News from around your health services

New Department Director

Ms. Lis Nixon has been appointed Director of Performance Improvement for Unscheduled Care with the Department of Health’s Special Delivery Unit (SDU) at a salary of €164,000 a year.

Ms. Nixon was previously a director of Lis Nixon Associates in the UK, a group of independent health service consultants specialising in service improvement and clinical coaching. She has had a major involvement in change management and service improvement in the NHS and in Canada and was appointed after internal applications did not meet standards.

Lis Nixon
Lis Nixon

Between 2003 and 2008 she was National Lead for implementing the NHS strategy to discharge or admit 98 per cent of emergency department patients within four hours and she worked in the Canadian emergency services reform.

Ms. Nixon has already carried out consultancy work for the HSE on the acute medicine programme and for diagnostic visits and reports at a number of hospitals.

The SDU was set up by Health Minister, Dr. James Reilly to tackle trolley waits and waiting lists for hospital admission.

The Department of Health said Ms Nixon will receive no pension or bonus payments. She will be paid travel and subsistence in Ireland but journeys to her home in Britain will not be paid.

Dr. Martin Connor, who was appointed in June 2011, to lead the work of the SDU for six months, subsequently got a three year contract worth €160,000 a year to work on a part time basis with the unit. This new contract was for an 80 per cent time commitment as he was also completing a research fellowship in Stanford University in the US. The Department said that he would be in Ireland for two weeks a month on average but would also conduct work by teleconference on a daily basis. He was a member of the Board of the HSE for some time, but during this period failed to attend six of the ten Board meetings.

Special measures for hospitals failing to meet targets

The new HSE Compstat system which is to be introduced shortly will provide much more detailed information on hospitals’ performances including  benchmarking against other hospitals. It will also provide for “special measures” against hospitals which fail to meet targets.

The comparative statistics will cover approximately 31 key performance indicators across activity, finance and resources in something approaching real time.

Compstat,  will replace Healthstat, which is due to be phased out over the coming months, will provide information  one month in arrears as opposed to Healthstat which is three months in arrears.

It is expected that the system will be web based and will enable hospitals to drill down by specialty and individual consultant.

Like Healthstat, it will have a red, orange and green traffic system. However, it will have an additional white traffic light which will be the signal for the introduction of special measures ranging from intensive support for the hospital up to changing the hospital’s management team.

It has not yet been  advised if there will be financial incentives or penalties in the new performance management system and, if so, what they will involve. At present, there are three  levels of support from the SDU with corresponding levels of autonomy linked to performance and confidence. Currently  hospitals which fail to reach their targets are financially penalised up to the tune of up to €25,000 per patient. . It is understood that the HSE is deferring collection of these penalties (which in the case of one hospital is believed to total over €1 million) until the end of September.

New Mater launched

Health Minister, Dr. James Reilly has officially launched the first opening phase of the new Mater Hospital in Dublin.

Dr. James Reilly, T.D.
Dr. James Reilly, T.D.

The new building includes a new Emergency Department (which is twice as large as the previous one) a larger outpatients department, 12 theatres, an ICU/HDU department, a radiology department and 120 individual ensuite rooms for patients. The building, which will be seven storeys, is due to be completed in the final quarter of this year.

The Minister was accompanied at the official launch by Sr. Helena O’Donoghue, Chair of the Mater Campus Hospital Development, Mr. John Morgan, Chair, Mater Misericordiae University Hospital and Mr. Donal Walsh, Chair of the Mater Misericordiae and the Children’s University Hospital, Temple Street.

Temple Street Researcher Wins Neil Buist Award

Karen Coss, a PhD student with the National Centre for Inherited Metabolic Disorders (NCIMD) at the Children’s University Hospital, Temple Street, Dublin, has been recognised with a prestigious research award by the US Society for Inherited Metabolic Disorders (SIMD).

Her research was carried out with Professor Eileen Treacy, NCIMD as the Principal Investigator and Co-Investigators, Dr. Peter Doran, Scientific Director of the UCD Clinical Research Centre and Professor Pauline Rudd, Head of the Dublin-Oxford Glycobiology Laboratory, NIBRT, Dublin.

Karen Coss
Karen Coss

Using gene analysis and glycomic studies, this novel research has shown that Galactosaemia is a modifiable secondary glycosylation disorder. With the aim of understanding the long-term complications associated with Classical Galactosaemia, Coss et al, Molec.Genet. Metab.2012, 105 (2), 212-20, illustrated the use of serum N-glycan analysis to optimise galactose modification and control in this partially treated metabolic disorder, proposed to improve future patient outcomes.

Karen received the Neil Buist Award for her presentation on this work at the annual meeting of the US Society in North Carolina earlier this month. The Neil Buist Award is presented annually by the Society to the student who gives the most outstanding presentation at the meeting. Karen was selected from 12 international award recipients on the basis of “an accomplishment which will change the course of the field”.

Gayle Kenney, Research Manager at Temple Street said “It is an outstanding achievement for an Irish researcher to be recognised among esteemed international colleagues. The standard was extremely high and we are delighted with the positive feedback, which reflects the world-leading research being carried out here at Children’s University Hospital.”

The National Centre for Inherited Metabolic Disorders is located at the Children’s University Hospital, Temple Street. It is the tertiary care referral centre for the investigation and treatment of individuals suspected of having a metabolic genetic disease in Ireland linked to the Newborn Screening Programme.

HSE National Director of Human Resources

Mr. Barry O’Brien has been appointed as HSE National Director of Human Resources, following the resignation of Mr. Sean McGrath.

Mr. O’Brien has 36 years experience in the Public Health System. Prior to taking up his new appointment, he was Assistant National Director of Human Resources, HSE South.

Barry O'Brien
Barry O'Brien

He was a member of the Health Sector Management Team that negotiated the Public Service Agreement. He previously worked on the Consultant Contract 2008 and was a lead executive for the Health Service Executive on its implementation.

Mr. O’Brien has a strong track record in delivering major change across a wide range of services and his team in the South are responsible for a number of precedent setting Labour Court recommendations, for example, relocation of services in excess of 45 kilometres and establishing the minimum period required for the information and consultation process. He was the chief negotiator for the amalgamation of all maternity services onto the Cork University Maternity Hospital Campus.

Adoption Authority Chief Executive

Mr. Pat Bennett has been appointed as the Chief Executive of the Adoption Authority, following an open public competition, conducted by the Public Appointments Service.

Mr. Bennett has many years experience in senior positions within the health and social services sector. His previous assignments have included extensive experience at senior level in both the acute hospital and community care services.

Pat Bennett
Pat Bennett

His most recent post was as Chief Executive of the Family Support Agency.

He was educated in St. Mary’s C.B.S. in Portlaoise, holds a Diploma in Hospital and Health Services Management from the Health Management Institute and is currently completing a Masters in Social Science in UCC.

Hospital takes top honours

The Children’s University Hospital, Temple Street, Dublin, has been recognised with two prestigious accolades at the 2012 Green Awards for its success in implementing a holistic approach to environmental management.

Temple Street was a finalist in both the Green Healthcare and Green Leadership categories, as well as making it into the top 10 of the 300 entries, ‘the best of the best’.

Stephen Wheeler, MD of Airtricity, presents the Green Leader Award to Padraig Ryan of CUH Temple Street
Stephen Wheeler, MD of Airtricity, presents the Green Leader Award to Padraig Ryan of CUH Temple Street

The hospital was honoured with the Green Healthcare Award for the structured approach that it has implemented over the past number of years towards environmental areas including waste, water and energy management.

Padraig Ryan, sustainability coordinator at Temple Street, commented, “We are delighted to be recognised for our continued hard work within this area. Over the last 12 months, the hospital’s sustainability agenda has continued to prosper. Our significant growth in terms of recycling and sustainable transport efforts has coincided with a reduction in gas and electricity consumption and also a reduction in the amount of waste being generated.”

Minister Jan O’Sullivan presents the Green Healthcare Award  to Padraig Ryan and Fergus Ashe of CUH Temple Street, Dublin
Minister Jan O’Sullivan presents the Green Healthcare Award to Padraig Ryan and Fergus Ashe of CUH Temple Street, Dublin

To add to this award, Padraig Ryan received the 2012 Green Leadership Award for his role in implementing and embedding a culture of sustainability within the hospital. He was commended for going that extra mile to promote the hospital’s sustainability agenda.

Mona Baker, acting chief executive officer at CUH, Temple Street, added “Padraig’s approach to embedding a culture of sustainability here at Children’s University Hospital has been an unprecedented success. The enthusiasm and tenacity which he brings to his role inspires others to engage with him. As a result of his hard work, the hospital has a better understanding of sustainability and is reaping the benefits associated with it. Sustainability has become a core goal of our organisation.”

Established in 1872, the Children’s University Hospital, Temple Street is a national facility.

Mental Health Commissioners appointed

Ms. Kathleen Lynch T.D., Minister for Disability, Equality, Mental Health and Older People has announced appointments to the Mental Health Commission for the period 2012 – 2017.

The new Commission will be chaired by Mr John Saunders, Director of Shine, the national organisation dedicated to upholding the rights and addressing the needs of all those affected by mental illness. The other members of the Commission include representatives of the medical, nursing, other health and legal professionals, voluntary bodies, mental health service users and the general public.

Minister Kathleen Lynch & Martin Rogan
Minister Kathleen Lynch & Martin Rogan

The Minister has appointed the following members:

  • Dr. Mary Keys, Lecturer, NUI Galway, (reappointed)
  • Dr. Michael Byrne, Principal Psychology Manager, HSE West
  • Dr. Maeve Doyle, Consultant Child & Adolescent Psychiatrist, Monaghan
  • Dr. Francis Xavier Flanagan, General Practitioner, Kildare
  • Ms. Pauline Gill, Principal Social Worker, National Forensic Service, Dublin
  • Dr. Anne Jeffers, Consultant Psychiatrist, Galway
  • Mr. Ned Kelly, Director of Nursing, Cork
  • Ms. Colette Nolan, Irish Advocacy Network
  • Ms. Catherine O’Rourke, Director of Nursing, Louth/Meath,
  • Ms. Patricia O’Sullivan Lacy, Barrister-At-Law, (reappointed)
  • Mr. John Redican, National Service Users Executive, (reappointed)
  • Mr. Martin Rogan, HSE, (reappointed)
  • Mr. John Saunders, Shine (reappointed)

The Minister said the Commission’s independent role was crucial in driving the agenda for change in the mental health service in the coming years.

The Mental Health Commission provides a process for the automatic review of all persons detained for care and treatment in approved centres. During the past five years over 9,200 Mental Health Tribunal review hearings have been held and the number of patients admitted to unsuitable psychiatric institutions has steadily declined.

Free GP Care

Ms. Roisin Shortall T.D., Minister of State for Primary Care has announced that the Government has given its approval to the preparation by the Department of Health of Heads of a Bill to progress the phased introduction of free GP care in line with the commitment in the Programme for Government.

Roisin Shortall
Roisin Shortall

She said it was envisaged that the first phase in the Programme would provide for the extension of access to GP services without fees to persons with illnesses or disabilities to be prescribed by regulations under the new legislation.

The Minister indicated that it was her intention that the legislation be drafted and enacted before the summer recess.

No change in screening guidelines

HIQA has advised the HSE that the cost of introducing repeat universal antenatal HIV screening in the third trimester is high compared to the expected benefits.

Therefore, HIQA has recommended that, at this time, there should be no change to the existing guidelines under which a single round of universal antenatal screening for HIV is offered at the time of first booking for antenatal care, with repeat testing offered throughout pregnancy to those who although their initial test is negative have an ongoing risk factors for acquisition of HIV.

The guidelines are due to be updated this year and Dr. Fiona Lyons, Consultant in Genitourinary Medicine at St. James’s Hospital, Dublin and Prof. Karina Butler, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, who developed the existing guidelines requested HIQA to undertake an economic evaluation of a potential new recommendation to introduce a policy of repeat universal HIV testing of pregnant women in the third trimester of pregnancy. This test would be in addition to the test performed at antenatal booking. The evaluation was to include cost-effectiveness analysis and a budget impact analysis. The purpose of the evaluation was to inform a recommendation and subsequent decision as to whether a change in the existing guidelines is warranted.

It was recognised that the existing recommended practice might not identify all women at ongoing risk, as there might be a small number of individuals who would initially test negative, but go on to seroconvert during pregnancy. The guidelines state that the mother to child transmission rate could be dramatically reduced by treatment of the mother and child, management of the delivery and the avoidance of breastfeeding. Therefore, the opportunity to intervene and reduce the number of infants who become HIV infected might be missed in this small cohort.

HIQA’s advice was:

  • Over a one-year period, in the absence of repeat universal antenatal screening for HIV in the third trimester, five infants would be exposed to HIV and one of these infants would become HIV-positive.
  • HIQA said that the introduction of repeat universal antenatal screening for HIV in the third trimester will on average, prevent one infection a year with the estimated discounted life years gained being 14.4 years.
  • The median incremental cost-effectiveness ratio is €66,278 (95 per cent CI: €42,369 – €101,089) per life gained.
  • The five-year budget impact is estimated at €6 million, with an average annual budget impact of €1.2 million, ranging from €1.25 million in the first year to €1.16 million by the fifth year.

HIQA said that the number of HIV-infected children born to women not previously known to be HIV positive as well as the prevalence of HIV in pregnancy should continue to be monitored.

Winner of outstanding achievement award

Cork based Mrs. Margaret Murphy,  of the WHO steering group of Patients for Patient Safety won the Pfizer Outstanding Achievement Award in Healthcare at the 2012 Biomnis Healthcare Innovation Awards.

The award was made in recognition of her work as a patient advocate and patient safety.

Mrs. Margaret Murphy
Mrs. Margaret Murphy

Following the death of her son as a result of medical error, Margaret Murphy has been actively involved as a patient safety advocate.   Margaret is the External Lead, WHO Patients for Patient Safety (a network of 200-plus patient safety champions from 51 countries with 19 collaborating organisations).

The focus of her work relates to seeing adverse events as having the potential to be catalysts for change as well as being opportunities for learning, identifying areas for improvement and preventing recurrence.

She promotes this viewpoint at local, national and international levels as an invited presenter to conferences, hospital staff and students.  Her area of particular interest is education as a vehicle to achieve sustainable culture change.

Viewed as a resource for including the patient perspective in a variety of initiatives and a range of fora, Margaret has been invited to partner and collaborate in the areas of:

  • Policy-making (Commission on Patient Safety & Quality Assurance and implementation steering group; member HSE National Risk Committee) ,
  • Standard-setting (HIQA working group)
  • Regulation (lay member, Irish Medical Council serves on policy committee and preliminary proceedings committee),
  • Education (Lectures to students UCC, Trinity, UHG, Queens)
  • Research (Collaborator on EU Handover Project, QUASER Project, currently reviewer of final stage applications for NIHR funding for Translation Research Centres in UK)..
  • Conference  speaker – often keynote (conferences, seminars, learning sets in  Ireland, UK,  Europe, US, Canada, Australia)
  • Critical incident reviews.

Mrs. Murphy told a recent Irish conference that every point of contact in the health service failed her son. She said her family were ”driven” down the litigation route, which they didn’t want, in an effort to arrive at the truth and gain an understanding of what had happened, “after being met with denial, collegiality, defensiveness and inappropriate behaviour”.

Award for Ennis General Hospital

The award for “Innovation in Quality Service Delivery-Hospital Based Service” went to Ennis General Hospital for their newly transformed radiology reporting service delivered by Global Diagnostics.

In April 2011, Ennis General Hospital partnered with Global Diagnostics to deploy an innovative teleradiology technology and a new clinical patient workflow.

Mairead Ruane, Ennis General Hospital, .Marie-Louise Butler, Global Diagnostics, Ansu Patel, Ennis General Hospital, Frank Keane, General Manager, Ennis General Hospital, Frances Fitzgerald T.D., Minister for Children and Youth Affairs. David Sheehan, CEO, Global Diagnostics, Sinead O’Connor, General Manager, Global Diagnostics Ireland, Dr Thomas Thiel, Global Diagnostics and Dr Michael Behan, Global Diagnostics pictured at the awards.
Mairead Ruane, Ennis General Hospital, .Marie-Louise Butler, Global Diagnostics, Ansu Patel, Ennis General Hospital, Frank Keane, General Manager, Ennis General Hospital, Frances Fitzgerald T.D., Minister for Children and Youth Affairs. David Sheehan, CEO, Global Diagnostics, Sinead O’Connor, General Manager, Global Diagnostics Ireland, Dr Thomas Thiel, Global Diagnostics and Dr Michael Behan, Global Diagnostics pictured at the awards.

Global Diagnostics works in close partnership with the Ennis team who manage the local patient engagement whilst Global provides the radiology support, workflow consultancy and reporting services.

In the first year of the new service:

  • Over 20,000 patients have benefited from the improved service.
  • Ennis General Hospital radiology department is fully digitised
  • Nine consultant radiologists, all members of Irish Specialist Register for Radiology, are now available to Ennis General Hospital seven days per week from 8am to 10pm
  • Average report turnaround time is now eight hours (previously ten days), with the A&E having an average report turnaround time of 45 minutes
  • Costs have been reduced by 29%

The partnership with Global Diagnostics and Ennis General Hospital is resulting in improved quality standards within the radiology service, faster turnaround times and a reduction in cost delivery.

Frank Keane General Manager, Ennis General Hospital stated “This was new, innovative and somewhat uncertain territory for a public hospital in the Irish healthcare system. At all times, we at Ennis General Hospital were committed to the project and our commitment was more than complimented by the drive and enthusiasm of David, Sinead and all the staff of Global. In our opinion, we now have an extremely robust, reliable, quality driven and cost effective solution in place for our patients, our hospital and the GP community we serve. The service continues to develop and grow and is proving to be an extremely viable solution for our service needs”

Winners of Biomnis Healthcare Innovation Awards

The 5th Biomnis Healthcare Innovation Awards took place on  Friday, May 18th, in the Burlington Hotel, Dublin.These awards recognised innovation and leadership within the Irish healthcare services across nine categories.

Judging panel member Dr. Deirdre Mulholland, Head of Standards and Methodology, HIQA said: “The Health Information and Quality Authority recognises and supports leadership and innovation in healthcare as important drivers in improving the quality and safety of care provided to patients. The high quality of all nominees reflects these qualities of leadership and innovation and we congratulate the finalists and the winners in each of the categories. The Authority also congratulates Margaret Murphy on winning a well deserved Outstanding Achievement award.”

Minister for Children and Youth Affairs, Ms.  Frances Fitzgerald, T.D., addressed the awards ceremony. She said: “Maintaining and improving our health is a key concern for us all. But providing a quality healthcare service requires both leadership and innovation. These awards play an important role in highlighting the importance of innovation in healthcare and the ongoing efforts to improve standards of care and patient safety while affording an opportunity to recognise and honour those already leading the way.”

2012 Awards Winners

  • The winner of the Health and Social Care Support Initiative is Dr. Joanne Nelson of the HSE and Cranmore Medical Ltd for the Children and Adolescent Sexual Assault Treatment Service (CASATS).
  • The winner of the Innovation in Quality of Service Delivery Award- Hospital Based is Frank Keane of Ennis General Hospital in recognition of the Hospital’s Radiology Service Transformation through Innovation.
  • The winner of the Innovation in Quality of Service Delivery Award – Community Based is the National Forensic Mental Health Service and the Irish Prison Service for the significant reduction in the use of ‘Seclusion (Isolation) Cells’ for vulnerable and mentally disordered prisoners detained in Mountjoy Prison by establishing a High Support Unit.
  • The joint winners of the Irish Technology or Products Innovation Award are Mr. Arun Thomas and Professor Thomas Lynch of Department of Urology, St. James’s Hospital, Dublin, for their Laser Assisted Laparoscopic Partial Nephrectomy for Localized Renal Cancer Programme, and John Hughes of Innovation Zed Ltd for the InsulCheck device for insulin pen users.
  • The winner of the Patient Safety Initiative is the HSE National Acute Medicine Programme for its National Early Warning Score & Associated Education Programme.
  • The winner of the Best Patient Groups/Support Organisations Category is The Irish Cancer Society for their Daffodil Centre Project.
  • The winner of the Best Health Promotion Project is the Irish Prison Service in partnership with the Red Cross for their Community Based Health and First Aid Prisons Project.
  • The winner of the Best Primary Care Centre Initiative is the GP co-op Caredoc CIT Team for their Carlow/Kilkenny Community Intervention Team.
  • Pfizer Outstanding Achievement Award in Healthcare is Margaret Murphy of the WHO Steering Group of Patients for Patient Safety, in recognition of her work as a patient advocate and her contribution to improving patient safety.