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REGIONAL HEALTH FORUM - DUBLIN NORTH EAST FÓRAM RÉIGIÚNACH SLÁINTE - BAILE ÁTHA CLIATH AGUS AN TOIRTHUAISCEART MINUTES OF MEETING HELD ON MONDAY, 24TH NOVEMBER, 2014 AT 2:00PM IN THE BOARDROOM, HSE, BECTIVE STREET, KELLS Members Present Cllr. Christy Burke Cllr. Tommy Byrne Cllr. Jack Chambers Cllr. David Costello Cllr. Kieran Dennison Cllr. Robbie Gallagher Cllr. Adrian Henchy Cllr. Deirdre Heney Cllr. Eithne Loftus Cllr. David Maxwell Cllr. Mary McCamley Cllr. Lorna Nolan Cllr. Ciaran O Moore Cllr. Tomás Sharkey Cllr. Gillian Toole Not in Attendance Cllr. Richie Culhane Cllr. Mark Dearey Cllr. Declan Flanagan Cllr. Gary Gannon Cllr. Séamas McGrattan Cllr. Brian McKenna Cllr. Noeleen Reilly Apologies Cllr. Philip Brady Cllr Wayne Forde Cllr. Paddy McDonald Cllr. Peter McVitty Cllr. Paddy Meade Cllr. Claire O Driscoll Cllr. Darren O Rourke Officials Present Ms. Rosaleen Harlin, Lead Manager, Regional Health Office - HSE DNE Mr. Des O Flynn, Area Manager, Dublin North City Ms. Roisin Maguire, General Manger, Specialist Services for Older People Mr. Enda Doody on behalf of Ms. Mary Walshe, Area Manager Dublin North Ms. Rose McCaffrey, on behalf of Mr. Leo Kinsella, Area Manager - Cavan/Monaghan Ms. Martina O Byrne, on behalf of Ms. Rosarii Mannion, Assistant National Director HR Ms. Katherine Kellett, Regional Health Office - HSE DNE Ms. Lorraine Timmons, Regional Health Office - HSE DNE Minutes of Regional Health Forum 1 24th November, 2014

1. Adoption of minutes of meeting held on Monday, 22 nd September, 2014 The minutes of the meeting held on Monday, 22nd September, 2014 were adopted by the Forum on the proposal of Cllr. Eithne Loftus and seconded by Cllr. David Maxwell. 2. Health Service Executive Updates Ms. Rosaleen Harlin, Lead Manager, Regional Health Office, gave a report to the meeting which dealt with the following:- HMI Leadership Award for Chatterbox, an innovative speech and language service in Cavan Monaghan; Cavan Monaghan Hospital commended for two projects at the Irish Healthcare Awards; Healthcare initiative leads the way in preventing pressure ulcers; Undertheweather.ie; Cavan General Hospital annual antibiotic awareness day; Delegates from all 29 receiving hospitals in Ireland attend Ebola conference; Rapid Access Prostate Cancer Service; Four more health centres in Meath become Tobacco Free; Information event to raise awareness of COPD; Children s Remembrance Event; Diabetes Information Evening at Louth County Hospital, Dundalk; Christmas Message. A discussion took place where members raised the following issues:- Request for information on the cost of hosting, turnout and engagement for the COPD Information event on 17 th November, 2014; Clarification on whether Chatterbox is unique to County Monaghan; Request for more information on Dublin hospitals to be included in HSE Updates. The requests and comments from members were responded to as follows:- A response will issue in relation to the COPD event; It is possible that the Chatterbox service could be rolled out nationally. However, at present it is only fully resourced in Cavan Monaghan; It was agreed to include further information on Dublin Hospitals in the HSE Updates. The report was noted by the Forum. 3. Presentation on Services for Older People Ms. Roisin Maguire, General Manager, Specialist Services for Older People, made a presentation to members on Services for Older People (copy appended to the official minute). Minutes of Regional Health Forum 2 24th November, 2014

Members thanked Ms. Maguire for her presentation and a discussion took place where members raised the following issues:- Shortage of long stay beds in North Dublin; Older people being encouraged not to wear slippers in order to prevent falls; Care for young people with alzheimer s disease - age limit; Delayed discharges belief that person should not be removed from hospital until a Home Care Package is in place; Types of elder abuse cases - request for numbers as opposed to percentages; Contact details for Senior Case Worker for Coolock; Comparisons re number of Home Help hours provided in previous year; Clarification on shifting emphasis of model of care to home and community supports maintaining an additional 1,000 older people to continue living in their own homes; Allocation of 23m from Fair Deal scheme to increase home care and community supports effect for people on waiting list for Fair Deal; Falls often related to medication problems - network of community pharmacists available for medication usage review; Dementia challenges including respite services, medication and care at night requirement for old age specialist nurse in certain circumstances; Strategy for dementia; Telecare systems and monitoring contractors and costs; Definition of older person. Ms. Maguire and senior management responded to the questions and comments from the members as follows:- Funding has been made available recently for additional long stay beds; The National Falls Strategy recommends older people wear footwear which fits properly, has good soles and is a suitable heel height for the individual; If a young person is diagnosed with an early onset condition that is usually a condition of the elderly then they are considered by older persons services. This might include dementia, alzheimer's, etc.; Within the Dublin hospitals, there was only one person waiting last week for a Home Care Package. This is huge progress. If a person is discharged by a consultant, they will be assessed to determine their needs at home or in the community. They will also be assessed again once home; Information on numbers of elder abuse cases to be provided; Details on the Senior Case Worker for the Coolock area to be forwarded to member; The number of Home Help hours provided in 2013 was the same as the current year; Potentially, 1,000 people would have gone to long term care changing the model of care will target this group to be cared for at home; Fair Deal will continue to maintain its level of service. However, the waiting list for Fair Deal is longer this year than in 2013; Medication usage review will be discussed with member; Minutes of Regional Health Forum 3 24th November, 2014

It is acknowledged that there is still a lot of work to be carried out in relation to dementia services. The possibility of including night carers into Home Care Packages is being examined. Currently, in most cases, private providers do not provide care at night time; The national strategy for dementia is due to be launched in the near future. It will be made available for members; The HSE provide contracted systems and monitoring as part of the Home Care Package. Details will be provided; An older person is classed as someone who is over 65 years old. 4. Motions That this North East Regional Health Forum will allocate and provide a minimum of 2,000 for the reprinting of a minimum 15,000 Signpost leaflets, an important resource produced by the Prevention and Education subgroup of the North East Regional Drugs Task Force. This publication is an invaluable health promotion tool, guidance document for parents, guardians and peers informing them of the manifold components of the misuse of drugs and alcohol in our communities. It provides clear signposts of where anyone can access help & support. Cllr. Gillian Toole Cllr. Gillian Toole commended the Signpost leaflets stating that they were excellent and the information contained in them was comprehensive. She stated that if funding could be found to reprint the leaflets, that it would be very graciously accepted. She hoped to be informed of a definite decision in the near future. 5. Questions To ask the Manger how many persons are currently on a Methadone Programme? Cllr. Lorna Nolan Cllr. Lorna Nolan queried if there was a generic version of methadone available and, if so, was it cheaper than methadone. Mr. Des O Flynn stated that this was clinical issue and that methadone is the primary prescription. Cllr. Gillian Toole informed the meeting that there are alternative manufacturers, however, costs remained similar. She stated that is was also a matter of client s preference and taste. Cllr. Christy Burke reported that he knew of clients that were on methadone for up to twenty years. He called on the HSE to produce guidelines on the length of time methadone can be prescribed, stating that reliance on methadone is just another addiction. To ask the HSE for an update on the situation pertaining to the Long Stay Units in Connolly Hospital which have been deemed not fit for purpose and which will close in the near future. Also, it is my understanding that money will be available to construct a new unit in their place. Can the HSE confirm whether planning for such a unit is imminent, as it is imperative that the residents of the old units Minutes of Regional Health Forum 4 24th November, 2014

avoid being traumatised by any disruption in their routine as some are quite delicate mentally? Cllr. Mary McCamley Cllr. Mary McCamley commented on the lack of timelines in the response and requested information on the timelines for the new 100 bed nursing unit. Ms. Roisin Maguire responded stating that the plans for the new unit were a recent decision and that the funding for the design was welcome. She stated that is was no possible to give a timeline at this stage but that an update would be provided at a future meeting. What is the current waiting time for children moving from early intervention services to HSE services in the region? Please provide a breakdown based on service where possible. Cllr. David Costello Cllr. David Costello referred to Speech and Language Therapy waiting times for children in the Dublin North City region and sought clarification on whether the wait time was for an appointment or to be seen. Mr. Des O Flynn informed Cllr. Costello that the wait time was in respect of the assessment. He also stated that a strategy is in place to move forward this waiting list. While recognising the National Forensic Hospital is a very positive development, not only for Portrane but the wider Fingal county, it is critically important that the HSE working in tandem with Fingal make a significant social dividend investment within the local community and this investment needs to reach to the wider community not just within the HSE campus. All of the groups on the Peninsula from Arts Culture, Sports and Voluntary sectors have long established links/association with St. Ita s, going as far back in some cases 100 years, and this relationship needs to be recognised by the HSE working within the area. Cllr. Adrian Henchy Cllr. Adrian Henchy contended the process of communication in the local area over the past number of months and stated that consultation should have been arranged with elected members. He stated that some community groups were unaware of the facility. He also stated that the commemorative plaque in Portrane cemetery was offensive and that the response in relation to the rejuvenation of a declining campus at St. Ita s was vague. In relation to the rerouting of walkways, Cllr. Henchy stated that these had been long established but were now lost. Have any meetings taken place recently between the HSE and the relevant government department, in relation to the promised new 100 bed unit at St. Mary s Hospital site, on the Dublin Road, Drogheda? Cllr. Tommy Byrne Minutes of Regional Health Forum 5 24th November, 2014

Cllr. Tommy Byrne stated that the response was very bad news and that the Government had promised a new 100 bed unit at St. Mary s Hospital. He said it was a disgrace and that he was bitterly disappointed and also that the people of Drogheda would not forgive. When will a full review of the methadone protocols be carried out, with input to be invited from all stakeholders involved in both the delivery of the service and most importantly, in receipt of this service? Cllr. Gillian Toole Cllr. Gillian Toole stated that a lot had changed in relation to the demographic of young people since the methadone review of 2010. She stated that it was necessary to expedite the actions from the Opioid Treatment Protocol. 6. Report by Chairperson of Committee The report was noted by the Forum. 7. Chairperson s Correspondence Cllr. Kieran Dennison, Chairperson, drew member s attention to the Forum Standing Orders section on Motions and Questions and asked that in future members would submit Motions and Questions specific to the area. 8. Date and time of next meeting The next meeting of the Regional Health Forum - will take place on Monday, 26th January, 2015 at 2:00pm. Signed: Kieran Dennison, Chairperson. Minutes of Regional Health Forum 6 24th November, 2014

REGIONAL HEALTH FORUM - DUBLIN NORTH EAST FÓRAM RÉIGIÚNACH SLÁINTE - BAILE ÁTHA CLIATH AGUS AN TOIRTHUAISCEART MINUTES OF MEETING HELD ON MONDAY, 24TH NOVEMBER, 2014 AT 2:00PM IN THE BOARDROOM, HSE, BECTIVE STREET, KELLS Members Present Cllr. Christy Burke Cllr. Tommy Byrne Cllr. Jack Chambers Cllr. David Costello Cllr. Kieran Dennison Cllr. Robbie Gallagher Cllr. Adrian Henchy Cllr. Deirdre Heney Cllr. Eithne Loftus Cllr. David Maxwell Cllr. Mary McCamley Cllr. Lorna Nolan Cllr. Ciaran O Moore Cllr. Tomás Sharkey Cllr. Gillian Toole Not in Attendance Cllr. Richie Culhane Cllr. Mark Dearey Cllr. Declan Flanagan Cllr. Gary Gannon Cllr. Séamas McGrattan Cllr. Brian McKenna Cllr. Noeleen Reilly Apologies Cllr. Philip Brady Cllr Wayne Forde Cllr. Paddy McDonald Cllr. Peter McVitty Cllr. Paddy Meade Cllr. Claire O Driscoll Cllr. Darren O Rourke Officials Present Ms. Rosaleen Harlin, Lead Manager, Regional Health Office - HSE DNE Mr. Des O Flynn, Area Manager, Dublin North City Ms. Roisin Maguire, General Manger, Specialist Services for Older People Mr. Enda Doody on behalf of Ms. Mary Walshe, Area Manager Dublin North Ms. Rose McCaffrey, on behalf of Mr. Leo Kinsella, Area Manager - Cavan/Monaghan Ms. Martina O Byrne, on behalf of Ms. Rosarii Mannion, Assistant National Director HR Ms. Katherine Kellett, Regional Health Office - HSE DNE Ms. Lorraine Timmons, Regional Health Office - HSE DNE Minutes of Regional Health Forum 1 24th November, 2014

1. Adoption of minutes of meeting held on Monday, 22 nd September, 2014 The minutes of the meeting held on Monday, 22nd September, 2014 were adopted by the Forum on the proposal of Cllr. Eithne Loftus and seconded by Cllr. David Maxwell. 2. Health Service Executive Updates Ms. Rosaleen Harlin, Lead Manager, Regional Health Office, gave a report to the meeting which dealt with the following:- HMI Leadership Award for Chatterbox, an innovative speech and language service in Cavan Monaghan; Cavan Monaghan Hospital commended for two projects at the Irish Healthcare Awards; Healthcare initiative leads the way in preventing pressure ulcers; Undertheweather.ie; Cavan General Hospital annual antibiotic awareness day; Delegates from all 29 receiving hospitals in Ireland attend Ebola conference; Rapid Access Prostate Cancer Service; Four more health centres in Meath become Tobacco Free; Information event to raise awareness of COPD; Children s Remembrance Event; Diabetes Information Evening at Louth County Hospital, Dundalk; Christmas Message. A discussion took place where members raised the following issues:- Request for information on the cost of hosting, turnout and engagement for the COPD Information event on 17 th November, 2014; Clarification on whether Chatterbox is unique to County Monaghan; Request for more information on Dublin hospitals to be included in HSE Updates. The requests and comments from members were responded to as follows:- A response will issue in relation to the COPD event; It is possible that the Chatterbox service could be rolled out nationally. However, at present it is only fully resourced in Cavan Monaghan; It was agreed to include further information on Dublin Hospitals in the HSE Updates. The report was noted by the Forum. 3. Presentation on Services for Older People Ms. Roisin Maguire, General Manager, Specialist Services for Older People, made a presentation to members on Services for Older People (copy appended to the official minute). Minutes of Regional Health Forum 2 24th November, 2014

Members thanked Ms. Maguire for her presentation and a discussion took place where members raised the following issues:- Shortage of long stay beds in North Dublin; Older people being encouraged not to wear slippers in order to prevent falls; Care for young people with alzheimer s disease - age limit; Delayed discharges belief that person should not be removed from hospital until a Home Care Package is in place; Types of elder abuse cases - request for numbers as opposed to percentages; Contact details for Senior Case Worker for Coolock; Comparisons re number of Home Help hours provided in previous year; Clarification on shifting emphasis of model of care to home and community supports maintaining an additional 1,000 older people to continue living in their own homes; Allocation of 23m from Fair Deal scheme to increase home care and community supports effect for people on waiting list for Fair Deal; Falls often related to medication problems - network of community pharmacists available for medication usage review; Dementia challenges including respite services, medication and care at night requirement for old age specialist nurse in certain circumstances; Strategy for dementia; Telecare systems and monitoring contractors and costs; Definition of older person. Ms. Maguire and senior management responded to the questions and comments from the members as follows:- Funding has been made available recently for additional long stay beds; The National Falls Strategy recommends older people wear footwear which fits properly, has good soles and is a suitable heel height for the individual; If a young person is diagnosed with an early onset condition that is usually a condition of the elderly then they are considered by older persons services. This might include dementia, alzheimer's, etc.; Within the Dublin hospitals, there was only one person waiting last week for a Home Care Package. This is huge progress. If a person is discharged by a consultant, they will be assessed to determine their needs at home or in the community. They will also be assessed again once home; Information on numbers of elder abuse cases to be provided; Details on the Senior Case Worker for the Coolock area to be forwarded to member; The number of Home Help hours provided in 2013 was the same as the current year; Potentially, 1,000 people would have gone to long term care changing the model of care will target this group to be cared for at home; Fair Deal will continue to maintain its level of service. However, the waiting list for Fair Deal is longer this year than in 2013; Medication usage review will be discussed with member; Minutes of Regional Health Forum 3 24th November, 2014

It is acknowledged that there is still a lot of work to be carried out in relation to dementia services. The possibility of including night carers into Home Care Packages is being examined. Currently, in most cases, private providers do not provide care at night time; The national strategy for dementia is due to be launched in the near future. It will be made available for members; The HSE provide contracted systems and monitoring as part of the Home Care Package. Details will be provided; An older person is classed as someone who is over 65 years old. 4. Motions That this North East Regional Health Forum will allocate and provide a minimum of 2,000 for the reprinting of a minimum 15,000 Signpost leaflets, an important resource produced by the Prevention and Education subgroup of the North East Regional Drugs Task Force. This publication is an invaluable health promotion tool, guidance document for parents, guardians and peers informing them of the manifold components of the misuse of drugs and alcohol in our communities. It provides clear signposts of where anyone can access help & support. Cllr. Gillian Toole Cllr. Gillian Toole commended the Signpost leaflets stating that they were excellent and the information contained in them was comprehensive. She stated that if funding could be found to reprint the leaflets, that it would be very graciously accepted. She hoped to be informed of a definite decision in the near future. 5. Questions To ask the Manger how many persons are currently on a Methadone Programme? Cllr. Lorna Nolan Cllr. Lorna Nolan queried if there was a generic version of methadone available and, if so, was it cheaper than methadone. Mr. Des O Flynn stated that this was clinical issue and that methadone is the primary prescription. Cllr. Gillian Toole informed the meeting that there are alternative manufacturers, however, costs remained similar. She stated that is was also a matter of client s preference and taste. Cllr. Christy Burke reported that he knew of clients that were on methadone for up to twenty years. He called on the HSE to produce guidelines on the length of time methadone can be prescribed, stating that reliance on methadone is just another addiction. To ask the HSE for an update on the situation pertaining to the Long Stay Units in Connolly Hospital which have been deemed not fit for purpose and which will close in the near future. Also, it is my understanding that money will be available to construct a new unit in their place. Can the HSE confirm whether planning for such a unit is imminent, as it is imperative that the residents of the old units Minutes of Regional Health Forum 4 24th November, 2014

avoid being traumatised by any disruption in their routine as some are quite delicate mentally? Cllr. Mary McCamley Cllr. Mary McCamley commented on the lack of timelines in the response and requested information on the timelines for the new 100 bed nursing unit. Ms. Roisin Maguire responded stating that the plans for the new unit were a recent decision and that the funding for the design was welcome. She stated that is was no possible to give a timeline at this stage but that an update would be provided at a future meeting. What is the current waiting time for children moving from early intervention services to HSE services in the region? Please provide a breakdown based on service where possible. Cllr. David Costello Cllr. David Costello referred to Speech and Language Therapy waiting times for children in the Dublin North City region and sought clarification on whether the wait time was for an appointment or to be seen. Mr. Des O Flynn informed Cllr. Costello that the wait time was in respect of the assessment. He also stated that a strategy is in place to move forward this waiting list. While recognising the National Forensic Hospital is a very positive development, not only for Portrane but the wider Fingal county, it is critically important that the HSE working in tandem with Fingal make a significant social dividend investment within the local community and this investment needs to reach to the wider community not just within the HSE campus. All of the groups on the Peninsula from Arts Culture, Sports and Voluntary sectors have long established links/association with St. Ita s, going as far back in some cases 100 years, and this relationship needs to be recognised by the HSE working within the area. Cllr. Adrian Henchy Cllr. Adrian Henchy contended the process of communication in the local area over the past number of months and stated that consultation should have been arranged with elected members. He stated that some community groups were unaware of the facility. He also stated that the commemorative plaque in Portrane cemetery was offensive and that the response in relation to the rejuvenation of a declining campus at St. Ita s was vague. In relation to the rerouting of walkways, Cllr. Henchy stated that these had been long established but were now lost. Have any meetings taken place recently between the HSE and the relevant government department, in relation to the promised new 100 bed unit at St. Mary s Hospital site, on the Dublin Road, Drogheda? Cllr. Tommy Byrne Minutes of Regional Health Forum 5 24th November, 2014

Cllr. Tommy Byrne stated that the response was very bad news and that the Government had promised a new 100 bed unit at St. Mary s Hospital. He said it was a disgrace and that he was bitterly disappointed and also that the people of Drogheda would not forgive. When will a full review of the methadone protocols be carried out, with input to be invited from all stakeholders involved in both the delivery of the service and most importantly, in receipt of this service? Cllr. Gillian Toole Cllr. Gillian Toole stated that a lot had changed in relation to the demographic of young people since the methadone review of 2010. She stated that it was necessary to expedite the actions from the Opioid Treatment Protocol. 6. Report by Chairperson of Committee The report was noted by the Forum. 7. Chairperson s Correspondence Cllr. Kieran Dennison, Chairperson, drew member s attention to the Forum Standing Orders section on Motions and Questions and asked that in future members would submit Motions and Questions specific to the area. 8. Date and time of next meeting The next meeting of the Regional Health Forum - will take place on Monday, 26th January, 2015 at 2:00pm. Signed: Kieran Dennison, Chairperson. Minutes of Regional Health Forum 6 24th November, 2014

REGIONAL HEALTH FORUM - DUBLIN NORTH EAST FÓRAM RÉIGIÚNACH SLÁINTE - BAILE ÁTHA CLIATH AGUS AN TOIRTHUAISCEART MINUTES OF MEETING HELD ON MONDAY, 24TH NOVEMBER, 2014 AT 2:00PM IN THE BOARDROOM, HSE, BECTIVE STREET, KELLS Members Present Cllr. Christy Burke Cllr. Tommy Byrne Cllr. Jack Chambers Cllr. David Costello Cllr. Kieran Dennison Cllr. Robbie Gallagher Cllr. Adrian Henchy Cllr. Deirdre Heney Cllr. Eithne Loftus Cllr. David Maxwell Cllr. Mary McCamley Cllr. Lorna Nolan Cllr. Ciaran O Moore Cllr. Tomás Sharkey Cllr. Gillian Toole Not in Attendance Cllr. Richie Culhane Cllr. Mark Dearey Cllr. Declan Flanagan Cllr. Gary Gannon Cllr. Séamas McGrattan Cllr. Brian McKenna Cllr. Noeleen Reilly Apologies Cllr. Philip Brady Cllr Wayne Forde Cllr. Paddy McDonald Cllr. Peter McVitty Cllr. Paddy Meade Cllr. Claire O Driscoll Cllr. Darren O Rourke Officials Present Ms. Rosaleen Harlin, Lead Manager, Regional Health Office - HSE DNE Mr. Des O Flynn, Area Manager, Dublin North City Ms. Roisin Maguire, General Manger, Specialist Services for Older People Mr. Enda Doody on behalf of Ms. Mary Walshe, Area Manager Dublin North Ms. Rose McCaffrey, on behalf of Mr. Leo Kinsella, Area Manager - Cavan/Monaghan Ms. Martina O Byrne, on behalf of Ms. Rosarii Mannion, Assistant National Director HR Ms. Katherine Kellett, Regional Health Office - HSE DNE Ms. Lorraine Timmons, Regional Health Office - HSE DNE Minutes of Regional Health Forum 1 24th November, 2014

1. Adoption of minutes of meeting held on Monday, 22 nd September, 2014 The minutes of the meeting held on Monday, 22nd September, 2014 were adopted by the Forum on the proposal of Cllr. Eithne Loftus and seconded by Cllr. David Maxwell. 2. Health Service Executive Updates Ms. Rosaleen Harlin, Lead Manager, Regional Health Office, gave a report to the meeting which dealt with the following:- HMI Leadership Award for Chatterbox, an innovative speech and language service in Cavan Monaghan; Cavan Monaghan Hospital commended for two projects at the Irish Healthcare Awards; Healthcare initiative leads the way in preventing pressure ulcers; Undertheweather.ie; Cavan General Hospital annual antibiotic awareness day; Delegates from all 29 receiving hospitals in Ireland attend Ebola conference; Rapid Access Prostate Cancer Service; Four more health centres in Meath become Tobacco Free; Information event to raise awareness of COPD; Children s Remembrance Event; Diabetes Information Evening at Louth County Hospital, Dundalk; Christmas Message. A discussion took place where members raised the following issues:- Request for information on the cost of hosting, turnout and engagement for the COPD Information event on 17 th November, 2014; Clarification on whether Chatterbox is unique to County Monaghan; Request for more information on Dublin hospitals to be included in HSE Updates. The requests and comments from members were responded to as follows:- A response will issue in relation to the COPD event; It is possible that the Chatterbox service could be rolled out nationally. However, at present it is only fully resourced in Cavan Monaghan; It was agreed to include further information on Dublin Hospitals in the HSE Updates. The report was noted by the Forum. 3. Presentation on Services for Older People Ms. Roisin Maguire, General Manager, Specialist Services for Older People, made a presentation to members on Services for Older People (copy appended to the official minute). Minutes of Regional Health Forum 2 24th November, 2014

Members thanked Ms. Maguire for her presentation and a discussion took place where members raised the following issues:- Shortage of long stay beds in North Dublin; Older people being encouraged not to wear slippers in order to prevent falls; Care for young people with alzheimer s disease - age limit; Delayed discharges belief that person should not be removed from hospital until a Home Care Package is in place; Types of elder abuse cases - request for numbers as opposed to percentages; Contact details for Senior Case Worker for Coolock; Comparisons re number of Home Help hours provided in previous year; Clarification on shifting emphasis of model of care to home and community supports maintaining an additional 1,000 older people to continue living in their own homes; Allocation of 23m from Fair Deal scheme to increase home care and community supports effect for people on waiting list for Fair Deal; Falls often related to medication problems - network of community pharmacists available for medication usage review; Dementia challenges including respite services, medication and care at night requirement for old age specialist nurse in certain circumstances; Strategy for dementia; Telecare systems and monitoring contractors and costs; Definition of older person. Ms. Maguire and senior management responded to the questions and comments from the members as follows:- Funding has been made available recently for additional long stay beds; The National Falls Strategy recommends older people wear footwear which fits properly, has good soles and is a suitable heel height for the individual; If a young person is diagnosed with an early onset condition that is usually a condition of the elderly then they are considered by older persons services. This might include dementia, alzheimer's, etc.; Within the Dublin hospitals, there was only one person waiting last week for a Home Care Package. This is huge progress. If a person is discharged by a consultant, they will be assessed to determine their needs at home or in the community. They will also be assessed again once home; Information on numbers of elder abuse cases to be provided; Details on the Senior Case Worker for the Coolock area to be forwarded to member; The number of Home Help hours provided in 2013 was the same as the current year; Potentially, 1,000 people would have gone to long term care changing the model of care will target this group to be cared for at home; Fair Deal will continue to maintain its level of service. However, the waiting list for Fair Deal is longer this year than in 2013; Medication usage review will be discussed with member; Minutes of Regional Health Forum 3 24th November, 2014

It is acknowledged that there is still a lot of work to be carried out in relation to dementia services. The possibility of including night carers into Home Care Packages is being examined. Currently, in most cases, private providers do not provide care at night time; The national strategy for dementia is due to be launched in the near future. It will be made available for members; The HSE provide contracted systems and monitoring as part of the Home Care Package. Details will be provided; An older person is classed as someone who is over 65 years old. 4. Motions That this North East Regional Health Forum will allocate and provide a minimum of 2,000 for the reprinting of a minimum 15,000 Signpost leaflets, an important resource produced by the Prevention and Education subgroup of the North East Regional Drugs Task Force. This publication is an invaluable health promotion tool, guidance document for parents, guardians and peers informing them of the manifold components of the misuse of drugs and alcohol in our communities. It provides clear signposts of where anyone can access help & support. Cllr. Gillian Toole Cllr. Gillian Toole commended the Signpost leaflets stating that they were excellent and the information contained in them was comprehensive. She stated that if funding could be found to reprint the leaflets, that it would be very graciously accepted. She hoped to be informed of a definite decision in the near future. 5. Questions To ask the Manger how many persons are currently on a Methadone Programme? Cllr. Lorna Nolan Cllr. Lorna Nolan queried if there was a generic version of methadone available and, if so, was it cheaper than methadone. Mr. Des O Flynn stated that this was clinical issue and that methadone is the primary prescription. Cllr. Gillian Toole informed the meeting that there are alternative manufacturers, however, costs remained similar. She stated that is was also a matter of client s preference and taste. Cllr. Christy Burke reported that he knew of clients that were on methadone for up to twenty years. He called on the HSE to produce guidelines on the length of time methadone can be prescribed, stating that reliance on methadone is just another addiction. To ask the HSE for an update on the situation pertaining to the Long Stay Units in Connolly Hospital which have been deemed not fit for purpose and which will close in the near future. Also, it is my understanding that money will be available to construct a new unit in their place. Can the HSE confirm whether planning for such a unit is imminent, as it is imperative that the residents of the old units Minutes of Regional Health Forum 4 24th November, 2014

avoid being traumatised by any disruption in their routine as some are quite delicate mentally? Cllr. Mary McCamley Cllr. Mary McCamley commented on the lack of timelines in the response and requested information on the timelines for the new 100 bed nursing unit. Ms. Roisin Maguire responded stating that the plans for the new unit were a recent decision and that the funding for the design was welcome. She stated that is was no possible to give a timeline at this stage but that an update would be provided at a future meeting. What is the current waiting time for children moving from early intervention services to HSE services in the region? Please provide a breakdown based on service where possible. Cllr. David Costello Cllr. David Costello referred to Speech and Language Therapy waiting times for children in the Dublin North City region and sought clarification on whether the wait time was for an appointment or to be seen. Mr. Des O Flynn informed Cllr. Costello that the wait time was in respect of the assessment. He also stated that a strategy is in place to move forward this waiting list. While recognising the National Forensic Hospital is a very positive development, not only for Portrane but the wider Fingal county, it is critically important that the HSE working in tandem with Fingal make a significant social dividend investment within the local community and this investment needs to reach to the wider community not just within the HSE campus. All of the groups on the Peninsula from Arts Culture, Sports and Voluntary sectors have long established links/association with St. Ita s, going as far back in some cases 100 years, and this relationship needs to be recognised by the HSE working within the area. Cllr. Adrian Henchy Cllr. Adrian Henchy contended the process of communication in the local area over the past number of months and stated that consultation should have been arranged with elected members. He stated that some community groups were unaware of the facility. He also stated that the commemorative plaque in Portrane cemetery was offensive and that the response in relation to the rejuvenation of a declining campus at St. Ita s was vague. In relation to the rerouting of walkways, Cllr. Henchy stated that these had been long established but were now lost. Have any meetings taken place recently between the HSE and the relevant government department, in relation to the promised new 100 bed unit at St. Mary s Hospital site, on the Dublin Road, Drogheda? Cllr. Tommy Byrne Minutes of Regional Health Forum 5 24th November, 2014

Cllr. Tommy Byrne stated that the response was very bad news and that the Government had promised a new 100 bed unit at St. Mary s Hospital. He said it was a disgrace and that he was bitterly disappointed and also that the people of Drogheda would not forgive. When will a full review of the methadone protocols be carried out, with input to be invited from all stakeholders involved in both the delivery of the service and most importantly, in receipt of this service? Cllr. Gillian Toole Cllr. Gillian Toole stated that a lot had changed in relation to the demographic of young people since the methadone review of 2010. She stated that it was necessary to expedite the actions from the Opioid Treatment Protocol. 6. Report by Chairperson of Committee The report was noted by the Forum. 7. Chairperson s Correspondence Cllr. Kieran Dennison, Chairperson, drew member s attention to the Forum Standing Orders section on Motions and Questions and asked that in future members would submit Motions and Questions specific to the area. 8. Date and time of next meeting The next meeting of the Regional Health Forum - will take place on Monday, 26th January, 2015 at 2:00pm. Signed: Kieran Dennison, Chairperson. Minutes of Regional Health Forum 6 24th November, 2014

REGIONAL HEALTH FORUM - DUBLIN NORTH EAST FÓRAM RÉIGIÚNACH SLÁINTE - BAILE ÁTHA CLIATH AGUS AN TOIRTHUAISCEART MINUTES OF MEETING HELD ON MONDAY, 24TH NOVEMBER, 2014 AT 2:00PM IN THE BOARDROOM, HSE, BECTIVE STREET, KELLS Members Present Cllr. Christy Burke Cllr. Tommy Byrne Cllr. Jack Chambers Cllr. David Costello Cllr. Kieran Dennison Cllr. Robbie Gallagher Cllr. Adrian Henchy Cllr. Deirdre Heney Cllr. Eithne Loftus Cllr. David Maxwell Cllr. Mary McCamley Cllr. Lorna Nolan Cllr. Ciaran O Moore Cllr. Tomás Sharkey Cllr. Gillian Toole Not in Attendance Cllr. Richie Culhane Cllr. Mark Dearey Cllr. Declan Flanagan Cllr. Gary Gannon Cllr. Séamas McGrattan Cllr. Brian McKenna Cllr. Noeleen Reilly Apologies Cllr. Philip Brady Cllr Wayne Forde Cllr. Paddy McDonald Cllr. Peter McVitty Cllr. Paddy Meade Cllr. Claire O Driscoll Cllr. Darren O Rourke Officials Present Ms. Rosaleen Harlin, Lead Manager, Regional Health Office - HSE DNE Mr. Des O Flynn, Area Manager, Dublin North City Ms. Roisin Maguire, General Manger, Specialist Services for Older People Mr. Enda Doody on behalf of Ms. Mary Walshe, Area Manager Dublin North Ms. Rose McCaffrey, on behalf of Mr. Leo Kinsella, Area Manager - Cavan/Monaghan Ms. Martina O Byrne, on behalf of Ms. Rosarii Mannion, Assistant National Director HR Ms. Katherine Kellett, Regional Health Office - HSE DNE Ms. Lorraine Timmons, Regional Health Office - HSE DNE Minutes of Regional Health Forum 1 24th November, 2014

1. Adoption of minutes of meeting held on Monday, 22 nd September, 2014 The minutes of the meeting held on Monday, 22nd September, 2014 were adopted by the Forum on the proposal of Cllr. Eithne Loftus and seconded by Cllr. David Maxwell. 2. Health Service Executive Updates Ms. Rosaleen Harlin, Lead Manager, Regional Health Office, gave a report to the meeting which dealt with the following:- HMI Leadership Award for Chatterbox, an innovative speech and language service in Cavan Monaghan; Cavan Monaghan Hospital commended for two projects at the Irish Healthcare Awards; Healthcare initiative leads the way in preventing pressure ulcers; Undertheweather.ie; Cavan General Hospital annual antibiotic awareness day; Delegates from all 29 receiving hospitals in Ireland attend Ebola conference; Rapid Access Prostate Cancer Service; Four more health centres in Meath become Tobacco Free; Information event to raise awareness of COPD; Children s Remembrance Event; Diabetes Information Evening at Louth County Hospital, Dundalk; Christmas Message. A discussion took place where members raised the following issues:- Request for information on the cost of hosting, turnout and engagement for the COPD Information event on 17 th November, 2014; Clarification on whether Chatterbox is unique to County Monaghan; Request for more information on Dublin hospitals to be included in HSE Updates. The requests and comments from members were responded to as follows:- A response will issue in relation to the COPD event; It is possible that the Chatterbox service could be rolled out nationally. However, at present it is only fully resourced in Cavan Monaghan; It was agreed to include further information on Dublin Hospitals in the HSE Updates. The report was noted by the Forum. 3. Presentation on Services for Older People Ms. Roisin Maguire, General Manager, Specialist Services for Older People, made a presentation to members on Services for Older People (copy appended to the official minute). Minutes of Regional Health Forum 2 24th November, 2014

Members thanked Ms. Maguire for her presentation and a discussion took place where members raised the following issues:- Shortage of long stay beds in North Dublin; Older people being encouraged not to wear slippers in order to prevent falls; Care for young people with alzheimer s disease - age limit; Delayed discharges belief that person should not be removed from hospital until a Home Care Package is in place; Types of elder abuse cases - request for numbers as opposed to percentages; Contact details for Senior Case Worker for Coolock; Comparisons re number of Home Help hours provided in previous year; Clarification on shifting emphasis of model of care to home and community supports maintaining an additional 1,000 older people to continue living in their own homes; Allocation of 23m from Fair Deal scheme to increase home care and community supports effect for people on waiting list for Fair Deal; Falls often related to medication problems - network of community pharmacists available for medication usage review; Dementia challenges including respite services, medication and care at night requirement for old age specialist nurse in certain circumstances; Strategy for dementia; Telecare systems and monitoring contractors and costs; Definition of older person. Ms. Maguire and senior management responded to the questions and comments from the members as follows:- Funding has been made available recently for additional long stay beds; The National Falls Strategy recommends older people wear footwear which fits properly, has good soles and is a suitable heel height for the individual; If a young person is diagnosed with an early onset condition that is usually a condition of the elderly then they are considered by older persons services. This might include dementia, alzheimer's, etc.; Within the Dublin hospitals, there was only one person waiting last week for a Home Care Package. This is huge progress. If a person is discharged by a consultant, they will be assessed to determine their needs at home or in the community. They will also be assessed again once home; Information on numbers of elder abuse cases to be provided; Details on the Senior Case Worker for the Coolock area to be forwarded to member; The number of Home Help hours provided in 2013 was the same as the current year; Potentially, 1,000 people would have gone to long term care changing the model of care will target this group to be cared for at home; Fair Deal will continue to maintain its level of service. However, the waiting list for Fair Deal is longer this year than in 2013; Medication usage review will be discussed with member; Minutes of Regional Health Forum 3 24th November, 2014

It is acknowledged that there is still a lot of work to be carried out in relation to dementia services. The possibility of including night carers into Home Care Packages is being examined. Currently, in most cases, private providers do not provide care at night time; The national strategy for dementia is due to be launched in the near future. It will be made available for members; The HSE provide contracted systems and monitoring as part of the Home Care Package. Details will be provided; An older person is classed as someone who is over 65 years old. 4. Motions That this North East Regional Health Forum will allocate and provide a minimum of 2,000 for the reprinting of a minimum 15,000 Signpost leaflets, an important resource produced by the Prevention and Education subgroup of the North East Regional Drugs Task Force. This publication is an invaluable health promotion tool, guidance document for parents, guardians and peers informing them of the manifold components of the misuse of drugs and alcohol in our communities. It provides clear signposts of where anyone can access help & support. Cllr. Gillian Toole Cllr. Gillian Toole commended the Signpost leaflets stating that they were excellent and the information contained in them was comprehensive. She stated that if funding could be found to reprint the leaflets, that it would be very graciously accepted. She hoped to be informed of a definite decision in the near future. 5. Questions To ask the Manger how many persons are currently on a Methadone Programme? Cllr. Lorna Nolan Cllr. Lorna Nolan queried if there was a generic version of methadone available and, if so, was it cheaper than methadone. Mr. Des O Flynn stated that this was clinical issue and that methadone is the primary prescription. Cllr. Gillian Toole informed the meeting that there are alternative manufacturers, however, costs remained similar. She stated that is was also a matter of client s preference and taste. Cllr. Christy Burke reported that he knew of clients that were on methadone for up to twenty years. He called on the HSE to produce guidelines on the length of time methadone can be prescribed, stating that reliance on methadone is just another addiction. To ask the HSE for an update on the situation pertaining to the Long Stay Units in Connolly Hospital which have been deemed not fit for purpose and which will close in the near future. Also, it is my understanding that money will be available to construct a new unit in their place. Can the HSE confirm whether planning for such a unit is imminent, as it is imperative that the residents of the old units Minutes of Regional Health Forum 4 24th November, 2014

avoid being traumatised by any disruption in their routine as some are quite delicate mentally? Cllr. Mary McCamley Cllr. Mary McCamley commented on the lack of timelines in the response and requested information on the timelines for the new 100 bed nursing unit. Ms. Roisin Maguire responded stating that the plans for the new unit were a recent decision and that the funding for the design was welcome. She stated that is was no possible to give a timeline at this stage but that an update would be provided at a future meeting. What is the current waiting time for children moving from early intervention services to HSE services in the region? Please provide a breakdown based on service where possible. Cllr. David Costello Cllr. David Costello referred to Speech and Language Therapy waiting times for children in the Dublin North City region and sought clarification on whether the wait time was for an appointment or to be seen. Mr. Des O Flynn informed Cllr. Costello that the wait time was in respect of the assessment. He also stated that a strategy is in place to move forward this waiting list. While recognising the National Forensic Hospital is a very positive development, not only for Portrane but the wider Fingal county, it is critically important that the HSE working in tandem with Fingal make a significant social dividend investment within the local community and this investment needs to reach to the wider community not just within the HSE campus. All of the groups on the Peninsula from Arts Culture, Sports and Voluntary sectors have long established links/association with St. Ita s, going as far back in some cases 100 years, and this relationship needs to be recognised by the HSE working within the area. Cllr. Adrian Henchy Cllr. Adrian Henchy contended the process of communication in the local area over the past number of months and stated that consultation should have been arranged with elected members. He stated that some community groups were unaware of the facility. He also stated that the commemorative plaque in Portrane cemetery was offensive and that the response in relation to the rejuvenation of a declining campus at St. Ita s was vague. In relation to the rerouting of walkways, Cllr. Henchy stated that these had been long established but were now lost. Have any meetings taken place recently between the HSE and the relevant government department, in relation to the promised new 100 bed unit at St. Mary s Hospital site, on the Dublin Road, Drogheda? Cllr. Tommy Byrne Minutes of Regional Health Forum 5 24th November, 2014

Cllr. Tommy Byrne stated that the response was very bad news and that the Government had promised a new 100 bed unit at St. Mary s Hospital. He said it was a disgrace and that he was bitterly disappointed and also that the people of Drogheda would not forgive. When will a full review of the methadone protocols be carried out, with input to be invited from all stakeholders involved in both the delivery of the service and most importantly, in receipt of this service? Cllr. Gillian Toole Cllr. Gillian Toole stated that a lot had changed in relation to the demographic of young people since the methadone review of 2010. She stated that it was necessary to expedite the actions from the Opioid Treatment Protocol. 6. Report by Chairperson of Committee The report was noted by the Forum. 7. Chairperson s Correspondence Cllr. Kieran Dennison, Chairperson, drew member s attention to the Forum Standing Orders section on Motions and Questions and asked that in future members would submit Motions and Questions specific to the area. 8. Date and time of next meeting The next meeting of the Regional Health Forum - will take place on Monday, 26th January, 2015 at 2:00pm. Signed: Kieran Dennison, Chairperson. Minutes of Regional Health Forum 6 24th November, 2014