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Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Bernard Durkan: ...is to discuss consideration of access to community neurological rehabilitation teams. To assist the committee with this I am pleased to welcome from the Neurological Alliance of Ireland, NAI, Ms Magdalen Rogers, executive director, Dr. Susan Coote, associate professor, University of Limerick, and Dr. Niall Pender, principal clinical neuropsychologist in Beaumont Hospital and associate...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: On behalf of the Neurological Alliance of Ireland, the national umbrella for more than 30 neurological charities, I thank the Chair and members of the committee for their invitation to discuss the issue of access to community neurorehabilitation teams. We welcome this opportunity to update the committee following on from the NAI presentation in March last year on growing...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: The addition of three specialist nurses to University Hospital Galway is very important and we warmly welcome it, although, as the Senator said, there is still a shortfall in specialist nursing in the hospital. It will take time to recruit and train the nurses. It is important that those nurses bed down in the system but also that there be longer term planning to...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: I spoke just yesterday to representatives of the Irish Neurology Nursing Forum, which was set up last year, and to the clinical lead for neurology services, and they assure me plans are coming on board for third level training for specialist nurses in neurology. That will increase the capacity in the system to recruit, train and put nurses in place in the more than 30...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: Yes. The nurse training was a critical aspect of this, and when we were running the campaign, we always knew this needed to happen in tandem. Thanks to the clinical lead for neurology services, Professor Hardiman, and the Irish Neurology Nursing Forum, that work has been done and is ongoing to ensure third level specialist training will be available for neurology...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: I will ask Dr. Coote to comment on that because there is an important aspect relating to specialism and the specialisms of the community neurorehabilitation teams.

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: Nationwide, we highlighted at the start of our campaign a shortage of over 100 specialist nurses in neurology services. Following the very successful campaign that we ran with the support of members of this committee and other elected representatives, we had 23 funded as part of the campaign, but if we take into account other initiatives within neurology services and the...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: There is. What we need to see is workforce planning in the medium to long term to put those nurses in place.

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: We were very realistic from the start of the campaign. We called for up to 20 nurses a year over five years in order to implement the model of care for neurology services, and that would still be our messaging around that. As I said, we have seen an unprecedented number with the 30 positions funded this year, but it is important to point out that this is after a very...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: Yes, that is correct.

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: Yes, that funding has been in place since November 2020 and we have not seen teams established on the ground - that refers to CHOs 6 and 7. Funding was announced in budget 2023 for two neurorehabilitation teams and an announcement came out last week from the Minister of State, Deputy Rabbitte, that those teams would be in CHOs 2 and 4.

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: The information on the current provision is also our understanding. The date of 2026 is new to me and the Neurological Alliance of Ireland. I would be concerned about that timeframe, given the implementation plan which was recommending the nine teams – that is, a team in each area - between 2019 and 2021 was not implemented. I would be concerned we are now...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: This is tried and tested. These teams have been up and running for a number of years. Those in CHO 1 and CHO 3 have been in place for more than a decade. There is a blueprint for these teams. There is a geographic inequity. We explain to patients on a daily basis that if they live in the CHO 1 or CHO 3 areas, they can access this service. That is not the case for...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: It is important. I thank Deputy Shortall for that comment and for reminding us about the neurorehabilitation strategy. The strategy dates back to 2011. We waited in the wilderness for an implementation plan, which eventually emerged in 2019 and covered the period up to 2021. As the Deputy Will be aware from other testimonies we have given to this committee, we saw...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: There were multiple reasons, including Covid-19 and staff changing. The delays between the publication of the strategy in 2011 and the emergence an implementation framework in 2019 show that there is a lack of a sense of urgency around the implementation of this strategy. While we have had engagement, there is a serious catch-up piece. I become anxious when I hear...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: With inpatient services, there are buildings and specialist staffing required. There are no buildings required for community neurorehabilitation teams. There are facilities up and running in the community where these teams could be accommodated.

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: Exactly.

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: The specialist model of care for rehabilitation services sets out the recommended staffing for community neurorehabilitation teams. At the moment, the national steering group is looking at a staffing of about 11 staff members, and that would include all the core disciplines, including speech and language therapy and occupational therapy, but ,critically, also services...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: Establishing the nine teams is just a first step. One would have one team to cover the 300,000 or 400,000 population within a CHO. It is a huge commitment for that team of 11 people, so we would see it as just a start. It is important to emphasise that even this, namely, even having one team for those huge CHO areas, has not happened in most CHOs. It is a forward...

Joint Oireachtas Committee on Health: Access to Community Neurological Rehabilitation Teams: Discussion (17 May 2023)

Ms Magdalen Rogers: That is very welcome.