Sláintecare in Action highlights the latest projects and activities that are helping us to deliver the right care in the right place at the right time.
End of year report 2020 from Laura Magahy, Executive Director, Sláintecare
Laura Magahy, Executive Director, Sláintecare has recorded a video message to provide an update on the progress made during 2020 to implement Sláintecare and a look ahead to 2021.
Wicklow Frailty First Response Team - Shifting care of older people from hospital environments to their own homes
Patients with falls accounted for 20% of ambulance calls in the Wicklow area and almost all were being transported to their local Emergency Department. The Wicklow Frailty Project set out to flip the traditional system, by providing a skilled team to respond to calls involving older adults, they are bringing the expertise to the patients in their own homes.
SMILE – Supporting multi-morbidity self-care through Integration, Learning and eHealth
Caredoc, in partnership with NetwellCASALA at Dundalk IT and the Trinity Centre for Practice and Healthcare Innovation (TCPHI) at Trinity College Dublin are delivering the SMILE project funded by Sláintecare.
Sláintecare established a learning network in 2019 for the +100 Integration Fund projects. Sláintecare is working with IFIC Ireland and the HSE to develop a series of learning webinars to share stories of how initiatives and services supported by the Sláintecare Integration Fund have contributed to delivery of care to help vulnerable people stay well in their communities.
This learning will be of particular relevance for services provided for those most at risk of developing Covid-19. Many of the integration-funded projects adapted to delivering their care in innovative ways as a result of infection-control measures, introduced to avoid social contact.
Ahead of World No Tobacco Day 2020 the “Supporting Pregnant Women to Quit and Stay Quit” initiative has had its 100th referral since the Sláintecare supported integrated care programme was launched three months ago.
Expectant mums are this week endorsing the success of the “Supporting Pregnant Women to Quit and Stay Quit” programme as being an illustration of Sláintecare’s aim to deliver the right care, in the right place and at the right time.
75% decrease in loneliness among the elderly thanks to AgeWell programme
AgeWell is an award-winning innovative new model of integrated care, supporting older people to remain safer and healthier in their own homes. It does this by building a relationship with each older person at home, realising that one size does not fit all, and that trusting, effective relationships are built slowly and with sincerity and care.
In the eighteen months since its inception, 75% of its clients have reported a decrease in feelings of loneliness, and of the 25% deemed to be at risk in March 2018, today no client is regarded at risk. Since 2018, 255 clients have received a total of 5,500 visits. AgeWell won a Social Innovative Award in 2018.
Beating Breathlessness - Nurse led WhatsApp support for Asthma improves self-management of condition
“Beating Breathlessness”, an Integration Fund project funded by Sláintecare and delivered by the Asthma Society, is providing easily accessible support, education and information to people with Chronic Obstructive Pulmonary Disease (COPD) and asthma.
Beating Breathlessness is a six-week self-management support programme delivered through text as well as a personalised nurse-led instant messaging service delivered through the WhatsApp platform. Beating Breathlessness will help people better understand and manage their condition.
Pathfinder Service - A new way to care for elderly people making 999 calls
At present all patients attended to by the National Ambulance Service are transported to
the Emergency Department (ED), unless the patient refuses transport to an emergency department.
An emergency department stay of more than 12 hours increases an inpatient’s length of stay by 2.35 days. In 2018, 9,861 patients aged 75 years and over presented to Beaumont Hospital’s ED, and approximately 50% of those patients were admitted, with an average length of stay of 17 days.
Presentation to emergency departments for elderly people increases the risk for elderly patients of experiencing an adverse event, such as pressure ulcer, infection, adverse drug event, functional decline, delirium or a fall. It can result in patient dissatisfaction, increased hospital length of stay, increased confusion and increased mortality.
More than 180 people gathered over three days from the 2nd to the 4th of March in the Department of Health to meet for the second get together of the Sláintecare Integration Fund Learning Network. This engagement took place over three days in order to meet with projects on a thematic basis, based on feedback from December’s event.
The themes of each of the days were as follows:
Monday 2nd March: “Innovations in shifting care to the community or providing hospital avoidance measures”.
Tuesday 3rd March: “Best practice and processes for chronic disease management and care of older people”.
Wednesday 4th March: “Promote the engagement and empowerment of citizens in the care of their own health”.
The first half of each day was focussed on projects getting updates on evaluation, communications, and supports available to them through the Network such as International Foundation for Integrated Care (IFIC) resources and the HSE’s Change Management Guide.
The second half of each day was then dedicated to networking among projects, and building resilience as “change-makers”.
Many Integration Fund projects presented over the three days, including those working on pain management education, care pathways, multi-morbidity self-care, “living well”, student sexual health, community mental health, and inclusion health with homelessness.
Integration Fund Learning Network March 2020 Presentation Pack
Social needs such as depression, anxiety and loneliness are the reason for roughly 20% of visits to healthcare professionals in Ireland. Isolation and the lack of a close network can also be the reason for delayed discharge from hospital and other healthcare settings. An increasing number of GPs are now referring patients to Social Prescribing programmes that help them with complex health conditions, as well as social isolation, anxiety, loneliness and other issues.
Sláintecare is supporting seven Social Prescribing programmes all over Ireland through the Integration Fund, they are based in Dublin, Waterford, Cavan, Monaghan, Sligo, Leitrim, Wicklow, Cork and Kerry.
Adrienne Dempsey is a Social Prescriber from the Fatima Groups United Family Resource Centre’s Dublin 8 Social Prescribing Project who sits in the Rialto Medical Centre. Support from the Sláintecare Integration Fund means that Adrienne is on site in the medical centre to meet patients, explain the variety of activities and supports available to them, and what the opportunities and benefits are. Before this, GPs at the centre could refer patients to the programme, but in general a lot of people did not follow up on the referral.
Around 55% of the people Adrienne meets are now taking part in activities run by the Social Prescribing project. Participants range in age from 23 to 87 years of age, and are about two thirds female and one third male. The main issues Adrienne is helping people to deal with are: a lack of social interaction; anxiety, depression and stress; and healthy eating and exercise.
There is a big focus on health and wellbeing activities, with yoga, meditation, pilates and other exercise classes on offer, as well as cooking, digital literacy, and arts and crafts.
Dr. Susan Smith is a GP working in Inchicore and is involved in the Link Workers Social Prescribing project, which is focused especially on patients in deprived areas.
Dr Smith said:
“Patients who live in deprived areas have worse health outcomes, and they develop chronic diseases earlier than the rest of the population. This project empowers GPs to work more effectively within their own communities.
"Sláintecare is about addressing health inequalities, integrating health and social care, and using all available supports to improve patient outcomes”.
Waterford Social Prescribing Service, funded by Sláintecare and run by the Sacred Heart Family Resource Centre, now has two full time Social Prescribers, who hit the ground running last November. One covers the Waterford City area and one covers Waterford County.
The Waterford Social Prescribing programme is also linking people in with other Sláintecare funded projects in the area. Patients have been referred to the Living Well programme, which is a six-week course that supports people to manage chronic health conditions such as arthritis, diabetes, heart conditions.
Social Prescribing addresses many of the goals of Sláintecare. Social Prescribing shifts care to the community and increases supports to people with chronic diseases, those who are feeling vulnerable, isolated and lonely as well as those who are frequent attenders at GPs. It creates opportunities for people to get involved in caring for their own health and wellbeing, it deepens links between community and medical care, and it reduces the need for people to seek medical appointments with either their GP or to attend hospital for care for their chronic conditions.
Budget 2019 provided €20 million for the establishment of a ring-fenced Sláintecare Integration Fund to test and scale how services can best be delivered.
The aim of the funding is to support the delivery of services which focus on prevention, community care and integration of care across all health and social care settings.
The 122 successful Sláintecare Integration Fund projects show how joined-up thinking and working in partnership can help us reach Sláintecare’s goals of shifting the majority of care to the community, reducing waiting lists and improving experiences for patients and staff across the health and social care system in Ireland.
Joined-up Thinking Around Care for the Older Person
The population of Ireland is ageing. While people living longer is a very positive sign of improving health among the population, older people are the largest users of the healthcare system. People aged 65 and over make up 12.7% of the population and 53% of hospital stays, while people aged 85 and over represent 1.4% of the population and make up 13.5% of hospital stays.
Sláintecare wants to provide as much care as possible as close to home as possible, meaning that people should only have to go to hospital when absolutely necessary. The HSE Integrated Care Programme for Older People has the same goals, especially for older people, and wants to move away from hospital stays because of illness, towards continuous and long-term care as close to home as possible.
The Integration Fund is supporting projects that help older people to access more care in their community, either through their GP, their Local Health Centre, Primary Care Centre, or from other health and social care, and community and voluntary services. These projects focus on caring for the person and joining up services between hospitals and in the community, so that people can stay healthy in their communities for as long as possible.
One of these projects is focusing on providing care for older people in their communities in the Cork City area, preventing illnesses that result in people having to attend hospital, and encouraging people leaving hospital to be cared for in the community. “Urgent Ambulatory Care and Virtual Ward for the Older Person in Cork City”, is run by Cork Kerry Community Healthcare. This project is working to provide an alternative for older people having to go to the Emergency Department or be admitted to hospital.
ALONE B Connect, which also receives support from the Sláintecare Integration Fund links healthcare, social care and community care together. The project uses technology to help older people better manage their own health and wellbeing, to come home from hospital quicker and to remain living independently at home. ALONE B Connect also provides training in the technology to older people and their families, and works with community and voluntary organisations to help them improve their service through using technology.
Siobhán Kennelly, National Clinical Advisor and Group Lead for the HSE’s Integrated Care Programme for Older People says:
“These projects really promote joined-up thinking around care for the older person, and put the older person at the centre of their work. This will have positive effects on the health and wellbeing of the older person and their families, as well as the hospital system”.
Together these projects will benefit the older person who will receive more care at home or in their community, and avoid unnecessary hospital admission, or allow them to have shorter hospital stays. Thanks to reduced Emergency Department attendance, hospital admissions and shorter hospital stays the health system will also benefit.
Supporting Pregnant Women to Quit Smoking
For women who are pregnant or planning to become pregnant, stopping smoking is the single most important thing they can do to protect their health and the health of their baby. Smoking, and smoking among pregnant women, is a major cause of health inequalities in Ireland. Health Inequality means that there is a five-year difference in life expectancy between the richest and poorest people.
Smoking while pregnant leads to the risk of low birth weight babies, complications in birth, and other complications in pregnancy. Women who quit smoking during pregnancy and beyond have an increased life expectancy and improved physical health, as well as the benefit of bringing their baby to a smoke-free home.
“Supporting Pregnant Women to Quit and Stay Quit”, run by Southeast Community Healthcare (SECH) is supported by the Sláintecare Integration Fund and will help everyone involved in the journey of the pregnant woman to stop smoking.
Healthy Ireland, Tobacco Free Ireland, and the National Maternity Strategy share the goals of this project. The Sláintecare Integration Fund is supporting projects that help people to learn more about their own health and to take simple and practical steps to take care of their health and wellbeing.
Quitting smoking in pregnancy is difficult but can be achieved when the right services are available. This project will deliver the support the woman needs, without judgement. The pregnant woman is at the centre of this project. Every health and social care provider the woman comes into contact with during her pregnancy, from GPs to Midwives and Maternity Hospitals, to Family Resource Centres, and pharmacists are supported to help the woman to quit and stay quit.
Members of the team will be trained to refer into dedicated smoking cessation clinics. These clinics will be established in each county in SECH in accessible primary care centres for the Pregnant woman and her extended family. One-to-one intensive smoking programmes are delivered by a Sláintecare funded Smoking cessation officer as part of a six -week program.
“Supporting Pregnant Women to Quit and Stay Quit” will have a positive impact on the pregnant woman herself, her child and family, as well as the maternity services and the wider healthcare system. These positive impacts include:
A healthy baby
A healthy mother who lives a good quality life free from chronic diseases
Supporting smoke free environments for children to live and grow in.
More disposable income for the pregnant woman and her family
Baby has reduced need for health care, suffers less chronic diseases
Compliance with Maternity Service standards of care
Improvements in the provision of quality health care
Breaks the cycle of addiction
To find out more about quitting smoking visit: www.quit.ie or Freefone 1800 201 203
For information about “Supporting Pregnant Women to Quit and Stay Quit in South East Community Healthcare” please contact:
David Phelan, Smoking Cessation Officer, Health Promotion, St Catherine’s Hall,
Kate Cassidy, Senior Health Promotion Officer, Health & Wellbeing, St Catherine’s Hall, Waterside, Waterford. Email: Kate.cassidy@hse. Mobile: 087 6529847
Sheds for Life-Improving Health and Wellbeing for Men in Their Own Communities
Men experience poorer health outcomes compared to women, particularly those in harder to reach groups, who are least likely to engage with health services and programmes.
One of the aims of the Sláintecare Integration Fund is to help people to take care of their own health and wellbeing, through simple and practical actions, as well as making it easier for people to access services to improve their health and wellbeing.
Sheds for Life, funded by the Sláintecare Integration Fund, and run by the Irish Men’s Sheds Association (IMSA), is a community-based health promotion programme aimed at addressing some of the serious health inequalities that exist for men in Ireland. The programme works to support the physical, mental and social wellbeing of men’s sheds members.
Sheds for Life will help men participating in the programme to better manage and improve areas of their life that will have a positive impact on their health and wellbeing. Members will take part in exercise and walking programmes, cooking and nutrition activities, digital literacy training and dental health workshops. Members will also have access to Heart Disease and Cancer screening, and Diabetes prevention and management workshops, these will all take place in a community based, non-medical environment, which makes it easier for members to access.
Based on the success of previous Sheds for Life programmes, The Irish Men’s Sheds Association will expand the programme to Counties Leitrim, Roscommon and Meath in 2020 thanks to Sláintecare funding.
Muriel Farrell of the Sláintecare Office said:
“It is fantastic to see a recipient of the Sláintecare Integration Fund provide such a targeted and beneficial programme that is in line with Sláintecare’s objective of promoting the engagement and empowerment of citizens in the care of their own health.
"Sláintecare Integration Funding will support the delivery of over 400 follow up health checks with participating sheds across the 2019 Sheds for Life programme while also assisting with the expansion of the 2020 programme to sheds across counties Leitrim, Roscommon and Meath.”
Over 200 men will benefit directly from Sheds for Life in 2020 through programmes and workshops, while 600 men will be reached through health screening (400 follow-up screenings from 2019, and 200 participants from new Sheds in 2020).
The positive effects on members will be measured through walking minutes, physical activity, changes in wellbeing, mental health, dietary knowledge and behaviours and knowledge in specific areas covered by the programme. These will be assessed and measured at the beginning and end of the programme.
A full evaluation of Sheds for Life is currently underway in partnership with the Irish Research Council, Waterford Institute of Technology and the National Centre for Men’s Health at IT Carlow, as well as a range of other major health organisations.
Right Care Right Place Right Time for Student Sexual Health in Athlone Institute of Technology
Image: Student Sexual Health in Athlone Institute of Technology
Athlone Institute of Technology (AIT), with support from the Sláintecare Integration Fund, has launched a comprehensive student sexual health service to meet the needs of its growing student population – 61% of whom are aged 18-24 and are classified as ‘high risk’ for sexually transmitted infections (STI).
This innovative pilot project is being delivered directly to students on campus, reducing the substantial medical, non-medical and economic costs associated with STIs. The project is also addressing the general upward trend in STIs, where the biggest risk groups are those aged under 25 and men who have sex with men. The service opened for appointments in late January and was inundated immediately, with over 120 enquiries for appointments in the initial days.
The project is led by Institute Nurse and Health Centre Coordinator Laura Tully, who has advocated for a service for students for many years.
“Previously, students faced travel times of up to an hour to find a specialised sexual health service, 90% of those referred simply did not attend those clinics and many presented inappropriately to emergency rooms or out of hours GP services. This project epitomises the Sláintecare vision, students now have access to an equitable, accessible service based on need right within their own campus community, and they can access the right care, in the right place, at the right time.”
Debbie Marshall, Registered Advanced Nurse Practitioner in Sexual Health has been appointed by the Institute to deliver the nurse led service to students for the duration of the project and will be supported by a specialist doctor weekly.
“Students feel this is a much needed service, and has integrated into the student health service seamlessly. I can already see the positive impact the service is having for students. I am confident we will enhance sexual health and promote positive health outcomes which can be sustained far into the future.”
This project will ensure that students can access comprehensive and age-appropriate sexual health education and information, and will have access to appropriate prevention and promotion services. This will ultimately encourage the development of a healthy sexuality throughout life; enhance people’s lives and relationships; reduce negative outcomes such as STIs and crisis pregnancies and create an environment that supports sexual health and wellbeing. The service is being delivered in line with the aims of the HSE National Sexual Health Strategy (2015-2020) and the Healthy Ireland Framework (2013-2025).
Kick-Off meeting for Integration Fund Learning Network
Image: Sláintecare Integration Fund Athlone December 2
The Sláintecare Integration Fund Learning Network launched on Tuesday last (10th December) at an event in Athlone.
The aim of the event was to get the successful projects together to kick off networking, sharing information and learnings among the projects, as they begin project implementation.
More than 200 people gathered to learn about the work of other projects, how they are delivering the right care in the right place at the right time, and share ideas and experiences. Integration Fund projects working on Youth Social Inclusion, Integrated Foot Protection, and a Network for Self-Management Support of Chronic Diseases presented their projects.
Sláintecare wanted to hear how we can support projects through the Learning Network, and projects gave very valuable input through a number of workshops.
The HSE’s Integrated Care Programme for Older People presented on the challenges and some insights on implementing Integrated Care, and the International Federation on Integrated Care presented on the added value of sharing learnings and networks.
Gráinne Healy, who chaired the event, delivered closing remarks capturing the positivity and energy in the room, encouraging participants to network with each other and harness the power and experience of existing networks.
The projects will begin implementation in 2020 and we will hold our next Learning Network Event in March 2020.
Sláintecare and Community and Voluntary Sector Gather to Discuss Opportunities
Image: Sláintecare and Community and Voluntary Sector gather to discuss opportunities
Minister for Health Simon Harris T.D. today welcomed over 80 Community and Voluntary organisations, representing thousands of Community and Voluntary workers at a conference on Sláintecare. The aim of the conference was to discuss Sláintecare and its implications for the work of the Community and Voluntary sector in health and social care.
Minister Harris said:
“The Community and Voluntary sector is vital to the delivery of integrated care, as close to home as possible. That is why we are meeting with the sector today to hear their views on Sláintecare, and what role the Community and Voluntary sector can play as we work together over the coming years to deliver Sláintecare.”
Recognising the important role of the Community and Voluntary sector in the delivery of health and social care services as well as support services, the conference was an early opportunity to connect with the sector in order to gather their views and opinions on Sláintecare.
Laura Magahy, Executive Director of Sláintecare opened the conference with Bridget Johnston, Chair of the Health Reform Alliance, co-organiser of the conference, providing an update on Sláintecare progress to date. The vibrancy and diversity of the sector was acknowledged as one its greatest strengths in contributing to the delivery of Sláintecare, where reaching people in their communities is key.
Laura Magahy said:
“This is a very important opportunity for Sláintecare as we enter the initial design phase of the Regional Integrated Care Areas. The Community and Voluntary sector are bringing Sláintecare alive every day, and they are a crucial link between patients and service users. Hearing from those who are providing services and delivering care as part of the broader health and social care system is vital to the implementation of Sláintecare”.
Sara Burke delivered her reflections on Sláintecare from a policy and research perspective. Some of her top messages included the importance of population based planning and the positive difference this can make to how care is delivered in the context of the new Regional Integrated Care Areas.
Gráinne Healy, an expert in citizen engagement, cited the All-Party Oireachtas Committee on the Future of Healthcare Sláintecare Report on the importance of Citizen Engagement to the success of Sláintecare. With the community links of the participating organisations, engagement was highlighted as a key opportunity for the sector in the implementation of Sláintecare.
Conference participants, some of whom are also successful Integration Fund Projects presented their project objectives, benefits and expected outcomes, and how they will contribute to the delivery of Sláintecare’s goals. The organisations cover areas such as Mental Health, Positive Ageing and chronic conditions.
The Minister concluded:
“I would sincerely like to thank all participants for their commitment to Sláintecare in coming here today and providing valuable input. The Community and Voluntary sector are key stakeholders for us in the Sláintecare journey, and I look forward to continued engagement”.
Image: Minister for Health announces €20 million funding for 122 Sláintecare projects
One hundred and twenty-two successful Integration Fund Projects were announced by Minister for Health Simon Harris TD, on 16th September 2019.
The €20 million fund was committed in Budget 2019 to test and scale ideas that demonstrate the Sláintecare goals of the right care, delivered in the right place and at the right time.
Speaking at the launch of the Integration Fund, Minister Harris said:
“The successful Sláintecare Integration Fund projects are leading examples of how innovative thinking can bring about meaningful and long-lasting change to health and social care in Ireland."
“These projects show how joined-up thinking and working in partnership can help us reach Sláintecare’s goals of shifting the majority of care to the community, reducing waiting lists and improving experiences for patients and staff across the health and social care system in Ireland. I look forward to seeing the end results of these projects and how they might be scaled up.”
The successful projects are in more than 100 locations right across the country. The project partners range from hospitals, hospital groups, Community Health Organisations, Community and Voluntary Organisations, Universities and Primary Care Centres.
Many successful projects will be delivered in partnership between hospitals and community organisations, highlighting the emphasis on integrated care and shifting care to the community.
The Minister made the announcement in Fatima Groups United Family Resource Centre, who were successful with their project “Dublin 8 Social Prescribing Project”. The project will strengthen the links with the existing healthcare practitioners in health and social care services, expand community programmes that respond to people’s needs within the area, covering issues such as stress and anxiety, exercise and healthy eating, education, and social Integration.
The project will also deliver a comprehensive evaluation that illustrates the need for social prescribing on a national basis.
More information on the projects will be available once contracts for all projects have been concluded. Keep an eye on our Twitter
List of successful projects for the Sláintecare Integration Fund
Successful applicants for the €20 million Sláintecare Integration Fund.
On 17th July 2019, a major step towards the restructuring of our health services was announced. This restructuring will ultimately establish six new regional health bodies, which will be responsible for planning and delivering health and social care in their regions.
The new regional health areas are in line with recommendations made in the Oireachtas Committee on the Future of Healthcare Sláintecare Report (2017), that regional bodies should be responsible for the planning and delivery of integrated health and social care services.
The proposed six regional health areas are based on population data, including how people currently access health services, as well as a public consultation.
This population-based approach will allow us to hear from the people in each region and ensure that an emphasis is placed on preventing sickness, keeping people healthy in or near their own homes for as long as possible and ensuring that excellent hospital care is available in a timely way, where necessary.
While the HSE will continue to be the central executive with responsibility for planning and strategy, restructuring will mean health regions will have greater autonomy to make decisions at a local level. Regional health bodies will have their own budget based on local population needs. This will enable the delivery of people-centred health and social care as well as supporting improved accountability and transparency.