REGIONAL HEALTH FORUM WEST 26 th November 2013 QUESTIONS & RESPONSES

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1 REGIONAL HEALTH FORUM WEST 26 th November 2013 QUESTIONS & RESPONSES NUMBER QUESTION RAISED BY Pg No. W48Q1239 Budget 2014 Cllr Brian Meaney 2 W48Q1240 Financial allocation St Joseph s Nursing Home complying with HIQA Standards Cllr Brian Meaney 2 W48Q1241 Human Papillomavirus School Immunisation Cllr Brian Meaney 2 W48Q1242 Older Doctors Cllr Brian Meaney 2 W48Q1243 Mammography Radiographers in HSE West Cllr. Sean McManus 3 W48Q1244 Capital Building Programme for UHG/Merlin Park Cllr Padraig Conneely 3 W48Q1245 Outstanding Insurance claims Cllr Padraig Conneely 3 W48Q1246 Publications into death of Savita Halappanavar Cllr Padraig Conneely 3 W48Q1247 UHG/Merlin Park staff on suspension with pay Cllr Padraig Conneely 4 W48Q1248 Impending Cuts Cllr Tom McNamara 4 W48Q m additional allocation to Psychiatric Services Cllr Tom McNamara 4 W48Q1250 Appointment of Rheumatologist at Mayo General Hospital Cllr Annie May Reape 4 W48Q1251 Opening of refurbished Dialysis Unit at Mayo General Cllr Annie May Reape 4 W48Q1252 Treatment of sepsis in adults and underage patients Cllr. Sean McManus 5 W48Q1253 Consultant Radiologist at Nenagh Hospital Cllr. John Carroll 5 W48Q1254 Number of medical/support staff transferred from Nenagh Hospital Cllr. John Carroll 5 W48Q1255 HIQA visits to Mid West Hospitals Cllr. John Carroll 7 W48Q1256 HIQA visits to Elderly Residential Care in Mid West CNU s Cllr. John Carroll 9 W48Q1257 Plans to re locate services away from Letterkenny General Cllr. Michael McBride 10 W48Q1259 Grove Hospital Tuam Cllr. Shaun Cunniffe 10 W48Q1260 Costs for unused Grove Hospital Cllr. Shaun Cunniffe 10 W48Q1261 HSE West deaths of children in care Cllr Laurence Fallon 11 W48Q1262 Stroke like condition at Portiuncula Hospital Cllr Laurence Fallon 11 W48Q Budget Cllr Laurence Fallon 12 W48Q1264 Orthopaedic & Neurology Outpatients list Cllr Laurence Fallon 12 W48Q1265 Merlin Park Campus Cllr Laurence Fallon 12 W48Q1266 Planning permissions for GUH Cllr. Catherine Connolly 13 W48Q1267 Aras McDara Compliment of Beds Cllr. Catherine Connolly 13 W48Q1268 Physiotherapy Services in Galway community Cllr. Catherine Connolly 13 W48Q1269 Waiting lists West/North West hospitals Cllr. Catherine Connolly 14 W48Q1270 Re build at Letterkenny General Hospital Cllr Ciaran Brogan 15 W48Q1271 Progress on new Community Hospital for Letterkenny Cllr Ciaran Brogan 16 W48Q1272 Medical/GP cards in Donegal compared to 2010 Cllr Ciaran Brogan 16 LATE QUESTIONS W48Q1273 Corrandulla Health Centre Cllr Mary Hoade 17 W48Q1274 Orthodontic waiting time for children in Galway Cllr Mary Hoade 17 W48Q1275 Dental/vaccinations provided in Primary School Cllr Mary Hoade 17 1

2 NUMBER QUESTION RAISED BY W48Q1239 With confirmation that 666 million is to be taken out of the Health Department s Budget in 2014, the adjustment to include a review of medical cards aimed at saving 113 million, and 268 million in pay related savings, how does the HSE west propose to meet these targets. What criteria are being used to reassess medical card entitlement in the HSE West? Cllr Brian Meaney The HSE is in the process of completing the National Service Plan for 2014 and financial allocations will also be finalised as part of this process. Gerry O Neill, RDPI W48Q1240 What financial allocation is proposed to facilitate St Josephs Nursing Home Ennis complying with HIQA standards? Cllr Brian Meaney St. Joseph's Hospital, Ennis is one of a number of public facilities for the provision of care for older people across the country. National plans are being developed by the HSE in consultation with the Department of Health regarding the built environment, and in particular those aspects which will not be compliant with the regulations. A range of options from partial new build on the existing site and refurbishment of the remainder to a complete new build, either on the existing or a new site are all possibilities. No decision has been made in respect of this. Recent references to a 40m requirement were not made by the HSE. There is currently no capital allocation specific to St, Joseph's Hospital. Bernard Gloster, Area Manager, Mid West PCCC W48Q1241 Having regard to the changes in sexual habits in Irish society, what is the view of the HSE in extending the Human Papillomavirus School Immunisation Programme to boys as is the practice in Australia? (For information ) Cllr Brian Meaney The Human Papillomavirus HPV Chapter of the 2013 Immunisation Guidelines was published in September 2013 and states: "HPV4 vaccine may be given to males from 9 to 26 years and should be considered for men who have sex with men (MSM), those who are HIV infected and post Haematopoietic stem cell transplant (see Chapter 3) to protect them from genital warts." There is currently no recommendation for universal vaccination of boys (and no budget yet to provide HPV vaccine to MSM, HIV infected or post HSCT). Our uptake rates for completed 3 dose vaccine courses for girls in 1st year (86%) and 6th year (72%) exceeded the targets set. Dr Diarmuid O Donovan, Director of Public Health W48Q1242 Are older Irish doctors six times more likely to pose a risk to patients? style/health and families/health news/older doctors are six times more likely to pose a risk to patients html Cllr Brian Meaney The Medical Council in Ireland (the body that regulates doctors in Ireland) have advised that this type of information is not available at present in Ireland. Dr Diarmuid O Donovan, Director of Public Health 2

3 W48Q1243 To ask the HSE for an up to date report on the current situation regarding training of new mammography radiographers by the HSE West. This report to include details of how many persons have finished such training and commenced work for HSE West, where they are located, how many are currently in training, when this current tranche of training will be finished and will one of these newly trained mammography radiographers be assigned to Sligo Regional Hospital. Cllr Sean MacManus As part of the on going commitment to improve access to mammography services, training has been offered to staff. 2 radiography staff commenced training in September 2012, however, due to personal commitments one was unable to continue the training; the other staff member has since completed the training. In September 2013 one Radiographer commenced Mammography training, as this training programme take approximately one year to complete, it is expected that they will complete in Summer To date there are 4 mammography trained whole time equivalents, however they are not exclusive to Mammography as they also participate in the on call roster in the General Radiology department to maintain their general radiology skills. W48Q1244 What is the current status of the Capital Building Programme for UHG/Merlin Park starting dates and cost of same? Cllr. Padraig Conneely As agreed, a presentation on Merlin Park Hospital will take place at the next Regional Health Forum West Committee on 17th December The presentation will provide details on this query and all related queries on the Hospital and its environs. W48Q1245 What is the current outstanding amount due to UHG/Merlin Park and the total amount outstanding to the West/North West Region from Private Health Insurance companies, and the total amount of claims awaiting signatures of Consultants? Cllr. Padraig Conneely The total amount outstanding in Private Health Insurance Claims for West/North West Hospitals Group at the end of September 2013 is 20,377m and the total amount for claims awaiting Signatures of consultants in WNWHG is 12,839m The amount outstanding to UHG and Merlin Park in Private Health Insurance Claims at end of September 2013 is 17,873,307. The total amount of claims awaiting signatures of Consultants (UHG/MP) at end of September 2013 is 5,527,963m. W48Q1246 Following the publication of three reports into the death of Savita Halappanavar (1) Inquest (2) HSE Clinical Review (3) HIQA Report. Has any disciplinary action been taken by UHG on foot of these damming reports, and what recommendations made in the reports have been implemented at UHG? Cllr. Padraig Conneely Statement to issue. 3

4 W48Q1247 How many staff (and for how long) are currently on suspension from UHG and Merlin Park and is full pay still been paid? Cllr. Padraig Conneely The Disciplinary Procedures for Employees of the HSE 2007 provides for the imposition of the sanction of Suspension without pay under Stage 4 of the process. It is only used in appropriate circumstances and after the provisions of the disciplinary procedure have been followed. There is a provision under a number of HSE procedures and policies including the disciplinary procedure and Trust in care, to place an employee on protective leave. This provision is usually availed of when alternatives are either not appropriate or not available. The purpose of this provision under the disciplinary procedure is to allow an investigation to proceed. It does not presuppose wrong doing on the part of the person who is placed on protective leave. It therefore not a sanction. Employees continue to receive full pay while on protective leave. The detail of the numbers of staff currently on either protective leave or suspension is not a matter appropriate to the Regional Health Forum. W48Q1248 In light of the impending cuts to the health services in Ireland for 2014 can the HSE West give an assurance to the people of the HSE West area that patient care will not be compromised as a result of these cuts? Cllr. Tom McNamara The HSE is in the process of completing the National Service Plan for 2014 and financial allocations will also be finalised as part of this process. Gerry O Neill, RDPI W48Q1249 Following the additional allocation of 35m for developing psychiatric services in 2012; (a) How much of this money was spent in the HSE West Area. (b) How many new community psychiatric posts were created as a result of this allocation in the HSE West area? Cllr. Tom McNamara (a) 7.279m (Note: This money was allocated to HSE West. Spend linked to recruitment of posts) (b) 95 additional community posts allocated to the HSE West in 2012 Gerry O Neill, RDPI W48Q1250 What is the delay in the long awaited appointment of the rheumatologist at Mayo General Hospital? The people in Mayo have been waiting a long time for this promised appointment to commence. Annie May Reape A new Consultant Rheumatologist commenced in July The consultant is based in Merlin Park Hospital and has a sessional commitment of 9 hrs to Mayo per week. At present she is developing her service in the regional Rheumatology service in Merlin Park which covers Mayo. W48Q1251 Can the delay in the opening of re furbished Dialysis unit at Mayo General hospital be explained? It is causing immense hardship to the Patients who require this service. Can you give a date? Annie May Reape 4

5 The new Renal Dialysis Unit has been completed and has been handed over to the hospital. The validation and commissioning of the Water Treatment and Reverse Osmosis (RO) plant is continuing. It is expected that this process will be completed in early December 2013 with a scheduled opening date of Monday, 9th December W48Q1252 To ask what steps the HSE West have taken over the past 4 years to identify and treat sepsis in both adult and underage patients presenting to health providers across this region. Please outline the guidelines put in place for the identification and management of sepsis in all age groups and the clinical governance arrangements and training put in place to deal with sepsis infections and if such arrangements are considered adequate or if steps are now been taken to update and improve how identification and treatment of sepsis is carried out throughout the region. Cllr Sean MacManus All hospitals in the West/North West Hospital Group have policies in place, for the management of sepsis. The National Early Warning Score (NEWS) has been introduced to all hospitals in the group. NEWS is a simple guide used by hospital nursing & medical staff to quickly identify and determine the degree of illness of a patient and to quickly recognize and respond to patients whose condition is rapidly deteriorating. The ISBAR (Identify, Situation, Background, Assessment and Recommendation) communication tool has now been implemented, to complement the NEWS. This tool allows for clear concise structured communication between clinicians. W48Q1253 Consultant Radiologist at Nenagh Hospital is due to retire at end of Nov 2013: Please advise date for replacement? Cllr John Carroll Dr Darby's retirement date is 31st January We are initiating the process of recruitment of his permanent replacement for UL Hospital Group and are seeking a locum replacement in the interim. Ann Doherty, CEO, UL Hospitals W48Q1254 Please advise Total Number of Medical / Supporting Services with relevant staff reductions discontinued or transferred from Nenagh Hospital since January Cllr. John Carroll The following staff have transferred from Nenagh Hospital since January 2010, o o o o o Consultant Cardiologist transferred to Limerick together with his team i.e. 1 Registrar and 1 SHO. Under Directorate Structure Hospital Manager transferred to Limerick with a remit to Nenagh. Infection Control Nurse transferred to UL Hospital, Limerick 2 days per week. Haemovigilence Nurse transferred to UL Hospital, Limerick, 2 days per week. Patient Flow Nurse transferred to Limerick permanently, Laboratory services reduced to cover in patients only. All other services transferred to UL Hospital, Limerick Since January 2010 our Local Emergency Centre changed to Local Injuries Unit. The Regionalization of Cardiac Investigation Department has commenced. Equally it should be noted that during this period there have been a large number of developments in Nenagh 5

6 Hospital. I set out these developments hereunder: Developments in Medicine There have been a number of Developments in Medicine such as the Development of PFT Clinics November Full & half sleep studies commenced in May 2013 and Latency sleep Studies will commence shortly. A Cardiac Failure Clinic has been developed and Phase III of Cardiac Rehab will commence in January, this will be a Multi disciplinary service with Physiotherapy, Nurse and Cardiology Services. Pulmonary Rehab Clinics have been developed as have Respiratory Nurse Specialist Services. An Infusion Services have been developed in the hospital We currently have eight nursing staff attending Post Graduate Courses in UL to support the development of Medical and Elderly Care Services in Nenagh including o Tissue Viability o Elderly Care Rehabilitation o Palliative Care Currently there are discussions within medicine regarding the expansion of MAU criteria and CT day diagnostics. Development in Surgery and Endoscopy Services: There are now seven surgical specialties in Nenagh and five of these have been developed since 2011 including: o ENT o Dermatology o Vascular Orthopaedic o Gynaecology Surgery o Endoscopy Services Endoscopy services now run up to six days per week compared to 2.5 days per week in The following procedures are now be carried out in Nenagh Hospital and are new to the hospital since 2013: o Gynaecology Ablations (prevents Hysterectomies) o Orthopaedic Injections in the Clinical Room o Cystistat (a treatment for patients with interstitial cystitis we are the only Hospital in group doing this) o BCG Treatment (post bladder tumour we are the only Hospital in group doing this ) o Prostate Biopsies (we are the only Hospital in group doing these) Developments November 2013 This month we are commencing Orthopaedics Injections using C Arm. This will involve a multi disciplinary team of o Anaesthetist o Radiology o Orthopaedic Surgeon o Nurse Developments in Outpatients Additional (extra) OPD Clinics commenced in 2013 including o ENT, o Urology o Rheumatology Capital Developments in Nenagh o Two new Theatres o A New Procedure/Minor Op Room (3 rd Theatre) 6

7 o A new two room Pre operative Assessment Clinic o New Surgical Day Ward o New Sterile Services Dept o New Dining room facilities o Development of new Family Room for relatives of Patients who have a loved one dying. o New Car Park Completed 2013 o Refurbishment to existing Medical Wards October & November 2013 o Proposed development of a 16 bed single room block onto Medical 1 Ward Ann Doherty, CEO, UL Hospitals W48Q1255 Please advise number of HIQA visits carried out at the following hospitals in the Mid West, Limerick Regional, Limerick Maternity, Croom Orthopaedic, Ennis & Nenagh Hospitals. Please advise purpose of visits and availability of reports. Cllr. John Carroll Name of Hospital University Hospital Limerick University Hospital Limerick Number of HIQA visits 1 visit in 2008/2009 as part of an investigation 1 visit on 10 th October 2008 Purpose of HIQA visit Investigation into the circumstances surrounding the provision of care to Rebecca O'Malley, in relation to her symptomatic breast disease, the Pathology Services at Cork University Hospital Symptomatic Breast Disease Services at Mid Western Regional (April 2009) National Hygiene Services Monitoring Assessment Report 2008 Mid Western Regional Hospital Dooradoyle ( October 2008) Availability of Reports University Hospital Limerick 1 visit on 27 th and 28 th August 2007 Hygiene Services Assessment Scheme Assessment Report 2007 Mid Western Regional Hospital Dooradoyle (August 2007) University Maternity Hospital 1 visit on 10 th July 2013 Monitoring Programme for the National Standards for the Prevention & Control of Healthcare Associated Infections Report of the unannounced focused monitoring assessment at Mid Western Regional Maternity Hospital Limerick (July 2013) 7

8 University Maternity Hospital 1 visit on 7 th Nov 2012 Monitoring Programme for the National Standards for the Prevention & Control of Healthcare Associated Infections Report of the unannounced monitoring assessment at Mid western Regional Maternity Hospital Limerick, part of the MWRH Group (November 2013) University Maternity Hospital 1 visit on 10 th May 2010 National Hygiene Services Monitoring Assessment Report Mid western Regional Maternity Hospital (May 2010) University Maternity Hospital 1 visit on 16 th November 2009 National Hygiene Services Monitoring Assessment Report Mid western Regional Maternity Hospital ( November 2009) University Maternity Hospital 1 visit on the 5 th November 2008 National Hygiene Services Monitoring Assessment Report Mid western Regional Maternity Hospital (November 2008) University Maternity Hospital 1 visit on 2 nd and 3 rd July 2007 Hygiene Services Assessment Scheme Assessment Report 2007 Mid Western Regional Maternity Hospital ( July 2007) Croom Orthopaedic Hospital 1 visit on 20 th October 2008 National Hygiene Services Monitoring Assessment Report 2008 Mid Western Regional Orthopaedic Hospital Croom ( October 2008) Croom Orthopaedic Hospital 1 visit on the 20 th 21 st August 2007 Hygiene Services Assessment Scheme Assessment Report 2007 Mid Western Regional Orthopaedic Hospital Croom (August 2007) Ennis Hospital 1 visit in 2008 /2009 as part of an investigation Report of the investigation into the quality and safety of services and supporting arrangements provided by HSE at Mid Western Regional Hospital Ennis (April 2009) Ennis Hospital 1 visit on 4 th Monitoring Programme for the 8

9 Ennis Hospital Ennis Hospital Nenagh Hospital Nenagh Hospital Nenagh Hospital September visit on 13 th October visit on 30 th and 31 st July visit on the 5 th September 2013 Ann Doherty, CEO, UL Hospitals 1 visit on 28 th and 29 th September visit on the 18 th and 19 th July 2007 National Standards for the Prevention & Control of Healthcare Associated Infections Report of the unannounced monitoring assessment at Ennis Hospital Co Clare (September 2013) National Hygiene Services Monitoring Assessment Report 2008 Mid Western Regional Hospital Ennis ( October 2008) Hygiene Services Assessment Scheme Assessment Report 2007 Mid Western Regional Orthopaedic Hospital Croom ( July 2007) Monitoring Programme for the National Standards for the Prevention & Control of Healthcare Associated Infections Report of the unannounced monitoring assessment at Nenagh Hospital Co Tipperary (September 2013) National Hygiene Services Monitoring Assessment Report 2008 Mid Western Regional Hospital St Joseph s Hospital Nenagh (September 2008) Hygiene Services Assessment Scheme Assessment Report 2007 Mid Western Regional ( St Joseph s Hospital Nenagh (July 2007) W48Q1256 Please advise the number of HIQA visits to Elderly Residential Care / Public Facilities at the following locations, St. Conlon s in Nenagh, Dean Maxwell in Roscrea, and Hospital of the Assumption Thurles? Cllr. John Carroll The number of HIQA visits to Elderly Residential Care / Public Facilities at the following locations: St. Conlon s CNU, Nenagh 7 Dean Maxwell CNH, Roscrea 6 Hospital of the Assumption, Thurles 5 Bernard Gloster, Area Manager, Mid West PCCC 9

10 W48Q1257 Are there any plans to relocate any services away from Letterkenny General Hospital and if so could we be furnished with details? Cllr. Michael McBride The West / North West Hospital Group is committed to the full reinstatement of all clinical services affected by the flood in July. A major rebuild programme is underway at the hospital involving a number of projects being worked on simultaneously, prioritising key patient areas. Currently there are up to 40 Outpatient Clinics every week taking place in temporary locations within the hospital or around the town and county. This is very inconvenient for patients and not very efficient as the staff, records, and clinical supplies are required to move from one location to another. It was decided to source offsite accommodation for the Outpatients Department (OPD) for a period of two years while the long term plan for the restoration of the OPD onsite is progressed. Following a detailed and exhaustive evaluation process, a location was selected and work is underway at the Court House Building in Letterkenny to prepare it for clinical use. The building will be handed over to the hospital on 02 December and we plan to conduct all outpatient clinics that are currently offsite from this new location from 09 December. It is important to note that this is a temporary measure while the rebuild programme is underway and OPD services will return to the hospital. There are no plans to re locate any other services away from Letterkenny General Hospital. W48Q1259 Given that planning permission is being sought for a primary care centre within the extensive grounds of the former Grove Hospital, Tuam which is entirely separate from the existing grove hospital building that has been unoccupied for over 10 years on a main street just of the town centre, can the HSE now agree and fund the development of a plan or process to divest themselves of this property and out of respect for the people and businesses of Tuam allow a productive use of this building be it commercial, community or otherwise. The continued mothballing of an important strategic commercial asset in Tuam by a state agency is unacceptable. Cllr Shaun Cunniffe The HSE plans to develop the Primary Care Centre within the grounds of the former Grove Hospital under a Public Private Partnership scheme delivered by the Government s national stimulus initiative. The Primary Care Centre scheme has been arranged to ensure that there is potential for further development of other facilities on the site in the future, including redevelopment of the existing building. Further development of the site and the existing building is dependent upon securing capital funding to meet the service needs and while the HSE has no plans to dispose of the building or grounds, a section of the existing building has been leased to the court service pending their completion of a new courts facility. Catherine Cunningham, Area Manager, Galway Roscommon PCCC W48Q1260 Can the HSE provide me with the annual costs of security, maintenance, insurance, heating and any other associated costs for the unused Grove Hospital building in Tuam? Cllr Shaun Cunniffe The following are the costs associated with the maintenance of the Grove site in Tuam. Lawn and garden maintenance is undertaken by HSE maintenance staff The utility costs are average 5, 000 annually for electricity which powers the central heating for the building. This cost is covered by the Courts service who rent it for Court sittings. Security costs average 1,300 per annum including VAT. 10

11 Insurance costs are covered under the overall HSE buildings insurance policy. There is currently an income generated of 13,000 per annum through rental of a section of the building to the Courts service. Catherine Cunningham, Area Manager, Galway & Roscommon PCCC W48Q1261 Given the latest criticisms unveiled in reports by the National Review Panel into the lack of care for Children whose deaths occurred in State Care, State aftercare or while known to the HSE, can the Forum be advised of how many of these deaths, if any, relate to the HSE West Area and if children in the HSE West's care are equally vulnerable as these children who are now deceased. Cllr Shaun Cunniffe The following is a brief overview of the above report in relation to the specific question; The panel issued 6 reports in In total 23 deaths were notified to the panel and one serious incident. Of the 23 deaths, 18 were of children living with their own families but known to the child protection services. Three children were in care and two in after care. Nine died by suicide, two in road traffic accidents, four in what is classed as other accidents, seven by natural causes and one homicide. Of the 23 deaths, six were known to the HSE West. They were two males and four females. The report highlights the role all HSE agencies have in looking after the needs of all vulnerable children through the services that are provided directly to them and/or their parents. The Child and Family Service continue to monitor our services and to benchmark them against reports such as the panel has published. There has also been the introduction this year of HIQA inspecting child protection services as well as the continued inspection of fostering services. The learning from such inspections as well as from individual incidents is disseminated to inform services and where possible to improve services. John Smyth, Regional Director Children & Family Services HSE West W48Q1262 At a previous meeting of the Regional Health Forum I was informed that a team where being trained to treat people presenting with stroke like conditions at Portiuncula Hospital and that this treatment would be available at the hospital in the near future. I now wish to know if the hospital will accept patients presenting with stroke like conditions and if it is in a position to administer Thrombolyic medication to stroke patients who require it. I also wish to know the position with regard to patients presenting with heart attack symptoms. If the response is that you can deal with all patients listed above I would be most grateful as it would be in keeping with the response I received at an earlier Forum meeting. If the answer is no I would like to know what is causing the delay and when will the HSE West be in a position to offer the full range of stroke and heart assessment and offer initial treatment for both conditions. Cllr Laurence Fallon We are currently awaiting replacement of a permanent Consultant Geriatrician, which will be advertised by the National Recruitment Service. The post was approved in June 2013 by the Consultant Appointments Unit. We have a locum Consultant Physician in place, a dedicated stroke care unit and a stroke Clinical Nurse Specialist for Stroke care. In respect of patients presenting with a suspected heart attack, the National Acute Coronary Syndrome stemi protocol is now in place in this region. Therefore if a cardiac ambulance is called and if it is determined by ambulance that the patient meets the stemi protocol criteria the patient will be brought directly to Galway. If a patient self presents to Portiuncula and they meet the stemi protocol criteria they will be transferred to Galway but all other patients presenting with heart attack symptoms can be managed appropriately in Portiuncula. 11

12 W48Q1263 In light of the recent budget cuts of 666 million Euros can the HSE West management inform me what impact this will have on the 2014 Budget for the Roscommon PCCC and what changes are being proposed to the Roscommon PCCC service plan as a result of those cuts? Cllr Laurence Fallon The HSE is in the process of completing the National Service Plan for 2014 and financial allocations will also be finalised as part of this process. Work is currently underway in preparing the local Galway/Roscommon ISA Service Plan. In line with previous years, Regional Health Forum and Oireachtas members in Galway/Roscommon will receive a formal presentation of the Plan when it has been completed. Catherine Cunningham, Area Manager, Galway & Roscommon PCCC W48Q1264 There are currently two waiting lists established at Roscommon County Hospital namely Orthopaedic and Neurology outpatient lists, could the management inform me if those 2 waiting have been abandoned and if they have not been abandoned which Consultants are currently working with patients on those lists at Roscommon County Hospital in the last 3 month, how many patients are on those 2 waiting lists and how many patients were attend to at Roscommon County Hospital in the last 3 months. Cllr Laurence Fallon Orthopaedic Clinics Currently RCH has a Waiting list for Orthopaedic Surgery. There are 708 patients on it as of 31 st October All letters which are received are uploaded onto the PAS and sent to Orthopaedic Consultant in Galway for Triage. When received back after decision on triage, they are re categorised and placed on the Waiting List. If a decision to treat a patient in Galway is made then that patient will be transferred to the GUH Waiting List. Mr O Sullivan is the only Orthopaedic Surgeon currently attending Roscommon Hospital. He attends on the 1 st Wednesday of the month. Due to NCHD shortages in Orthopaedics in GUH he will not be attending his scheduled OPD session in Roscommon Hospital from November 2013 to January 2014 inclusive. He is expected to recommence his OPD service in February Neurology there never has been a Neurology Service at RCH. Urology Mr. Jaffry is the Consultant in charge of Urology Services. Mr. Jaffry and Team attend RCH on the second and fourth Monday of every month. There are 130 patients on the waiting list for OPD. W48Q1265 Due to the location of Merlin Park Hospital with its 200 acres of greenfield space situated close to a motorway and close to the Galway City ring road why is it deemed necessary to allow the current services being provided there to go into decline while at the same time forcing more and more services into UCHG, an area that is grossly overcrowded, very inaccessible and very lacking in car parking. Can you please inform me what is the reason for forcing the public into this overcrowded space when it is not necessary or suitable? Cllr Laurence Fallon As agreed, a presentation on Merlin Park Hospital will take place at the next Regional Health Forum West Committee on 17th December The presentation will provide details on this query and all related queries on the Hospital and its environs. 12

13 W48Q1266 Please provide full details of all existing planning permissions for the Regional Hospital site including outline planning permissions and clarifying when the permissions were granted including any current applications before the City Council and clarify whether any of these applications will have implications for the existing helipad site. Cllr Catherine Connolly As agreed, a presentation on Merlin Park Hospital will take place at the next Regional Health Forum West Committee on 17th December The presentation will provide details on this query and all related queries on the Hospital and its environs. W48Q1267 In relation to Áras Mhic Dara: Please clarify the exact position re complement of beds giving the number of beds occupied, the number of beds empty and the reasons why together with the number on the waiting list as well as the number and breakdown of staff working there and the required complement of staff to run the home safely and in compliance with all necessary standards and regulations if the full complement of beds were occupied and finally confirmation of the status of the application/proposal to extend the nursing home. Cllr Catherine Connolly Total No of beds 52 long stay, 3 short stay No of beds empty 13 long stay, 2 short stay. This is due to day to day operational challenges such as appropriate management of challenging behaviour in patients, effective infection control measures and staffing shortages. No. of staff : (Wholetime Equivalent) Director of Nursing x 1 WTE Clinical Nurse Manager 1.87 WTE Clinical Nurse Manager 1.87 WTE Nursing x 13.1 WTE Health Care Assistants x 19 WTE Multi Task x 8.8 WTE Chef x 0.9 WTE Clerical Admin x 2 WTE Additional staff required if beds were to open Nursing x 5.2 WTE Health Care Assistants x 1 In seeking to address staffing shortages, Galway/Roscommon has applied for approval to fill additional posts through the Graduate Nurse Programme and the Intern Programme. Catherine Cunningham, Area Manager, Galway Roscommon PCCC W48Q1268 Please clarify the position in relation to physiotherapy services in the community in Galway including identifying the places where the service is provided and clarification re the source of referral to avail of the services and clarification on all waiting lists. Cllr Catherine Connolly 1.The Galway Physiotherapy service is provided in the following locations: Tully Ballinahown Health Centre (HC), Aras Ronan Community Nursing Unit (CNU), Inis Mor, Inis Oirr HC, Carraroe HC, Cill Chiaran HC, Clifden Hospital, St. Anne s (CNU),Clifden, Roundstone HC, Oughterard HC, Clonbur HC, Headford HC, Tuam HC, Irish Wheelchair Association, Tuam, Castlerea HC (for residents of Glenamaddy PCT who live closer to Castlerea), Roscommon Hospital (for 13

14 residents of Glenamaddy PCT who live closer to Roscommon Hospital), Ballinalsoe HC, Portiuncula Hospital, Kilconnell HC, Portumna Social Services, St Brendan s CNU, Loughrea, Gort HC, Kinvara HC, Athenry Primary Care Centre (PCC), City East PCC, Merlin Park Hospital, St. Francis PCC, Newcastle, Croi building, Newcastle and University Hospital Galway. In certain cases one or two Physiotherapy sessions can be provided in a domiciliary setting where clinical needs indicate e.g. a person discharged home following a stroke who requires assessment of their home environment. 2. Referrals are made to the service from members of the PCT (such as GPs, Public Health Nurses, Occupational Therapists). Other Health Care Professionals such as Speech and Language Therapists, Dietician, Social Worker, Podiatrist, Home Help Co ordinator, Consultants and hospital based staff can also refer to the service. 3. The total number of patients on the waiting list for the service is 1, % of patients are waiting less than 12 weeks. Every effort is made to prioritise those with the greatest clinical need and to see them as soon as possible. Waiting Lists by Primary Care Network area are as follows: Network 1: (West Galway area) 251 Network 2: (Headford, Abbeyknockmoy area) 187 Network 3: (Tuam, Mountbellew, Glenamaddy area) 484 Network 4: (Ballinasloe, Loughrea, Portumna area) 295 Network 5: (Athenry,Gort, Oranmore area) 286 Network 6: (City East) 218 Network 7: ( City West) 169 The following steps have been taken to increase the numbers of patients seen and reduce waiting lists: Reduction in proportion of domiciliary work from 25% to 10% Increase in frequency of clinic based work, which enables staff to see more patients each day Reduction in the duration of patient treatment sessions Greater use of clerical staff and support staff to relieve Physiotherapists of non clinical duties such as scheduling of appointments, answering telephone queries Use of class based settings to treat certain patient groups e.g. class to see whiplash patients as soon as possible in a group session to start them on their treatment programme early, thus decreasing the number of sessions required. Demand for the service has doubled in the past 3 years. Possible reasons for this include: Greater clinical need from patients for the service Greater awareness of the benefits of Physiotherapy for certain conditions Improved access to enable GPs refer patients to the service Transfer of more outpatient services from hospital to community based services, Fewer members of the general public availing of Physiotherapy services privately. Catherine Cunningham, Area Manager, Galway & Roscommon Services W48Q1269 Given the welcome reduction in both the outpatient and inpatient waiting lists for the Regional/Merlin Park hospitals please clarify the number of patients referred to private hospitals as part of effecting this reduction including private hospitals in Galway and/or outside over the last two years and the cost of same. Cllr Catherine Connolly The West/North West Hospitals Group has been very focused on reducing the waiting lists in line with the nationally set Special Delivery Unit targets. In 2012, 645 patients for inpatient procedures were referred to other centres. The associated costs of this initiative were funded centrally by the Special Delivery Unit. To date, in 2013 a total of 1194 patients were referred for outpatient services and 592 patients were referred for inpatient procedures to external healthcare facilities. The cost of these referrals to date is for inpatients 200,000 for outpatients 14

15 W48Q1270 Could I have an update on the rebuild at Letterkenny General Hospital, what works tendered, awarded to and cost and timescale of same? Cllr Ciaran Brogan In the immediate aftermath of the flood at the end of July, the focus was on restoring as many services as safely and quickly as possible. Within three weeks an interim Emergency Department and Radiology Department was up and running and most of the other services were restored at various locations around the hospital and in Letterkenny town and throughout Co Donegal in the following weeks. The rebuild programme is a major undertaking involving a number of projects being worked on simultaneously, prioritising key patient areas. As previously stated, we will ensure that the new buildings are restored in line with current standards in patient care, resulting in improvements in a number of areas. Emergency Department (ED) and Acute Medical Assessment Unit (AMAU) This is one of the highest priority areas and work commenced on site on November 11 with an expected completion date of March The interim ED facility continues to work to the same capacity as pre flood. Services at the AMAU continue to be constrained as it has just five patient bays, a reduction from the eleven previously available. Pharmacy, Cardiac Investigations, Pulmonary Investigations and the Floor B corridor Work also commenced on these areas on November 11 with an expected completion date of February These services continue to be fully operational from interim facilities on site. Outpatients Currently there are up to 40 clinics every week taking place in temporary locations within the hospital or around the town and county. This is very inconvenient for patients and not very efficient as the staff, records, and clinical supplies are required to move from one location to another. It was decided to source offsite accommodation for the Outpatients Department for a period of two years while the long term plan for the restoration of the OPD onsite is progressed. Following a detailed and exhaustive evaluation process, a location was selected and work is underway at the Court House Building in Letterkenny to prepare it for clinical use. The building will be handed over to the hospital on 02 December and we plan to conduct all outpatient clinics that are currently offsite from this new location from December 9. Gynaecology/ambulatory care This has been completed and services re commissioned. The new facilities represent a considerable improvement on the previous environment including the provision of an additional eleven inpatient beds to help manage peak flow in the temporary Emergency Department. Radiology The HSE s National Capital Steering Group has approved the development of a multipurpose radiology interventional suite, a diagnostic X ray guided facility for the diagnosis and treatment of multiple illnesses including cardiac, gastrointestinal, orthopaedic and oncological diseases This suite will be a significant enhancement of LGH s pre flood capacity enabling us to diagnose more patients locally who previously would have had to travel to Galway or Dublin. Radiology continues to be provided on site from two mobile CT scanners and plans are being finalised to resume an MRI service onsite (currently provided by the Northwest Clinic at Ballykelly). Other projects Work on the remainder of the key areas are at various stages of development scoping, design and tendering. These include the kitchens and dining room, medical records department, offices, chapels, mortuary and boiler house and utilities ducting tunnels. 15

16 Flood management As previously advised, we have improved interim arrangements in place at the culvert with additional monitoring and clearing. This includes the location of a digger onsite and access on a 24 hour basis to a roster of drivers. The culvert is monitored by CCTV and water monitoring equipment. The rebuilding works will include a new culvert costing approximately 250,000. A planning application has been submitted to Donegal County Council. Internal flood management measures such as flood doors are also being designed into the new building works. A detailed flood management strategy involving the culvert and buildings is being finalised by HSE Estates. Costs The indicative budget for the rebuild works is in excess of 15m and overall costs will exceed 30m when equipment and contingency costs are taken into account. Discussions are ongoing with insurers. Goodwill The rebuild project is complex and it will take time for all the pieces of the jigsaw to come together. The goodwill demonstrated to the hospital and staff in the immediate aftermath of the flood was outstanding and I am asking all our patients to bear with us while we restore services to their rightful locations within the hospital. We greatly appreciate the ongoing support and cooperation of local officials and public representatives. National Commitment Reflecting the West/North West Hospital Group's and the national commitment endorsed by the Minister for Health, Dr James Reilly, to the full reinstatement of all clinical services, the Letterkenny Hospital Rebuild Steering Group meets on a fortnightly basis. This steering group is comprised of senior hospital and group management and clinical staff, members of the design team and HSE Estates, including Mr Jim Curran, the HSE National Director of Estates. Works awarded: Gynaecology John Sisk and Sons Completed Emergency Department John Sisk and Sons Complete March 2014 Pharmacy Joseph Mc Menamin & Sons Complete March 2014 (Stranorlar) Ltd Values are commercially sensitive but are overall in region of 2.5m. W48Q1271 Has there been any progress on the proposed new community hospital for Letterkenny? Cllr Ciaran Brogan The Oireachtas and Health Forum members in Donegal will be advised of all approved capital projects in the HSE s Capital Programme. This will include progress in relation to the development of a Community Hospital / Nursing Unit at Letterkenny. As stated in response to previous question (W47Q1226) the business case in support of this development has been submitted to the HSE S National Capital Steering Group. John Hayes, Area Manager, Donegal Services W48Q1272 How many medical cards and G.P cards are in Co. Donegal now compared to 2010? Cllr Ciaran Brogan Not available at time of printing. 16

17 Late Questions W48Q1273 Can you confirm to me what is the situation with the Corrandulla Health Centre? It is closed since August for renovations and refurbishment. Can you confirm if this work will take place and when it will open again? Cllr Mary Hoade An application has been made to the HSE Estates Dept. at national level for minor capital funding for Corrandulla Health Centre to refurbish it and also to upgrade the heating system. We anticipate being advised as to the outcome of minor capital funding requests in the first quarter of When funding becomes available the refurbishment works will commence. Catherine Cunningham, Area Manager, Galway & Roscommon Services W48Q1274 Can you confirm what is the waiting time from when an assessment for a child for Orthodontic treatment takes places until the treatment starts? How many are on the current waiting list for treatment? (Galway) Cllr Mary Hoade Based on the figures up to September 2013 the number of children on the GUH orthodontic waiting list was The current waiting time from assessment to commencing treatment is approximately 30 months. Patients are prioritised based on their clinical needs. W48Q1275 Can you confirm to me if dental services are currently provided to the primary school and are all vaccinations that should be given in primary school given? (Galway). Cllr Mary Hoade With regard to Dental services, from 1 st Dec. 2012, Galway Community Dental Service was reorganised in response to a number of retirements and resignations in order to provide a fair and equitable service across the entire county. All of the 283 primary schools (including special schools) have access to dental assessment at 6 th class. The 6 th class was chosen as children have usually lost all of their baby teeth at that stage and the dentists can assess and treat their permanent teeth. Joe O Connor, Principal Dental Surgeon for Galway has explained as follows: Our goal is to make sure that every primary school pupil is seen by the community dental service and if we leave the old system in place we could not ensure access for every child. By reorganising our reduced staff numbers we can provide an assessment service to every 6 th class child and we can provide an emergency service for children who have severe pain or have had an accident that affects their teeth. This is often a same day service (Mon. to Fri.). This new system allows us to continue to provide orthodontic assessment and onward referral if required to the Orthodontic Department. The Department also provides: A dental service for patients who are medically compromised, some who require a general anaesthetic. Referrals to University Hospital Galway (UHG) oral maxillofacial and orthodontic departments for advice, assessment and treatment. Referrals for the extraction only service in hospital theatre UHG. All Primary School Vaccinations that should be provided in primary schools are being provided. Where children are absent from school when the HSE s School Immunisation Team visits, they are seen at subsequent central mop up clinics to ensure the highest possible uptake of immunisation of school children is achieved. Catherine Cunningham, Area Manager, Galway & Roscommon 17