Healthy Ireland in the Health Services Implementation Plan 2015 – 2017 focuses on where the Health Services can take concerted and specific actions, at all levels to improve health and wellbeing and prevent the onset of disease, writes Sarah McCormack, National Programme Lead, Healthy Ireland, Health & Wellbeing Division.
The Plan builds on existing good practices, exploits the unique scale as the largest public body in the state, allowing it to capitalise on its influence, governance and decision-making, its powerful workforce, and the day-to-day interactions with everyone living in Ireland.
It identifies three strategic priorities:
- Building on the Health Services System Reform to embed health & wellbeing,
- Reducing the burden of chronic disease and self care management and
- Improving the health and wellbeing of our greatest asset, our workforce.
The plan sets out 126 actions, sixty of which refer to Hospital Groups and CHOs. Each Hospital Group and CHO are developing their own implementation plan for the delivery of these actions. HI Executive Leads and Project Managers are identified in a number of Hospital Groups.
The Saolta University Hospital Group was the first Hospital Group to launch its HI Implementation Plan in October 2014. The development of that plan and its ongoing implementation informed the development of subsequent plans. In June 2016 the UL Hospital Group launched its plan and in October 2016 Minister Corcoran Kennedy launched the RCSI Hospitals Group plan. The Ireland East Hospital Group plan is at an advanced stage of development.
In each hospital in these groups there are HI Leads and HI Implementation Teams in place who are spearheading this implementation. Work will continue with the remaining Hospital Groups for the development of their plans. In addition the Community Heath Organisation (CHO 4) Cork and Kerry has commenced the development of the first CHO Healthy Ireland Implementation Plan. Now all nine CHOs have new Heads of Health and Wellbeing at Senior Management Team meetings.
The implementation of HI aims to achieve “Making Every Contact Count” for lifestyle changes. Making Every Contact Count (MECC) is about health professionals using their routine consultation to empower and support people to make healthier choices to achieve positive long-term behaviour change. This approach will bring about a move to a position where discussion of lifestyle behaviour is routine, non-judgemental and central to everyone’s role. Underpinning this approach is the development of the National Behaviour Change Model which has four tiers – Brief Advice, Brief Intervention, Extended Brief Intervention and Special Interventions, together with the development of a National Self Management Support Framework for asthma, chronic obstructive pulmonary disease, diabetes and cardiovascular disease. The staff in the health services make millions of contacts each year with our population e.g. 3m clinical consultations and 1.43m procedures each year with 70,000 babies are born in our maternity services.
Health Services Staff Health & Wellbeing
The Health Service, being the biggest employer in the country, has prioritised the health and wellbeing of its 100,000 staff working across over 2,500 work locations. A number of policies have been developed for implementation which includes Smoke Free Campuses, Calorie Posting and Healthy Vending Machines. Eighty per cent of hospitals have commenced calorie posting with very positive feedback from the staff. Existing vending machines are being replaced with the 60/40 vending products where 60% are offering the healthy food choice. The advantages of physical activity are identified as a key requirement for health and wellbeing. A sedentary lifestyle is identified as being a key risk factor and physical activity now quoted as “the new drug”. The results from the recently launched Second National HI Annual Survey showed that on average people spend 6 hours 36 mins sitting in a day. To promote physical activity within the health service and leading by example, HI teamed up with the RTE Operation Transformation programme last year which encouraged staff to become more physical active. In September a HI Team with staff members from the Department of Health and across the health services cycled as a HI Team in the Great Dublin Bike Ride.
To promote staff initiatives to improve the health and wellbeing of staff, a 2016 health and wellbeing fund was established and proposals invited for staff initiatives. Funding was distributed to all successful Hospital Groups and CHOs for a variety of activities including stress management courses, mindfulness, physical activities, staff choirs, arts and standing desks. A number of evaluations accompany these activities so that evidence can be gathered on their wellbeing impact for staff.
The forthcoming National Healthy Workplace Framework will also strengthen the development of staff health and wellbeing, not just in the health services but in all work places.
Reducing Chronic Disease
The HSE has appointed National Policy Programme Leads for Alcohol, Tobacco, Sexual Health, Healthy Eating and Physical Activity and Healthy Childhood and will continue these appointments for other priority programmes such as Positive Ageing. In addition there is now a Head of Health and Wellbeing appointed to the Senior Management Team in each CHO area. These appointments will strengthen the focus on prevention to achieve the aims of HI. The programme leads work through service decisions to plan and translate government policy and strategy into health service priorities and actions.
The building of partnerships is highlighted in the HI Framework as Healthy Ireland is bringing together people and organisations from across the country into a national movement to address the social, economic and environmental factors that contribute to poor physical and mental health and to address health inequalities. A strong partnership is established with the Department of Housing, Planning, Community and Local Government. A representative from the HSE is a member of almost all of the 31 Local Community Development Committees (LCDCs). All of the recently published Local Community Development Plans (LECPs) include health elements for the improvement of health and wellbeing of their communities and we plan to build on this. This approach reflects a stated and shared commitment in Government and throughout communities to support people to be as healthy and well as they can.
The delivery of Healthy Ireland involves every part of the health service, and partners. It places a responsibility on each person to be aware of why change is needed and to be prepared to do things differently. It is a very challenging and important undertaking, and an essential process to secure the future for Ireland’s health services and our community at large. http://www.hse.ie/eng/health/hl/hi/