HPV Vaccine for boys new Hse board meets - Significant experience and expertise
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staff magazine of the IRISH HEALTH SERVICE vol. 14 | issue 19 | AUTUMN 2019
New HSE
board meets
HPV vaccine
Significant for boys
experience New school programme
and expertise is rolled out
features general news you section lifestyle
Welcome tO the Contents
latest edition of You Features
Health Matters 6 HPV vaccine 22 Annual report
Boys included for first time Achievements of 2018
In this edition we speak to Dublin mum
8 Life story books 24 Long-term suites open
Amanda Kenny who explains why she
Helping dementia patients Minister in Castlebar
is grateful that her son will be among
10 Steps to Health 25 START at the GAA
the first boys in Ireland to receive the
Another epic year Parents and children learning
HPV vaccine.
12 New board meets 26 Social media
Now as a first year in secondary
Momentum for change Use it to engage your audience
school, Charlie will get the HPV
13 Therapy dog 27 Breastfeeding
vaccine to protect against HPV-related
Cody is a big hit Heavy investment
cancers in later life.
14 Senan’s story 28 Good infection practice
By Charlie receiving the HPV vaccine,
Vaccines save lives Be picture perfect
he will also be protecting any partners
16 Values in Action 29 Traumadoc
he might have in the future, protecting
We are growing New clinical proforma
others as well as himself from life-
18 Living with lymphoedema 30 HIV Fast-track cities
threatening diseases.
New model of care Irish quartet sign up
Dementia can take away so much
19 Know Check Ask 31 Cyber security
from a person but a new initiative at a
Medication awareness campaign How to recognise suspicious emails
community care home in Galway has
20 Home sharing scheme 32 Genio collaboration
given their residents back their own
Families open their homes Reforming social services
‘life story’.
34 Dementia
Maria Donnellan tells us about the
Making the most of technology
life story books which are created for
36 Mental health
each person with dementia living in the
Primary care level
Creagh Suite in St Brigid’s Hospital,
Ballinasloe, to discover more about
them, their lives, likes and dislikes,
relationships and interests. She explains
how it has promoted greater empathy
and understanding between them and the
staff that care for them.
We also meet some of the families in
the north-west who have been opening
their homes for years to children and
adults with a disability as part of the
amazing Home Sharing Scheme. Helena
Ryan says that her guests have become
part of the family over the years and they
get as much from the scheme as the
family they provide respite for.
If there’s anything you would like to see
included in the magazine or if you have
any other feedback, you can contact us at
healthmatters@hse.ie
Thank you 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
This magazine is produced by the
HSE Communications Division
Publishers: Celtic Media Group
www.celticmediagroup.ie
Feedback: Send your feedback to
healthmatters@hse.ie
autumn 2019
HEALTH MATTERS AUTUMN 2019
37 Healthy Ireland plan
Community Healthcare East
38 Open Disclosure
Vital we get it right
39 World Patient Safety Day
We must speak up
40 LGBT training
HSE launches elearning course
41 Rainbow badges
CAMHS initiative
42 Pension Improvement Programme
Enhancing communication
43 Robotic gynaeocological surgery
Fertility preserved
44 Brexit
Get your department ready
45 Quality improvement
11
Shared experience in Ethiopia
46 PCERS award
ISO 9001 certification
48 Strategic plan
PCERS lays outs aims for next three years
49 Data centre
Move one year on
50 55
30 71
2019 autumn health matters 
Contents
News
50 Hand hygiene 61 Accessibility
Train the trainer Ward space changed
50 Ghana trip 62 Mental health
Team from Limerick travel Engagement forum
51 Health Passport 62 Smoking
Equal access to care Mental health and recovery
52 End-of-life care 63 EGovernment awards
Award for Kerry hospital HBS shortlisted
52 PJ paralysis 63 Cessation service
Commentator visits Tallaght staff to benefit
53 Maternity outreach 64 Future leaders
New service for Sligo 51 complete course
43
53 Medical career days 65 NAS symposium
Joint initiative Critical care
54 Self-management support 66 Abortion numbers
New directory Figures travelling to UK fall
54 Oncology unit 67 Going tobacco-free
Cancer care for south west Personal experience
55 Family room 68 Pioneering service
Elderly and stroke patients benefit psychosis intervention
56 Midwifery conference 69 Cork boost
Ethical issues Primary care centre opens
57 Online training 70 Final journeys
Handling complaints Training for staff
58 Patient booklets 71 Mind Monsters
Enhancing experiences Support for teens and young adults
59 Future health summit 71 Text service
HBS play pivotal role Crisis service
60 Midwife day 72 Prestigious award
Lourdes staff celebrate Limerick cancer nurse honoured
60 Surfer’s ear 73 New guidelines
33 Advice for sea swimmers Dysphagia
26 40
health matters autumn 2019
HEALTH MATTERS spring 2019 online
Sites we like www. b4udecide.ie/
19 www. myoptions.ie
Lifestyle
74 Creative arts
Hospital partners with charity
75 Swim markers
Healthy Ireland initiative
76 Borrowbox
Your always-open library
77 Celebration of art in community
EVE talent showcased
78 Cork Summer Show www. hospicefoundation.ie
HSE staff reach out
www.hselibrary.ie
2019 autumn health matters 
You
Section
Mum Amanda Kenny explains why she is
grateful that her son will be among the first
boys in Ireland to receive the HPV vaccine.
Vaccine will
help boys
to protect
themselves
and others
t’s hard to believe that my son have in the future, protecting others as well as
I
Charlie is now a teenager and himself from life-threatening diseases. Charlie
starting secondary school. It and his generation are so lucky to have this
seems like only yesterday that available to them, I would urge all children to
I was hugging him goodbye get vaccinated. It’s normal to worry sometimes
(much to his embarrassment) on his first day of about the safety and effectiveness of any
primary school. medication but there’s lots of good scientific
Not only that, but he is now taller than me information available to read up about it. For
(not that it’s very difficult as I’m only 5 foot 2). example, the HSE website www.hpv.ie has been
It’s wonderful to see how he has grown into an really helpful. ABOVE: Pictured with Minister Simon Harris as
intelligent, friendly and sporty boy, passionate Thankfully, HPV vaccination is becoming the HSE launches HPV vaccination programme for
all first year secondary school students including
about soccer, basketball (and of course his the norm in Ireland for girls with more than
girls and for the first time boys were Michael Daly,
beloved Xbox). seven out of ten receiving the vaccine. With the Amanda Kenny with her son Charlie Wescott,
Starting secondary school is a huge deal for vaccine available from September for boys, I’m Emma Daly, Fionn Teehan with his father Stu
any child, and Charlie is no different. His main sure it will become the norm of the boys too. Teehan. BELOW: Pictured as the HSE launches HPV
vaccination programme for all first year secondary
concerns this September are finding his classes Charlie and I had a good chat about the HPV school students including girls and for the first time
on time, and how he will get on with so many and other vaccines and he is well aware of how boys were Michael and Emma Daly from Charleville
new teachers. we can help protect his future. in Cork with Kevin Brennan, brother of the late HPV
As he grows and matures, as his mum, I have Like every other parent in Ireland I want the vaccine campaigner Laura Brennan.
Pic: Marc O’Sullivan
to continue to make decisions about his future best for my child. That’s why I’m grateful that
to try and give him the best possible outcomes Charlie has the opportunity to receive these
now and later in life. After all, we all want potentially life-saving vaccines in September.
what’s best for our children.
Thankfully Charlie has always been a healthy
boy, and I did, and continue to do my best to
keep him that way. Amongst the million and one
things that parents need to do for their children,
I made sure he got all of his recommended
vaccines. This protected him and others from
infectious diseases. As Charlie is protected
it means he cannot pass on these diseases
to other people who may not be able to be
vaccinated for medical reasons.
Now as a first year in secondary school, Charlie
will once again receive more vaccines to keep
him safe. As well as getting vaccines to protect
against tetanus, diphtheria, whooping cough
and meningitis, Charlie will be amongst the first
boys in Ireland to get the HPV vaccine to protect
against HPV-related cancers in later life.
By Charlie receiving the HPV vaccine, he
will also be protecting any partners he might
health matters autumn 2019
Brennan family so proud of Laura’s role in promoting vaccine
The HPV vaccine is now being given to all first year students in Endorsing the Vaccination Programme, Minister for Health Simon
secondary school, including girls and, for the first time, boys. Harris said it was an ‘important milestone on the path to our ultimate
HPV is a virus that can cause cervical cancer, and other cancers in goal – the effective eradication of cervical cancer’.
both women and men. The HPV vaccine will protect young people “In all that we do to advance that goal, we continue to be inspired
from HPV related cancers when they grow up. The uptake of the HPV by one incredible woman who is sadly no longer with us. Associated
vaccine has a participation rate of approximately 70pc, which is an by many with the simple phrase ‘Thank you, Laura’, it is always with
increase of 20pc points since 2017. great gratitude that we remember Laura Brennan,” he said.
The increase is in no small part due to the tireless work of HPV “We might have been launching this latest campaign with
vaccine campaigner Laura Brennan. Laura’s family are continuing her uptake for the vaccine still as low as 50pc. But thanks to Laura’s
work following her death six months ago and were in attendance at passionate advocacy, we are building now from an increased rate
the recent launch. of 70pc. Laura’s work has been so important and highlights why
Speaking at the event her brother, Kevin Brennan said, “Laura it remains so vital that parents are provided with accurate and
poured herself into this campaign, knowing every time she told her credible information to help them to make a fully informed decision
story; it had the potential to save a life. The increase in the uptake concerning HPV vaccination.
rates of the HPV vaccine in last year’s first year girls is bittersweet for “I would also like to remind parents that it is not too late for girls
us – we’re delighted that Laura has played a part in helping to protect who missed the vaccine in previous years. Any parents who have
so many more young people from HPV cancers. And the introduction reconsidered their decision and are seeking the vaccine for their
of the boys to the vaccination programme is very welcome news too. daughters can use the HSE catch-up service.”
But we’re all very aware of Laura’s absence today and how much she The HSE is also promoting new and informative videos online and
would have loved to share this occasion. on social media, in order to support parents’ decision to get their
“As Laura would say, Get the Facts, Get the Vaccine. Protect Our children vaccinated. The videos feature real families who have either
Future,” he added. received the vaccine or who will be getting vaccinated in the coming
With high uptake of the HPV vaccine there is the potential to save year. Participants include the Daly family from Cork, the Houston
112 lives each year by preventing the most common strains of HPV Family from Donegal, Amanda Kenny and her son Charlie from
that cause cervical cancer and other cancers. The HPV vaccine now Dublin and Stuart Teehan and his son Fionn, from Wicklow.
protects against nine out of 10 HPV cancers. The HPV virus can cause The vaccine is endorsed by major medical and scientific bodies
cancers and conditions that can affect boys too, making it extremely worldwide including the World Health Organization, the Centres
important for all young people to get the vaccine. This year Ireland for Disease Control in the USA, the EU funded European Centre for
will join over 20 other countries including the UK in giving HPV Disease Control and Prevention, and the International Federation of
vaccine to boys and girls in first year of secondary school. Obstetricians and Gynaecologists.
2019 autumn health matters 
You
Section
In iti ativ e promotes em pa th y an d un de rstan di ng
books give dementia patients
back their own life stories
ementia can take away so much
D
from a person but a new initiative
at a community care home in
Galway has given their residents
back their own ‘life story’.
Life story books were created for each person
with dementia living in the Creagh Suite in
St Brigid’s Hospital, Ballinasloe, to discover
more about them, their lives, likes and dislikes,
relationships and interests. It has promoted
greater empathy and understanding between
them and the staff that care for them.
The Creagh Suite is home to older adults
with a dementia diagnosis as well as a history
of mental health difficulties.
“For some of the residents, St Brigid’s has
been home for many years and memories
of their earlier lives are forgotten or rarely
accessed. The aim of the Life Story book
initiative was to discover more about these
residents. For each resident, a physical
Life Story book was developed, containing
photographs, stories from their youth,
details of their childhood and major events
and relationships in their lives,” said Maria
Donnellan, CNM 3, Psychiatry, at the hospital,
who leads the project.
“The process of obtaining this information
from family and friends resulted in increased
visits and parcels to the ward, as well as
deepening our knowledge and understanding
of the residents that we work with every day.
“We use the Life Story books to engage
residents by looking through photos or talking
about aspects of their earlier lives. The
books also help us understand the needs and
Life Story books been in,” she said.
Back in 2016, Maria Donnellan returned
preferences of residents, especially when have helped us to college to further her professional
verbal skills may be limited. As such, we can
adapt their environment or activities to better
see beyond the dementia development. Part of the course was to
explore new ways to develop person-centred
suit their individual interests and needs. and mental illness to care. She put forward the idea of the Life
“Life Story books have helped us see beyond
the dementia and mental illness to the
the person, and this Story books to the dementia multi-disciplinary
team (MDT) at the hospital, who gave the
person, and this naturally promotes greater naturally promotes project the green light.
empathy and understanding between staff
and resident.”
greater empathy and A proof of concept was presented to
the MDT so that all relevant professional
Dr Diane O’Mahoney, clinical psychologist, understanding between could give their input. They all volunteered
explained how information for the books was
gathered.
staff and resident their individual skill-sets so as to aid in the
development of a working, content-based
“You put in lots of information about the system to construct the Life Story books.
person’s early history, where they were born, good, were they bold, what kind of outings “The Life Story book has allowed us to
where they lived, where they went to school, did you have. If somebody was a nurse, we identify many of the likes and dislikes of the
how many siblings they had, what their would talk about the training they had. If residents as well as interests and hobbies
parents did and so on. For instance, if we knew they are non-verbal, you can find out about they may have had. This valuable information
somebody was a school teacher, we could what the training would have been like back now allows us to tailor the care we provide
ask what were the rhymes you used when then and talk to them about it or show them and helps preserves the personhood of the
you were teaching kids, were any of the kids photographs from settings they may have resident,” said Maria.
health matters autumn 2019
Maria Donnellan, the multi-disciplinary team, and her mother accepting the award from Tony Canavan, Chief Officer, Community Healthcare West
“This accumulated insight into the life of care plan. Due to Maria’s work, the Life Story in the team is encouraged to champion their
the resident has also led to more harmonious book is now reflected in the therapeutic and own personal attributes. Recently we had
work environment. Now staff report feeling recreational time table. two clinical nurse managers, Aislinn Gannon
more connected on a personal level and While on a visit to the unit Helen Rockford and Fergus McNicholas, who brought their
are more mindful of the things that make Brennan, chair of the working group for expertise in particular in computer technology
these residents people they can identify dementia in Europe, recognised the work to help transform the way we deliver care
with. Residents presenting with challenging Maria was doing and invited her to speak on a daily basis. This is only one example of
behaviour are now beginning to be viewed because she was working as a change agent which there is many. I would like to thank all
in a different light, where once viewed as and a champion in the organisation. the staff of the entire Ballinasloe services in
troublesome, are today seen as someone with The recent Mental Health Commission their commitment and dedication providing an
something troubling them.” report found that there was ‘excellent outstanding service.”
All this has being done without the need for overall compliance’ with regulations at She highlighted the importance of good
extra funding. In the long-term, according to 97pc, an improvement from 73pc in 2018. clinical governance.
Maria, this initiative could be cost-saving as 14 compliances with regulations were rated “My role in this is the implementation of
incidents relating to challenging behaviour excellent. There were no conditions attached policy ensuring we are meeting our legislative
reduce, and residents’ quality of life is to the registration of this approved centre at requirements and evidence-based practice
enhanced by understanding their individual the time of inspection. leading to highly professional practices. All
needs and wants. Commenting on the reports, Dr Susan of this is done through the line management
The work Maria has done in implementing Finnerty, Inspector of Mental Health Services, structure and in collaboration with our
these Life Story books into residents care said, “It is heartening to see Creagh Suite assistant directors of nursing (ADON) Brian
plans has helped identify issues and highlight reaching such a high level of compliance. Murphy and Kathleen O’Malley, and colleague
information that could never have been This provides an example to other approved Siobhan Dooley.”
obtained through traditional methods. In many centres and holds out the hope for patients Maria paid tribute to the nursing staff on
cases, residents have being reunited with and families that high levels of compliance the Creagh suite who work ‘above and
friends and relatives they have not seen or are possible and can be achieved.” beyond the call of duty to deliver such a
spoken to in years. Maria said that if she was asked what the high standard of care’.
“We have received photos and items secret to their success was, she would say “Anyone can have an idea for change
relating to residents when they were only ‘team-work, innovation and with a strong but without the frontline staff, nothing
small children and some of these items have emphasis on support’. can be achieved. All staff have a life
come from as far afield as America. I have “The importance of support is vital, as it story to tell. We are all individuals as our
documented interviews with these long lost reassures staff of their value while giving patients are. Like my patients, I am also a
friends and relatives as they recalled their them the confidence to report issues in mother, a wife, a daughter, a sister. What
childhood memories from when they were a prompt manner when they arise. This keeps me motivated is the confidence
close,” said Maria. support for staff translates into benefits for and trust my ADONs have in me and
The Mental Health Commission has patients and the care they receive while also my fellow dementia champions Carmel
commended this initiative on the last two promoting positive change in organisational Geoghegan and Siobhan Dooley. I thrive
visits while expressing how they felt moved culture,” she said. on human connection hence my belief in
by the archive of the patients’ lives. The “Combine this with a strong clinical lead, Dr the humanistic approach which I champion
Commission also remarked on well the Life Sabina Fahy, and you have the ingredients of and has allowed me to foster a positive
Story book was being implemented into the highly productive team. Each and every person relationships within the organisation.”
2019 autumn health matters 
You
Section
An epic year
for the Steps to
Health Challenge
he Steps to Health
T
Challenge 2019 was a
resounding success, we
had almost 10,000 staff
walking daily counting their
steps. We would like to sincerely thank
each and every person who took part in
the challenge, those of you who entered
our competitions and posted on our social
media channels.
Much of the success can be attributed
to our team co-ordinators, many of you
made tremendous efforts to motivate
your colleagues creating Whatsapp
groups, leaderboards, sharing inspirational
messages and walking at breaks. Some
days when it was hard to get those steps
done, many reported that it was easier
when you had a supportive team behind you.
We know that many of you want to
continue and run some further challenges
locally so we have put together The Challenge in numbers
some ideas together for you on hse. Year 2017 2018 2019
ie/stepschallenge/ where you can order
Participants 2,032 6,534 9,629
fresh Participant’s Guides to record your
steps on healthpromotion.ie. Go to: order Team Coordinators 426 467 664
publications, log in as a professional and % of HSE Staff 2% 6% 10%
search ‘physical activity’
Website Visits 6,767 6,629 6,629
Best wishes from the organising team:
Clodagh Armitage, Norma Deasy, Meagan Exit Survey Completion 187 231 239
Hanley, Agatha Lawless, Adrienne Lynam, Twitter followers 251 559
Edel McNamara, Caroline Murray, Sarah
Yammer followers 143 184
O’Brien and Muiriosa Ryan.
Maureen encouraged others to her local parkrun,” said Maureen.
“I think Maureen deserves a prize for her hard work, motivation and
join in too for encouraging both staff and her peers. Rose Higgins, staff nurse, and
We ran a competition for staff who were inspired by the challenge health care assistants Mary Lyttle and Kitty Dolan were other strong
to get motivated and out walking. We had a great response from team players.”
participants on how the challenge positively impacted their lives both Since the Challenge finished the team is still walking, Angela reported
at work and at home. that she herself has a new habit too, “I wear my pedometer all the time!”
Joint winner Maureen is a service user in Strokestown mental health
services. She used to be very overweight and managed to lose three
stone five years ago. However, since then she reported that she lost her Cancer can’t stop Mary
motivation for exercise and was ‘stuck in the same routine’ and did not Joint winner Mary Holden, Communications Manager in the Coombe
feel inspired to lose weight. Hospital, gave everything she had in the Steps Challenge, all the while
Angela Shally, CNM2 introduced the Steps to Health Challenge to living with incurable cancer.
Maureen and she was so excited that she wanted to start a week “The last Steps Challenge I did was a couple of years ago, and my team
ahead of time. was the winning team here in the Coombe. It was just months before I
“Every day Maureen reported her step count to staff and smashed it. was diagnosed with breast cancer which, on diagnosis, was also found to
She was walking miles ahead of staff and her face was beaming with have spread to my lungs and bones as well. My cancer is incurable but
smiles. Every day she was beating her previous day’s steps. Maureen treatable, and since November 2016, I have had treatment every 28 days
also encouraged other service users to join in, and her goal was to join but am still, thankfully, holding down my full-time job,” she said.
10 health matters autumn 2019Blogger Peter becomes the step king
The team also want to say a huge thanks to our “No, knees are just there quietly doing their job
blogger Peter Dineen, who regaled us with his and trying their best not to let us down. Mine
highs and lows during the five weeks, below is an must be under constant pressure trying to support
extract from his sign-off blog: the upper part of the body but thankfully they
“This five-week challenge has been brilliant. My haven’t given up yet. I think it was Wednesday that
health has definitely improved and I feel better for I noticed something different about the essential
having decided to give it my best shot. Of course, joints in my supporting pillars. I noticed that I still
there were days that were tougher than others but actually had knees.
overall it wasn’t too bad. “You see, weight loss is a strange thing. I would
“The last week was my best one. I walked, I ideally love to lose weight off the belly, that’s
jogged and I danced. Well I say I danced and to where I have most of it but it doesn’t work like that.
be honest in my mind that’s what I was doing at my You lose it everywhere. Your face, your neck and I
friend’s wedding, but in reality I imagined I looked have even lost it from my wrist and now believe it
like a hippo on roller skates, moving, but not very or not, around my knees.
gracefully. It got my steps in though. “I have begun to see my kneecaps again, the fat
“My best day last week was Thursday. I around them has been pared back a bit and the
managed 20,009 steps. I walked in Killarney in the shape of these bones have become visible after
morning, around Kenmare town in the afternoon years of being covered up for so long.
and at home in the evening. But to reach the “I wonder how many years and miles of walking
20,000 before midnight I had to walk around my and sweating I’ll have to endure before I see my
kitchen about 50 times as the clock ticked down. abs or even a rib.
I was delighted to reach it but not very proud “I’ve really enjoyed the last five weeks and I hope
of the step monster I’ve become. I mowed the to keep up the challenge of doing at least 10,000
lawn twice last week just to get the steps in. The steps a day. I enjoy feeling fitter and healthier. I
garden that once looked like a ploughed field enjoy the walking and I’m loving the challenge of
could now be mistaken for the 17th green at the the Saturday morning Park Runs but I don’t think
Augusta golf course. I’ll ever become a person obsessed with running
“I’ve lost weight over the last five weeks. My or fitness and I don’t want to.
knees look different. I was getting dressed the “I like walking, but like most people there are
other day and they just looked different, these times when I’m lazy or tired or afraid of the rain or
knobbly unattractive things looked even more the cold to get up from the desk or the couch and
knobbly. I never gave them that much thought walk. I’m flawed, I eat scones and takeaways on
before now. I mean they are not the most occasion, I park near the door some days, I sit in my
appealing part of the body and not the most car and flick through social media while my young
shown off part either. fella is at training and I look at the weeds growing
“I’ve never heard anyone saying that their knees instead of getting out and digging them up.
are their best feature or how it was their partner’s “But this challenge has meant that I do all
knees that first attracted them. You never see ads these things less and I do hope that I can keep
on TV selling creams and other aids helping you to all the good habits that I’ve started over the last
make your knees the best that they can be. five weeks.”
“Cancer is a bit of a menace but, as far as I’m concerned, is simply ‘It was the motivation I needed
a chronic illness that I’m having to get on with. The oncologists
don’t recommend extreme dieting and extreme exercise and in any at the right time’
event, cancer does give you the excuse to indulge in treats and be For Sharon Crowley, a Medical Secretary in Mullingar, the start date
too tired to do anything but sit on the couch. So I indulged and my for the Steps to Health Challenge was a sign that she needed to
weight went up. start looking after herself. “I am 36 years old and coincidentally was
“To get it back down I need to reduce the treats and my scheduled for a breast clinic appointment for the start date for the
oncology team has allowed me to increase my limited exercise Steps to Health Challenge! I took it as a sign that I need to start doing
with the Step Challenge. whatever I can to try and ensure my own wellbeing,” said Sharon.
“The Step Challenge has been a blessing. I’ve gone from an “As a Mammy to 7, 4 and 2-year-old children, together with working
average 8,000 or 9,000 steps a day pre Step Challenge to 20,000 four days a week, I find it difficult to find the time to put myself first
and over on some days.” and look after myself and always have an excuse not to! So I am now
Mary was the team coordinator. She took a softly softly approach fully committed to taking some time to look after myself. It was just the
to motivating team as she didn’t want to turn anyone off. motivation I needed at the right time.”
“We had great fun conversations. We compared pedometer and Following the Challenge, her tests were thankfully all clear.
phones. If people didn’t get a good week I told them they were “I’m continuing the Steps to Health. Our Team - PCBrigade - plan to
brilliant no matter how low their count was. There was even an walk every Thursday. I found the 10k very hard to reach daily but did get
almost informal competition among staff to be the first to send in there by the end and really noticed how little I had been doing before I
their weekly step count to me,” she laughed. started to count them,” she added.
2019 autumn health matters 11You
Section
Signi fican t experience an d expe rti se
New HSE Board meets
T
he Health Service Executive improve governance and accountability in the · Supporting the leadership and staff of the
(Governance) Act 2019 health system. HSE to continue to improve health outcomes
commenced on June 28th Ciarán Devane has been appointed as the of the public;
2019 and on that day, the Chairperson of the Board with Professor · Developing and implementing an effective
newly established Board of the HSE met for Deirdre Madden as Deputy Chairperson. There performance management and accountability
the first time, with Minister for Health Simon is provision for 10 other Board members. Nine system in the HSE;
Harris in attendance. of these have already been appointed with an · Developing a plan for building public trust
Under this Act, the Board is now the additional member to be announced shortly. and confidence in the HSE and the wider
governing body of the HSE, accountable to the The Board includes members with significant health service;
Minister for Health, with the Chief Executive experience and expertise across a range of · Ensuring the HSE’s full support for
Paul Reid accountable to the Board. These competencies necessary to enable the Board and implementation of the Government’s
changes in governance in the HSE were to govern and lead the HSE. programme of health reform as set out in the
recommended in Sláintecare in order to The key immediate priorities for the Board are: Sláintecare Implementation Plan.
‘We must exploit the momentum for change’
Health Matters caught up with Ciarán Devane You have publicly set-out the Board’s
to talk about taking up the role as Chairperson priorities. How soon will staff see the
of the Board and his vision for how the Board’s influence of these priorities in their
appointment will change the HSE. day-to-day work?
Our key priorities revolve around: performance
There are new 11 Board members management and accountability; public trust
including you. What breadth of and confidence; implementing Sláintecare and
experience will the new Board improved health outcomes through supporting
members bring to the HSE? leadership and staff.
The composition of the Board encompasses While these priorities will take time to develop
members with significant experience and and fully implement, I am certain that those
expertise across a range of competencies working in the public health service will quickly
necessary to enable the Board to govern and We will do all we can to exploit the momentum see the start of the gradual incremental changes
lead the HSE including: corporate and clinical for change that has been started in reaching as we take the early steps to build a better
governance; human resources; strategic planning agreement on Sláintecare. We must, however, health service.
and financial management. There are also ensure that there are appropriate systems and
members with patient advocacy experience controls in place to ensure that financial stability And finally, what is your vision for the
whose appointment was a key recommendation and predictability of the HSE. The support of HSE in the future?
of the Scally report on the national cervical the Board to the Executive is vital to ensuring I suppose it is fair to say that my ultimate vision
screening service ensuring the patient’s voice we develop public confidence in our financial for the HSE in the future would be to have a
is kept at the heart of the future direction of management and to ensuring we target scarce health service that is valued and trusted by those
Ireland’s health service. resources in the best possible manner. who we serve right across the country.
It is important to acknowledge that the role of While I know that major infrastructural
the Board is not an executive one, we are here You were a member of a Board of improvements need to be delivered, for me it’s is
to oversee the operation of the organisation NHS England from 2012 -2015. What even more important that we have the right mix
through a regime of strong governance which similarities if any do see between the of staff, in the right place, with the correct skills
supports the executive in their operational role journey the NHS has taken over the last to deliver a world class service that we can be
but also, importantly, holds them to account for decade and the direction of the HSE? proud of.
their actions. The phrase ‘noses in – fingers out’ is In terms of similarities, I think one of the key My vision is for a health system that values
relevant here. tasks will be the building of trust and confidence. staff and empowers them to be the best that
In NHS England we held our meetings in public they can be. I believe that we can build on the
How will the Board impact the and published all the papers being considered huge progress that we, as a health system, have
running of the HSE? by the Board. I would like to move in that made in terms of increased life expectancy and
While the Board does not have a day to direction with the HSE Board over the coming reduced morbidity and that we can celebrate
day operational role, it will provide robust months. I believe that transparency is one of the the achievements that we have made while
governance structures that will ensure that the keys to trust. recognising that there is much to be improved on.
significant taxpayers’ resource entrusted to the Like the NHS, we are on a journey that will And finally, of course, my vision is for a health
HSE is spent in the most effective and efficient have many twists and turns but, to have a system that is focused more on self-care and care
manner ensuing value for money and strong long-term vision such as Sláintecare with its in the community with a reduced dependency
clinical outcomes that are on a par with other cross-party support is a huge positive on our on acute hospital care with improved access to
OECD countries. transformational journey. services and shorter waiting times.
12 health matters autumn 2019Therapy dog Cody brings
smiles to ICU patients
Ody is a six-year-old old Golden
C
Retriever who lives a normal
life like any other dog… mostly.
Once a week, he puts on his
Irish Therapy Dog uniform and
trots through the door of the ICU in Portiuncula
University Hospital (PUH), where his calming
and comforting influence is felt in abundance.
Charlotte Carter, Clinical Nurse Manager, ICU
explains, “A patient in ICU faces a potentially
scary and dread-filled environment. The
isolation and loneliness of not being able
to interact with their own natural support
system, family and friends can have a huge
impact on their physical and psychological
status. We initiated pet therapy as a non-
pharmacological intervention for the mind
and body and to create a more humanised
environment for ICU patients and their families
along with health care professionals.
“Cody made his first visit to the ICU in the ABOVE: In the ICU at Portiuncula University Hospital, from left: Gary Mullin, Cody’s owner and handler;
patient PJ Connor from County Roscommon and Dr Vinod Sudhir, Consultant Anaesthetist. TOP OF
summer to meet patients and staff. He received
PAGE: In the ICU at Portiuncula University Hospital, from left: Dr Naser Shayoub, Anaesthetic Registrar;
a warm welcome and of course lapped up all Gary Mullin, Cody’s owner and handler; Evelyn Mullin, Acting Clinical Nurse Manager; Charlotte Carter,
the attention. He is such a welcome visitor, Clinical Nurse Manager and Dr Vinod Sudhir, Consultant Anaesthetist.
bringing with him so much warmth. This
interaction is a powerful thing to witness. You so much joy into my life and into the life of out to The Irish Therapy Dogs. Myself and Cody
can stand back and simply watch as the positive others. He has such a unique way with people, are so lucky to be the chosen visiting team for
energy fills the room. they just gravitate towards him. I felt there Portiuncula University Hospital.”
“He will continue to visit the ICU for one hour was an opportunity to share the impact that Every Thursday after a thorough brushing
every Thursday. Already he has brought a sense Cody has on me with more people by becoming and grooming, Cody puts on his uniform and
of healing along with all that unconditional a volunteer with the Irish Therapy Dogs who heads off to the hospital. He is warmly greeted
love. Improving the patients’ experience and have been having a fantastic impact throughout by all the staff and by the time he reaches ICU
decreasing their suffering is what we desire for Ireland for many years,” says Gary. he has already made a number of new friends.
our unit,” says Charlotte. “We applied and were delighted to make Once on the ward, like anyone else who visits
Cody’s owner and handler Gary Mullin explains it through the application process. We then PUH, he knows that hygiene is essential and
how he found Cody when he was about five became registered volunteers with Irish Therapy clean paws are a priority. After a busy day
weeks old abandoned on the side of the road. Dogs. Portiuncula University Hospital wanted he heads home for a well-earned rest and
“From that moment he has continued to bring to take part in the programme and so reached perhaps a little treat or two.
2019 autumn health matters 13You
Section
‘I felt sense of relief that fl
was available to protect o
iny Senan Fraser received
Would I have
T
the first of his childhood
vaccinations in the Rotunda regretted this
Hospital before he should have
even been born.
decision if Senan had
At 63 days old, having been ventilated five developed a severe
times endured countless procedures, his
parents Stuart and Caoimhe gave consent
infection? I’ll never know,
for their strong son to get the vaccines. but I do know that every
Although it was difficult to see him endure
more needles, their feeling was one of relief.
person who took the
“Was it difficult to consent? Of course I time to take the vaccine
wished that he didn’t have to have more
injections in his tiny muscles and I wondered
increased the chance of
if his little body could respond effectively, but survival for Senan
mostly I felt a sense of relief that vaccines
were available to protect our son from had to make for Senan. We had both gotten
diseases that have caused so many deaths,” the vaccine in October, and it was one way
said mum Caoimhe. we knew we were protecting him.”
Senan was delivered by emergency She said that they did not ask any staff
caesarean section in December at 25 weeks members in the NICU had they received
and six days gestation. the influenza vaccine, nor did they request the people that were working so skillfully to
“He weighed just 765 grams after pregnancy that they only wanted vaccinated staff to keep our son alive. Would I have regretted
induced hypertension became a risk to both care for Senan. this decision if Senan had developed a severe
Senan and I,” said Caoimhe. “I did it for the same reasons that patients infection? I’ll never know, but I do know that
“As an Assistant Director of Nursing in do not complain: I did not want to upset every person who took the time to take the
Infection Prevention and Control in a large
teaching hospital in Dublin, I have spent years
educating about outbreak prevention. I have
had the opportunity to review the evidence
and know that vaccines work. There is little
you can control as a mother of a premature
baby that is covered in wires and tubes.
“People often asked me at the beginning
‘how can you bear to leave him every night?’ I
coped by trying to be as practical as possible
to enable me to put one foot in front of
the other. Part of that was to rely on my
knowledge of what is safe care.
“It soon became apparent that the quality of
the care in the Neonatal Intensive Care Unit
(NICU) was exceptional and all care provided
included and focused on reducing the risk
of Senan acquiring an infection as much as
is possible. I knew that providing safe care
during influenza season included having a
good staff uptake of the influenza vaccine.”
She said that learning that the Rotunda
Hospital had over 80pc compliance rate of
uptake reassured her that staff were thinking
of how to protect little Senan before they
even walked through the door of the Neonatal
Intensive Care Unit (NICU).
“High vaccination uptake rates indicated to
both my husband Stuart and I that the staff
believed in evidence-based care, which helped
us trust the other life-saving decisions they
14 health matters autumn 2019lu vaccine
our son’
vaccine increased the chance of survival for
Senan,” explained Caoimhe.
“How can the result of that ever truly be
measured? In the future, will the people that
Senan loves or that love him, the people that
he makes laugh, educates, or the impact his
life will have in the world be attributed to
vaccine uptake? Of course not. Healthcare
has such complex delivery that there is
millons of ‘what ifs’ that could have changed
his path thus far. In addition to the superb
skill of the staff, watching the scientific
inventions and practices that have kept
Senan alive has been somewhat terrifying,
fascinating and most importantly successful
as we finally brought Senan home after over
three months in the NICU.
“Senan and his comrades in the NICU
receiving their vaccinations have to be the
heroes of this story. The tenacity, strength and Protect your
grace of the tiny babies in the unit is a truly
unique thing to witness and very humbling. community,
But the staff will always be my heroes too get the vaccine
for protecting our son by getting vaccinated.
You have made a difference and helped Senan Mum Julie Arnott explains why she and her son
along his way. Thank you.” be getting the flu vaccine
In October 2018, my son Ronan was a bit
under the weather so I took him to our GP.
Ronan wouldn’t wake up by the time I got there.
His eyes opened after a nebuliser, but he was
still limp. The GP sent me straight to hospital
where Ronan was admitted, given steroid
inhaler, oral steroids and, after an x-ray, he got
an antibiotic just in case. He was diagnosed with
viral-induced asthma. Thankfully, he recovered.
In January 2019, I collected Ronan from crèche
Friday evening and he had a bit of a snuffle.
The next day I heard his chest wasn’t great so I
gave him his inhaler and thought I better bring
him to the doctor. I arrived in K-doc and Ronan
was taken straight from the waiting room by
the nurse who called an ambulance. A doctor
arrived and Ronan was given oral steroids and
nebulisers. He was given more nebulisers in
the ambulance on my lap on the stretcher. His
eyes were rolling and he wasn’t conscious. He
was carried into triage by a paramedic whilst
the other held an oxygen tank. In triage, the
two paramedics, two nurses and the paediatric
doctor gave him more nebulisers and tried to
stabilise him. I felt helpless. I was so glad when
CLOCKWISE FROM TOP:
Senan ready to go home after three months in Ronan made a full recovery.
the hospital; a tiny Senan gets some precious Ronan and I will be getting the flu vaccine
skin-to-skin time with mum Caoimhe and dad this season. The more people that get the
Stuart; with the consultant neonatologist; the
vaccine, the more people in our community
staff at the NICU in the Rotunda Hospital say
goodbye to Senan as his mum and dad were can be protected.
finally able to bring him home.
2019 autumn health matters 15You
Section
En ergised Bootcam p ta kes place
Values in Action is growing
Community Healthcare
East joins the movement
ommunity Healthcare East
C
joined the growing Values
in Action social movement
this year, to empower staff
to lead the change that we
need to create a better health service. This
commenced with an incredibly energised
Bootcamp that took place in June.
Martina Queally, Chief Officer for Community
Healthcare East when speaking on the day
was keen to emphasise that “this is a grass
roots movement lead by you, the staff on the
ground. You are being empowered to make
a difference. It is all of our responsibilities to
help shape the future of our health service.”
Martina expressed how excited and
optimistic she was to see Values in Action
begin at the bootcamp. She went on to focus
on the importance of improving the culture in
Community Healthcare East.
“Yes it’s about creating better working
environments for staff that support
recruitment and retention. Yes it’s about
making people feel proud to work in the Irish
health system but most importantly we want
our patients, service users and their families
to have a positive experience when they come
into contact with the public health system.”
Alice Harding, Director of Nursing, told us,
“I was invited to the two-day Bootcamp to
participate as a Champion. I was pleased that The Project Team was established in us understand the commitment the senior
my peers nominated me and thought of me January. Vandana Iqbal, Acting Assistant management team in Community Healthcare
in that way. I was also reluctant. However, I Director of Nursing in Clonskeagh Community East have for this.”
came away enthusiastic that Values in Action Nursing Unit, explained, “For me, the lightbulb Stephen said that it was an excellent
could be incorporated into our workplace. I moment was when I realised that this project opportunity to work collaboratively with
was amazed and surprised at the concepts starts from transformation within. I might colleagues from across the area, enhancing
that were teased out at Bootcamp - I loved the be the only person representing the HSE a sense of wider HSE belonging and of the
storytelling aspect and the power of one. to a service user on a certain day. Have I committed and dedicated staff. Over 100
represented the core values of the HSE?” Champions attended and learnt about how the
introduce concepts social movement works. The core values of the
“When I returned after Bootcamp, the first urban and rural areas HSE translated into nine behaviours and staff
thing I did was take out the local induction Stephen Hayden, Assistant Director of are empowered to live these behaviours.
policy and put in a piece regarding Values in Nursing, a member of the Project Team and In Clonskeagh, Stephen has seen evidence
Action. I thought, this is the place to introduce Bootcamp MC, said, “Community Healthcare of the social movement starting and there is a
the concepts. At the annual staff appraisal I East provides services to both urban and positive energy around the campus.
have put in a question about the values which rural areas. The challenge was to be able Vandana finished by saying, “Our social
now seeks for staff to know about the values to initiate change and maintain momentum, movement goes beyond ‘doing’ the daily tasks
and incorporate this into the workplace for all. across this large geographical area, to enable and ‘being’ the face of HSE. It has enabled
“I have been using the 9 behaviours by doing the 9 behaviours to become the norm in our me to showcase the good work that is being
an extra kind thing and by putting myself in everyday practice.” carried out every day within the silos. Values
other people’s shoes. If every staff member Stephen remembered the first day when in Action is the opportunity to tell people our
becomes involved, then culture will change. he started on the Project Team. “The room stories. To change the culture where people
This change will cost nothing but will be was full of energy and enthusiasm, with a can see, hear and feel the HSE core values.
powerful in bringing about change in the way clear sense of expectation and ownership. Champions from my area met the very next
we treat each other,” she added. Martina Queally, our Chief Officer really helped day to plan the now and the next.”
16 health matters autumn 2019Happy 1st birthday DNCC!
Community Healthcare Organisation Dublin
North City & County (CHO DNCC) celebrated its
first Values in Action Birthday in June.
Mellany McLoone, Chief Officer, said,
“Well done to all the staff in CHO DNCC
who have done a fantastic job to implement
Values in Action within our CHO over the
last year. It would not happen without the
support of our staff.”
There were many activities to mark this
milestone across the CHO. We spoke to Derek
Clarke, Senior Clinical Engineer in Audiology, to
find out why he got involved in Values in Action
and the difference it is making to his department
and their clients.
What inspired you to get involved?
I was nominated back in March 2018, but was
very sceptical at first – as to whether or not this
really is something that would make any real
change in culture and perception of the health
service. But because I knew many like-minded
people in Audiology who had been to Bootcamp
already, and brought back a very positive
experience, I decided to become involved.
Tell us what Values in Action has
meant to you?
I like being involved and being part of a very
progressive movement that is trying to change
the way the HSE is perceived externally and to
create a positive vibe within the work place.
Have you seen any differences since
Values in Action was introduced?
I think the ‘Hello my name is….’ name badges
has been a great success, as now patients really
have a great reference point for feedback.
Where I work, some elderly patients who may
not remember names, can now visually see
names and I think the conversations feel more
personal and friendly. I also feel, for me, using
the now and the next behaviour, and just
explaining to the patient exactly what is or will
happen next leaves the patient understanding
our process and in what time frame they will be
seen. Also our colleagues are now more aware of
our busy and sometimes stressful environment.
Asking that simple question “can I help you”
“do you need any help” has now become more
the norm in our department.
Any stories where you have seen the clinician told the patient to take a seat said initially I was quite sceptical, but there
the behaviours being demonstrated and would fit them in as soon as they had are really many people just like you who are
or lived? some spare time. The patient was seen over willing to try to change our culture, and if
Recently a very elderly patient arrived a the clinician’s lunch break. you read the nine behaviours they are really
couple of days early for an appointment, and not difficult to follow and implement in any
was upset when they realised they would not What would you say to people department, and such small changes can
be seen as the clinics are booked up weeks who might be sceptical of Values have such a big impact on your own service
in advance. in Action? and you will immediately see a difference in
But on hearing the distress of the patient, I would say definitely get involved, as I your workplace.
2019 autumn health matters 17You
Section
‘My lymphoedema
no longer
defines me’
New model of care for management
of chronic condition Lymphoedema and
anaging her lymphoedema Lipoedema Treatment
I just
M in Ireland
is a full-time job for 33-year-
old Dundalk woman Sarah couldn’t
Walker. She is just one of an
estimated 12,380 people in
cope. I was A Model of Care for Irela
Report
nd – A Working Group
Ireland living with this chronic, progressive told that I had
condition that causes swelling in the
body’s tissues.
the condition
Sarah first developed lymphoedema and then just 2018
when she was 13. She had the lymph
nodes on her left leg removed when she
sent off by
was six which meant that her body’s myself to deal
lymphatic system didn’t work properly.
The lymphatic system is a network of
with it
glands and channels in the body that helps
fight infection and remove excess fluid.
As well as causing serious discomfort and Lady of Lourdes Hospital in Drogheda for The MOC proposes an integrated treatment
significantly curtailing her life, Sarah said transforming her life. service involving specialist and non-specialist
managing the condition has had a major “I used to think that I was just care provided in the community with links to
impact on her mental health. lymphoedema. That was the thing that acute and palliative care services as follows:
“I just couldn’t cope. I was told that I defined me. Two years ago I got a referral • Specialist lymphoedema clinics in each
had the condition and then just sent off from my GP to the clinic. I was so down in CHO to provide assessment and intensive
by myself to deal with it. It was incredibly myself at that stage but Kay changed all that. treatment and links to non-specialists in local
difficult but I just hid it by wearing baggy She completely lifted me and my mental Primary Care Teams to provide maintenance
clothes. Nobody told me what I should be health. She got me into garments to help the treatment and support self-care.
doing with it, nobody explained how I could leg – I hadn’t even heard of them before that. • Early detection services in high risk areas
make it better. Nothing. I just got used to She showed me how to bandage the leg to e.g. oncology, care of the elderly.
lugging it around,” she explained. help with manual drainage. These were all • Links between acute and primary care
She has never even been on a sun holiday basic things that nobody had explained to me services for patients with lower limb cellulitis
because it is too uncomfortable to manage before,” said Sarah. associated with chronic oedema.
her leg in the heat and the travel is ‘too “There are even surgeries available now
much hassle’. that will be able to help me and I am hoping “Investing in lymphoedema services
However, a new model of care for people to be able to get one in the future. It really is now will have a significant impact on a
living with lymphoedema and lipoedema a hidden condition and people like me need to patient’s quality of life. With early detection
is changing the way they are supported to be fully supported and not forgotten.” and appropriate treatment there will be a
manage their condition. The need for improved lymphoedema/ reduction in severity and complications such
Based on international best practice, project lipoedema services and a model of care as cellulitis that will reduce costs for the
population needs and results of a national (MOC) was highlighted by Lymphoedema health service,” said Kay.
survey, this new model of care will improve Ireland, a patient advocacy group, and within Setting up services in each CHO will
the quality of life of people living with these the HSE Divisions (Acute and Primary Care) have varying requirements depending on
chronic conditions. and the National Cancer Control Programme. population, existing resources and demand.
Project Manager for Lymphoedema It is essential that services are realigned Since the publication of the model of care
Services, Kay Morris, said, “It’s important and increased to manage the current this year, two proof of concept sites have
that lymphoedema is identified and treated demand and also to introduce prevention been approved; (i) at the Mater Hospital to
as soon as possible. Managing patients in and early detection services to reduce develop early detection services in oncology
the early stages can prevent lymphoedema. future demand. For patients that develop and (ii) in CHO 8 Laois/Offaly for a Specialist
Without treatment it can lead to an increase lymphoedema, their needs can be met early Lymphoedema Clinic. These projects
in secondary problems of pain, cellulitis, by health care professionals in local primary are in the planning phase and should be
hospitalisation, reduced mobility for patients.” care centres with an emphasis on self- implemented by the end of the year.
Sarah credits Kay and her clinic in Our management and support. The MOC is available on hse.ie
18 health matters autumn 2019You can also read
