HSE–HfH Joint Oversight Group

Progress & Plans

Cillian Twomey

Chairman, Joint Oversight Group

• Dying

• End of Life

• Death• whilst ….maximising living to the

fullest possible extent …..

• Bereavement

End-of-Life Care

No one should have to face death or bereavement without the appropriate care and support.

Optimum End-of-Life Care

is primarily about placing the individual at the centre of

ALL decision-making

Optimum End-of-Life Care

•Exercising choice

•Communication

•‘Nothing about you, without you’ (SAGE)

Hospice Friendly Hospice Programme

• Joint IHF & HSE pilot in Our Lady of Lourdes Hospital, Drogheda

(2005-2006)

• HfH (IHF-HSE-AP) Programme

(2007-2012)

–Quality Standards• Patient – Family – Hospital – Staff

The 4 standards

Public Consultation152 submissions received

The Link between Standards and Audit

• Joint IHF & HSE pilot in Our Lady of Lourdes Hospital, Drogheda (2005-2006)

• HfH Programme (2007-2012)– Quality Standards

• Increasing enthusiasm, interest & involvement by healthcare staff – in all settings –– EoL Coordinators, – EoLC Committees, – Staff discussion and – protected time for education

47 Hospitals linked to the HfH Programme

Saolta RCSI

IE

S / SW

12/05/17 Presentation Title goes here 13

RCSI Hospitals Groups

Rotunda Hospital, Dublin

Beaumont Hospital

Connolly Hospital, Blanchardstown

Cavan General Hospital

Louth County Hospital, Dundalk

Our Lady of Lourdes Hospital, Drogheda

Saolta University Health Care Group

University Hospital Galway and Merlin Park

Letterkenny General Hospital

Sligo Regional Hospital

Mayo General Hospital

Roscommon County Hospital

Portiuncula Hospital, BallinasloeIreland East Hospitals Group

Mater Misericordiae University Hospital

National Maternity Hospital, Holles St

Midland Regional Hospital Mullingar

St Luke's General Hospital, Kilkenny

Wexford General Hospital

Our Lady's Hospital, Navan

St Vincent’s University Hospital (Public)

St Michael’s Hospital, Dun Laoghaire

South / South West Hospital Group

Cork University Hospital

Cork University Maternity Hospital

Bantry General Hospital

Mallow General Hospital

South Victoria University Hospital

Mercy University Hospital

South Tipperary General Hospital

Kerry General Hospital

University Hospital Waterford

Dublin Midlands Hospital Group

St James's Hospital

Tallaght Hospital

The Coombe Women and Infant University Hospital

Naas General Hospital

Midland Regional Hospital, Portlaoise

Tullamore Hospital

DM

University of Limerick Hospitals Group

University Hospital, Limerick

University Maternity Hospital, Limerick

Nenagh Hospital

Ennis Hospital

St John’s HospitalUL

(August 2016)

Children’s Hospitals

Our Lady's Children's Hospital, Crumlin

Templet St Children’s University Hospital

Private Hospitals

Mater Private Hospital

The Galway Clinic

Bons Secours Hospital, Dublin

The Beacon Hospital, Dublin

The Hermitage Medical Clinic

S-SW

Irl-East

SaoltaRCSI

A Good Death (2014)

A Reflection on Ombudsman Complaints about End of Life Care in Irish Hospitals

Oifig an OmbudsmanOffice of the Ombudsman

Website: www.ombudsman.ie

Survey of Bereaved Relatives

VOICES MaJam Results (2016) Mater Misericordiae University Hospital, Eccles Street, Dublin 7

www.mater.ie

St James’s Hospital, James’s Street, Dublin 8

www.stjames.ie

Voices – MaJam Survey of Bereaved Relatives

•356 Relatives – 2 Hospitals – 46% Response Rate

•Quality of Care

• Outstanding – 34%

• Excellent – 36%

• Good – 17%

• Fair– 7%

• Poor– 5%

• Don’t Know– 1%

10 years on …….• Increased awareness of palliative and end of life

issues

• Service improvement focus and pivot for change

• Facilitates practical expression of HSE corporate and staff values

• Design and Dignity Grant system provides funding for build environment

• Maternity and Child Networks highlight needs of particular groups

Joint HSE-HfH Oversight Group

• Provide recommendations on approach to mainstreaming the HfH programme across hospitals into the future.

• Provide practical recommendations on increasing the level of awareness and communications associated with HfH across hospitals nationally

• Provide recommendations on alignment of HfH within the broader Acute Hospital Division – quality and service improvement initiatives (e.g. National and Hospital Group Strategic / Operational plans).

Joint HSE-HfH Oversight Group

• Provide recommendations on alignment of HfH within other HSE division quality and service improvement initiatives (e.g. Quality Improvement, HR, Primary Care).

• Assess the expansion opportunities for the HfH programme across the hospital system

• With the agreement of the Hospital Group CEOs, the Oversight Group may facilitate joint and collaborative working across hospitals on specific initiatives or projects.

Membership

• Chairman• Clinical Programme representatives from Emergency

Department, Older Persons, Paediatric Care and Palliative Care,

• End-of-Life Coordinator reps x 2• HfH Acute Network Chair• HSE (Acute Hospital Division) • HSE (Primary & Community Care) – 2018 • HSE (Quality Improvement)• Hospital Group CEOs • Hospital Group DoNs • IHF reps x 2• Office of the Ombudsman

So far …..

• Inaugural OG meeting – 8 May 2017– 2 Oct 2017– Next meeting 19 Feb 2018

• Met Ombudsman (20 Oct ‘17)

• Planning to meet Hospital Groups CEOs

Themes to datePatient Experience: •How can HfH programme be informed by experience of patients and families?

Linkages with Clinical Leads: •How can HfH cross reference existing outputs with HSE Clinical Programmes

Education/Training: •Identify approach to review FJ training and determine other ways to improve content and access to education and training on end of life, palliative and bereavement care

Care delivered at End-of-Life?•How can the oversight programme reduce variability that exposes care delivered at end of life?

Working Relationships

National Director Acute Hospitals

ChairOversight Group

Joint Oversight

Group

Hospital Groups CEOs

Hospitals and EoL Committees

HSE (Primary & Community Care)

Ireland – 65yrs+

• by 2020 – 1 in 4 will be >65 years

• by 2050 - older people will outnumber children for the first time

Ageing demography

• Life Expectancy –

– 83.5 yrs (female)

– 79.3 yrs (male)

• Census 2016 – 637,567– an 19.1% increase since Census 2011

– projected to > by 167% by 2048

It is essential that:

–ALLHSE CEOs, DoNs & Clinicians/Clinical Leads buy-in and support

• include HfH funding in their Annual Service Plans

Happy 10th • Well done all

• Keep up the good work …

• Thank you ….