activity walks.
The walks in Merlin Park University Hospital
were names after central figures in the
hospital’s history such as:
Dr Noel Browne – the Minister for Health
who built this hospital as a TB sanatorium.
Dr Norman White – the architect who
was keen that every patient would get to
see every tree and shrub and hence he
incorporated wonderful views of nature into
the design plans.
The Waithman’s – the Waithmans were the
owners of the property (estate) which was
taken over by compulsory acquisition in order
By changing the
work environment
to include accessible
walking routes, we can
help to raise awareness
of the many benefits of
physical activity to one’s
health and wellbeing
to build a sanatorium and they were very
upset at the time but felt if they could save
one life it would be worth it.
The Hitchcock walk—Dr Hitchcock worked
in MPUH and wrote the book ‘TB or not TB’
The Kneafsey Walk—Dr Kneafsey was a
revolutionary Cardio-thoracic surgeon at
MPUH.
Staff can now set their own activity goals
and begin to indulge in some of these short
walks early in the morning or at lunch time
in the hospital grounds or indeed by simply
getting off the bus early and walking the rest
of the way to work. They will begin to reap
the many health benefits of being active on a
personal level but also enjoy the many social
benefits. Taking part in a lunch time walking
group is a great way to support people to stay
motivated and reach their goals.
For more information, contact Paul.gillen@
hse.ie or Pamela.normoyle@hse.ie.
winter 2016 | health matters | 69

Lifestyle
Awards for Healthy Eating and
Active@Work
o far this year, a total of 46
staff completed the Irish Heart
Foundation Active@Work
S
training day as part of the HSE’s
commitment to improving staff
health and wellbeing guided by Healthy Ireland
in the Health Services implementation plan
2015-2017.
The implementation plan recognises the
role that our staff have in being positive role
models and champions within the workplace.
Staff from all over the country and from
various health care and administrative
disciplines attended various training days
with one common goal - to seek support
and guidance on how to get their staff more
motivated to be active at work.
The course covers the current guidelines
for physical activity, key benefits, barriers
and motivators.
It lists and describes a range of workplace
programmes offered by the Irish Heart
Foundation, including the Step and Walk
Challenge, development of Sli na Slainte
walking routes for workplaces. The course also
presents a number of case studies on how to
implement the Active@Work programme and
recognises success, facilitated through the
annual IHF workplace Awards.
The Irish Heart Foundation Workplace
Awards recognises those who have achieved
key markers in healthy eating and physical
activity in the workplaces.
Emer Smyth, Head of Health Promotion and
Improvement with responsibility for Physical
Activity Programmes nationally, said, “The
HSE’s high level strategic priority to improve
Slí na Sláinte Routes give Nexus staff path to health
The weather was glorious for the launch of six Slí na Slainte Routes
from the Nexus Building, Ballycoolin Dublin 15. The Nexus Building
is home to 180 HSE and TUSLA staff working in Primary Care,
Environmental Health, Health Promotion as well as Children and
Family services and others.
The Health and Wellbeing Committee compromises of
representatives from each department within the building. The
energetic committee have organised several initiatives to date
including lunchtime Pilates, a Book Club, Operation Transformation,
Zumba as well as social events.
Laura Molloy, chair of the group, said, “We were delighted to work
with the Irish Heart Foundation in setting up this initiative. Having six
mapped, measured routes from the building ranging from 330m to
5.8km gives staff of all abilities a choice for lunchtime walks and jogs”.
Slí na Sláinte, meaning ‘Path to Health’, is an innovative scheme
developed by the Irish Heart Foundation and supported by the HSE
and the Irish Sports Council, to encourage people of all ages and
abilities to walk for leisure and good health.
Slí na Sláinte Walking Routes are mapped, measured routes which
use attractive signage at kilometre intervals on established walking
routes to help walkers identify the distance they walk. For more
information see www.irishheart.ie
Staff at the Nexus Building get ready to walk, jog or run at the launch of the
new Sli na Slainte routes.
70 | health matters | winter 2016

staff health and wellbeing along with the
opportunity to train staff in promoting physical
activity in the workplace can only help provide
more opportunities for staff to live more
healthy and active lives.”
At this year’s awards ceremony, staff from
Cavan General Hospital and the Royal Victoria
Eye and Ear Hospital received both awards
- a huge achievement.
For further information on the Active@Work
training day, you can contact Tara Curran in the
Irish Heart Foundation by email at tcurran@
irishheart.ie
FAR LEFT: (l-r) John Healy, TV Maitre’D and Irish
Heart Foundation Ambassador; Dr Kate McGarry,
President, Irish Heart Foundation; Ann Gillick and
Yvonne Doran, Royal Victoria Eye & Ear Hospital,
Dublin 2 who achieved Silver (Active@Work) and
Gold (Healthy Eating) and Marcella Corcoran
Kennedy, Minister for Health Promotion.
TOP OF PAGE: (l-r) John Healy, TV Maitre’D
& Irish Heart Foundation Ambassador; Dr Kate
McGarry, President, Irish Heart Foundation; Jacinta
McAree-Murphy, Paula Gallagher and Peggy
Plunkett, Cavan General Hospital who achieved
Gold (Active@Work) and Silver (Healthy Eating)
Awards with Marcella Corcoran Kennedy, Minister
for Health Promotion.
LEFT: (l-r) John Healy, Irish Heart Foundation
Ambassador; Dr Kate McGarry, President, Irish
Heart Foundation; Liz Timony, Yvonne Collins
and Mary Cullivan, Our Lady’s Hospital, Navan,
Co Meath, who achieved the Bronze Award in
both categories, with Marcella Corcoran Kennedy,
Minister for Health Promotion.
winter 2016 | health matters | 71

Lifestyle
Enjoy this winter by
being physically active
ith the dark evenings and the
worsening weather conditions,
winter can sometimes pose
W
a challenge to even the most
discerning physically active
HSE worker. However, with our reasonable
climate there are no excuses for not being
active during the winter season. Colm
Casey, Physical Activity Co-ordinator,
shares some tips.
Move more
I AM often asked, “What is the best type of
exercise?” The answer is simply, “The one
you do and like.”
Try and find ways to move more daily.
Do your best to accumulate 10,000
steps per day. Use a simple pedometer or
download a pedometer application from
your Smartphone and you will find yourself
looking for opportunities to walk more.
You will probably start talking the stairs
instead of the lift.
You may perhaps park the furthest distance
from the door instead of driving around the
car park for ten minutes before work looking
to park as close as possible to the door.
If possible leave your car at home or a
distance from your worksite and commute
actively. Walk around your estate, park or
garden when you get home in the evenings or
nab a friend and take an hour to catch up.
Home gym
For those who simply can’t get out, you
could also set up a home or office gym by
buying some inexpensive equipment such as
kettlebells or exercise bands and design a
simple exercise circuit. There are numerous
workout sessions for every type of physical
activity on Youtube.
There are a large number of HSE work sites
now offering exercise classes during lunch
and straight after work.
Local gym
You could join a local gym or fitness studio
and avail of the wide range of classes
available in the community. For some gyms,
you don’t have to be a member, you can just
sign up for one of their classes.
Your gear
Try and select the correct training gear. The
breathability and waterproofing of training
gear has come a long way and can make the
harshest conditions bearable. You can pretty
much participate in any sport all year long
by choosing the correct gear and dressing
appropriately. Normally in winter, you should
be looking for gear that covers the whole
body and keeps you warm, dry and allows
perspiration to evaporate.
Layering is the best advice for being active
outdoors. Maybe start by wearing a couple of
layers and as you get warmer, you can peel
the top layer off.
The best and most comfortable materials
for breathability are polyester, goretex or
merino wool. Surfers are able to withstand
the winter north Atlantic swells and stay in
the water for hours at 6 degrees so anything
on land can be possible.
Be safe, be seen
No matter where you live - rural or urban
- you should wear high visible and reflective
garments that can reflect from the front,
sides and behind while exercising outdoors.
You must be visible. There are bike lights
as powerful as car lights on the market
today and make it possible to cycle at
night. Head torch or lamps can be used by
runners, joggers and walkers for lighting in
rural areas on and off road. It’s about being
prepared properly.
CHOOSE THE RIGHT ACTIVITY
FOR YOU
Ideally, you should try and fit in a quick
session before work, during lunch or straight
after work if you like being active during
daylight hours. You should aim for a minimum
of 30 minutes of exercise per day, a minimum
of five days a week.
The key thing is to exercise at the right
intensity. Intensity is how hard a person
works to do a specific exercise. You should
be working out at a moderate to vigorous
intensity.
more information
For more information visit
www.getirelandactive.ie
or follow us on Facebook and Twitter
72 | health matters | winter 2016

St Finbarr’s a hive of activity
Management at St Finbarr’s Hospital
Campus (SFHC) in Cork have been working
closely with staff from the Department
of Public Health and Health Promotion/
Improvement (Health and Wellbeing division)
to improve staff Health and Wellbeing on its
campus for the last three years.
SFHC is located in the heart of Cork City with
a total complement of over 1000 HSE staff.
Since 2014, a small staff Health and Wellbeing
group have been working closely to implement
some important staff Health and Wellbeing
initiatives aimed particularly at reducing
sedentary behaviour of staff that have largely
‘desk-based sitting jobs’ in raising awareness
of the dangers to our health of pro-longed
occupational sitting and the importance of
keeping active at work.
In 2014, an audit and staff survey of the
walkability of the campus was undertaken by
the local Deptartment of Public Health and a
re-vamped “Walkways to Health” 1km walking
path, with new signage and stencil footprints
marking the route, was officially promoted
and launched to staff. It was felt that it was
important to maximise walkability on site for
staff, patrons and residents and to promote
staff walking as a worksite wellness initiative.
Staff lunchtime walking groups were
established during months of June and Sept/
Oct this year. A follow-up staff survey was
conducted in June where 55pc of staff who
took the survey stated that they had used the
“Walkways to Health” route before, with 42pc
stating that they used it at lunch time. Staff
were asked about what further improvements
could be made to the walking route and these
are being addressed.
A communal staff bike scheme is the latest
ABOVE: The staff lunchtime walking group from St Finbarr’s Hospital in Cork. BELOW RIGHT: Launching
the SFHC Staff Bike Scheme was Ruth Bullough of Cycle Sense. BOTTOM OF PAGE: Staff at St Finbarr’s in
Cork get walking during their lunch break.
health and wellbeing initiative that was
launched in September. The purpose is to
replace some car-based trips during the working
day around the city, with trips made by bicycle,
thus reducing traffic congestion and emissions
while simultaneously contributing to improved
staff health and wellbeing. SFHC staff can now
avail of a bicycle for short term use during the
working day should they wish to go for a cycle
at lunchtime or leave the car and cycle to that
meeting in the city. Depending on uptake, more
bikes will be purchased for staff use.
As of March of this year, St Finbarr’s staff
can now avail of an outdoor gym during
lunchtime hours weekdays only between
12.30pm and 2pm.
Finally, the campus has an active staff choir
that has been meeting every Wednesday at
lunchtime for a number of years. Joining a staff
choir is a great way to meet other staff and
contribute to your sense of wellbeing.
winter 2016 | health matters | 73

Lifestyle
HSE earn first conviction
Battling allergens
The Environmental Health Service protecting
the public from this very real food safety risk
he HSE Environmental Health
Service (EHS) recently secured
a conviction against a food
T
business in Galway as a result of
a customer having had a severe
allergic reaction. It was the first legal case of its
kind taken in Ireland and is an example of how
important the regulatory work of the EHS is
with regard to food safety and the protection of
public health.
what is a food allergy?
A food allergy is an abnormal, exaggerated
bodily reaction to certain foods. While the
body’s immune system is designed to protect
against outside invaders, like viruses and
bacteria, sometimes it produces antibodies in
response to something that is normally not
harmful at all, causing an immediate reaction in
a susceptible person.
Most allergies are just annoying with symptoms
such as itchy/ watery eyes, sneezing, and a
runny nose but other allergic reactions such as
anaphylaxis can be more serious and can cause
severe illness and even death. Anaphylaxis is
life-threatening and occurs immediately when
an allergic trigger causes histamines and other
chemicals to be released from various tissues
throughout the body. Dangerous symptoms like
narrowed airways and difficulty breathing, shock,
sudden drop in blood pressure, swelling of the
face or tongue, vomiting or diarrhoea, chest pain
and heart palpitations, slurred speech, loss of
consciousness and death can result.
Incidents
A number of incidents have been reported in
recent years in relation to food allergies. In 2013,
a teenage girl, out for a meal with her family
in Dublin accidentally ate a nut-based sauce
and suffered a severe anaphylactic reaction
within minutes. Not having immediate access
to an EpiPen she tragically died. More recently,
in October this year a pharmacist in Dublin
intervened when a 17-year-old girl presented
suffering from a severe nut allergy.
Displaying characteristic symptoms of
anaphylactic shock including a rash and
swollen lips, pharmacy staff immediately
called an ambulance and administered
two adrenaline pens before the girl was
hospitalised. On this occasion, it is believed
that a chocolate milk drink led to her
allergic reaction.
In the UK recently the owner of an Indian
restaurant was jailed for six years after he
was found guilty of manslaughter following
the death of a customer with a peanut
allergy. Prosecution lawyers said the owner
had replaced almond powder with cheaper
groundnut mix, made from peanuts, to cut
costs. The customer who had informed the
74 | health matters | winter 2016

curry house of his allergy, had ordered a meal
with no nuts but later was found dead in his
bathroom after eating the takeaway. The Court
heard how the owner of the restaurant took a
“reckless and cavalier attitude to risk” and “put
profit before safety”.
legal responsibilities of food
industry
Up to recent times in Ireland the law in this area
meant that those running food businesses when
asked by a customer only had to give verbal
information on any allergic ingredients that may
be in a dish.
New legislation with more specific
requirements on the provision of food information
to the consumer was implemented in 2014.This
legislation applies to both packaged foods and
unwrapped foods/dishes. There are 14 specific
allergens listed and if these are used in preparing
or producing food in the premises they must be
declared. The manner in which this information
has to be provided is proscribed in the law to
ensure that it is clear and understandable for the
consumer. The 14 allergens are:
Cereals containing gluten, Crustaceans e.g.
crab, lobster, crayfish, prawn, shrimp etc.,
Eggs, Fish, Soybeans, Milk (including lactose),
Celery and celeriac, Mustard, Sesame Seeds,
Sulphur dioxide and sulphites, Peanuts, Tree
nuts (including almonds, hazelnuts, walnuts,
cashews, pecans, Brazil nuts, pistachios and
macadamia nuts), Molluscs, Lupin. There is a
responsibility on all food businesses to comply
with this legislation; some have adapted
menus and display boards to do this, while
others display an ‘allergens folder’. The HSE
Environmental Health Service enforces this
legislation routinely in conjunction with other
statutory food safety inspections.
First Prosecution
In September, the Environmental Health Service
received a complaint relating to an adverse
reaction suffered by a customer of a Chinese
restaurant and take-away in Galway. The
customer had ordered a dish in person at the
counter and had specified on two occasions that
she wanted it be ‘nut free’ due to an allergy.
Within minutes of eating her take-away meal
of chicken and prawn chow mein at home, the
customer developed an anaphylactic reaction.
Fortunately an EpiPen was to hand and, following
discharge from the local A&E Department, there
was no long term health damage. Subsequent
analysis of the food by the Public Analysts
Laboratory in Galway showed it contained very
high levels of peanut.
Due to the potential seriousness of the
situation, a prosecution was taken by the
Environmental Health Service.
After hearing evidence, the Galway District
Court judge found the business operator guilty.
He was fined €300 with costs awarded to the
HSE of €750. In her concluding remarks, the
judge praised the customer and advised that “she
had done the state some service” for highlighting
the matter.
Speaking after the hearing, Dave Molloy,
Assistant National Director for Environmental
Health, said “The successful outcome of this case
brings with it valuable lessons for all concernedthe
real risk to public health posed by food
allergens, the symptoms of an allergic reaction,
the need for immediate action if someone
presents with those symptoms and the need
for those known to suffer from severe allergic
reactions to carry an EpiPen.
“For the EHS the lesson learnt is the continued
need to work with food business operators to
inform and educate them on the risks of food
allergens and their legal and moral obligation
to provide accurate and correct consumer
information. In the 45,000 food businesses
that it supervises, the EHS endeavours to work
with industry to build compliance with the law
and recognises that the vast majority of food
businesses in Ireland demonstrate a commitment
to food safety, but where the law is breached the
EHS will continue to protect public health up to
and including the application of legal sanctions
where appropriate.”
Images kindly provided by the Food Safety
Authority of Ireland.
winter 2016 | health matters | 75

Lifestyle
Parents
urged
to give
children
child-sized
portions
Bigger portions of healthy food also
contributing to obesity problems
afefood, in partnership with
the HSE, has recently ran an
awareness campaign recently
S
on child-sized portions.
Portion size was identified as
a key issue in preventing children becoming
overweight and we are urging parents
to give children child-sized portions. The
message is clear that how much children
eat as well as what they eat is very
important. Recent studies¹ have found that
children aged over two ate up to 40pc more
food when bigger portion sizes were made
available to them.
Dr Cliodhna Foley-Nolan, Director, Human
Health and Nutrition, safefood said: “It’s
well established that for adults, we eat
more food and consume more calories
when we’re given bigger portions and we
now recognise that this goes for children
as well.
“There has also been a significant increase
in food portion sizes over the past 20 years,
this all contributes to more of our children
nowadays carrying excess weight.
“What’s also interesting is that young
children up to the age of two have good
appetite control and only eat what they
need, but older children lose this ability to
know when they’re full.”
Research has shown that food portion
sizes have significantly increased over the
past 20 years, particularly among baked
foods like scones, croissants and danishes
as well as takeaway foods; some takeaway
food portion sizes are now 180pc bigger
compared to the late 1990s.
Margaret
O’Neill, HSE’s
National
Dietetic
Advisor said,
“As a parent
myself and a
dietitian, I know
how important food is for growth and
development in children. However, it is
the quality of the food we provide our
children that is key. Infants and children are
not small adults and they need different
nutrients than we do as they are growing.
We need to look at the amounts we are
serving children and give them appropriate
portion sizes of nutritious food for their
age. A teenage boy requires very different
portion sizes to a five-year-old.
Tips on reducing portion sizes for kids
• Kids need child-sized portions, not adult ones. So
give them small portions of food on their plates to
start with. If they want more, then give it to them.
• If they say they’re hungry after a meal, offer them
something nutritious like fruit.
• Try to avoid having fatty and sugary snack foods
freely available between and after meals.
• For smaller kids, use plates and cutlery that
match their size, not yours.
“The food pyramid is a useful guide for
children aged five years and upwards.
The HSE and safefood have published a
very useful guide for health professionals
to assist parents and guardians in
communicating with their children about
body weight.”
See www.healthpromotion.ie/
Submitted by the HSE’s Healthy Eating
and Active Living programme.
• Don’t pressure children to eat all the food on
their plate and allow them to stop when they say
‘I’ve had enough’.
• Remember the proportions of food you offer
during the day. They should be roughly one-third
fruit and veg; one-third starchy foods like bread
and potatoes; one-third dairy like milk, cheese and
yogurt and one-third protein like meat and fish.
• Keep treats at a realistic level – a little and not
every day.
76 | health matters | winter 2016

Plan to improve
Ireland’s health
and reduce the
burden of obesity
new policy and action plan
aims to reverse obesity
trends, prevent health
A
complications and reduce the
overall burden for individuals,
families, the health system and the wider
society and economy.
Minister for Health, Simon Harris, together
with the Minister for Children and Youth Affairs,
Dr Katherine Zappone TD, and Minister of
State for Health Promotion, Marcella Corcoran
Kennedy TD recently launched A Healthy
Weight for Ireland - Obesity Policy and Action
Plan 2016- 202 and Healthy Lifestyles – A
Consultation with Children and Young People.
In recent years, levels of overweight and
obesity have increased dramatically with 60pc
of adults and one in four children in Ireland
either overweight or obese.
It is estimated that the cost to society in
Ireland of adult obesity exceeds €1 billion per
annum.
Overweight and obesity are significant risk
factors for many chronic diseases.
The links between obesity and heart disease,
cancers, Type 2 diabetes, mental health issues,
respiratory problems and musculoskeletal
conditions are well established.
The ministers announced a range of actions
which would be undertaken over the coming
years to address the growing concerns about
overweight and obesity.
These include:
• New national Healthy Eating Guidelines
• Calorie Posting Legislation
• Development of a Nutrition Policy
• A new clinical Lead for Obesity will be
appointed in the HSE
• Prioritisation of Obesity services in the HSE
service plans for 2017 and subsequent years
• Support for introduction of a Sugar Levy
to encourage a reduction in the rates of
consumption of sugar-sweetened beverages
• Working with key stakeholders to develop
a voluntary industry Code of Practice for food
advertising, promotion and marketing
• ‘Whole of school’ approaches to healthy
lifestyles with the Department Education and
Skills
• Development of guidelines in relation to the
built environment
• Agreement on food reformulation targets
with the food industry and establishment
of a forum for engagement with industry on
best practice initiatives towards a healthy
food environment.
Welcoming the launch, Sarah O’Brien, HSE
National Lead, Healthy Eating and Active
Living programme said, “The launch of the
plan is most welcome and many of the actions
will be implemented by the HSE.
“We look forward to co-operating with
colleagues in the Department of Health and
other partners who are equally concerned
about Ireland’s growing weight problem.
“The accompanying report on the
consultation on ‘Healthy Lifestyles with
Children and Young People’ gives us insights
into the views of children and teenagers
and how they think society should tackle
healthy lifestyles.”
Minister Marcella Corcoran Kennedy; Margaret
O’Neill, HSE National Dietetic Advisor; Minister
Simon Harris; and Sarah O’Brien, HSE National
Lead, Healthy Eating and Active Living Programme
pictured at the launch. Photo: Conor McCabe.
winter 2016 | health matters | 77

Lifestyle
CITROEN GRAND
C4 PICASSO
First
Drive!
FACTS AT A GLANCE
Citroen Grand C4 Picasso Flair
BlueHDi 150
Engine: 2.0-litre, four-cylinder turbodiesel
producing 148bhp
Transmission: Six-speed automatic
Performance: 0-62mph in 10.1 seconds,
top speed 129mph
Economy: 64.2mpg combined
Emissions: 115g/km
WHAT’S NEW?
Only a particularly keen eye would be able to
tell the difference between the new Grand C4
Picasso and the second-generation model that
arrived in 2013. Its exterior retains the familiar
shape of the old car, but features a number of
subtle tweaks that help keep it looking fresh
and up-to-date.
As you would expect from a car designed
purely for carting vast numbers of children to
and from school and sports practice, the new
Picasso can be specified with a raft of active
safety systems. These include Speed Limit
Sign Recognition, and Active Land Departure
Warning to name but a few.
LOOKS AND IMAGE
Generally speaking, large MPVs aren’t
the best looking cars on the road. However,
Citroen seems to have this area nailed - the
Grand C4 Picasso is definitely one of the
better-looking people movers currently
available on the market.
A suite of very subtle updates that would
be difficult to notice on their own make
an appearance on the new car. Changes
include a redesigned front end, 3D-effect
rear lights, rear chevrons finished in gloss
black with chrome surrounds and new 18-
inch alloy wheels.
Together, these add up to an end product
that is a marked improvement over the
older car. At the end of the day, an MPV is
never really going to be considered a cool
car, even one as attractive as the Grand C4
Picasso. That said, cars like this will always
place function over form. The added bonus
with the big Citroen is that you don’t have to
compromise too much in the form department
if you’ve got a load of children to ferry around.
SPACE AND PRACTICALITY
This is the Grand C4 Picasso’s piece de
resistance. A seven-seat layout means you’ll
be popular with other parents on the school
run, and should help prevent any squabbles
from breaking out on longer journeys with
the family.
The middle row of seats can fold down flat
to increase boot space, and can also slide
back and forth to allow for more legroom in
the third row. The two third row seats fold
down into the boot floor, allowing for 645
litres of storage space in the boot when the
second row of seats are in their forwardmost
position.
Another handy feature that has been
introduced is a hands-free tailgate. Simply
wave your foot underneath the rear bumper
and the boot will pop open, meaning you can
load the car up easily even when your hands
are full.
BEHIND THE WHEEL
The Grand C4 Picasso isn’t exactly a small
car, although it masks its size rather well.
Thanks to plenty of forward visibility out of the
large windscreen and a raised driving position,
you don’t really feel like you’re behind the
wheel of a big people mover.
To drive, the Picasso is very manageable.
At low speeds, the steering is quick enough
to allow you to manoeuvre into tighter
parking spaces, and features like a rear
parking camera mean you shouldn’t bump
into any obstructions.
Out on the open road, you’re afforded a
generous view of the road ahead. The seats
are comfortable, supportive and easily
adjustable – although depending on your body
frame, the driving position might be a tad
awkward. The steering wheel is quite far away,
while the pedals are right under your feet.
There is a fair amount of wind noise at
motorway speeds, owing largely to the boxy
shape of the car, and the 18-inch alloys fitted
to our test car also created a fair amount of
tyre roar. For the most part, the four-cylinder
diesel engine is unobtrusive and refined,
although it does create a bit of a racket under
heavy acceleration.
Any lumps and bumps on the surface of the
road are dealt with by the Citroen’s supple
suspension set-up, although this does lead to
a dash of body roll through the corners.
VALUE FOR MONEY
In terms of bang for your buck, the Grand
C4 Picasso in Flair trim makes a good case
for itself. It comes with a wealth of handy
features as standard, including the new
3D Citroen Nav system. This incorporates
mapping data from TomTom that can be
displayed through either the seven-inch
touchscreen in the middle of the dash, or the
12-inch display on the upper dash.
Other features include front and rear
parking sensors, cruise control, dual-zone air
conditioning, DAB radio and Bluetooth and
USB connectivity. Mirror Link and Car Play -
which are included as standard - help to make
connecting your smartphone that much easier.
WHO WOULD BUY ONE?
This is a car that will largely appeal to buyers
with young children. It will tackle the school
run with ease, and thanks to an economical
diesel engine, it won’t be too expensive to keep
topped up with fuel either.
78 | health matters | winter 2016

Win a two night Bed & Breakfast in one of our Luxury Rooms, with private Balcony
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our RiverBank Restaurant.
The four star Court Yard Hotel, steeped in history, built on the original site where
Arthur Guinness created his brewing empire, and situated in the colourful heritage
town of Leixlip Co. Kildare. A region blessed with some of Ireland’s most spectacular
scenery, the hotel has been meticulously restored and refurbished and offers old
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The Court Yard Hotel has long been appreciated for its romantic and picturesque
setting. The property combines a stunning location, contemporary accommodation,
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The Health Service Executive would like to
wish all service users and staff a...
...especially those who find themselves
ill and in hospital over the festive period,
and the staff taking care of them.