Ms Colette Cahill:

Health and continence is one of the six key theme areas we have within Crann. As the Deputy rightly said, we have made a business case for an SLA within the HSE. Speaking to Ms Jarvey's point on the research carried out, the need identified by the stakeholders was the lack of community support around bowel and bladder continence services. We set about addressing this at Crann. We set up our continence service, which is the only community continence service that covers both bowel and bladder. It is a sensitive area for us, as a nation, and in our culture to talk about, but it is the elephant in the room when it comes to disability. If you ask a person with a spinal cord or another type of injury, continence is the biggest factor that causes a lot of ripple effects.

Our continence service has grown exponentially. In the last year alone, we have seen 75% growth in people attending our service, which is quite substantial. What we provide is support to the individual. It is a human right to be able to manage your continence and to go out. It affects families because they plan their trips and journeys based on where the next toileting facility is. For the service we provide, we bring in and meet with families and work with them over a period of time. Our nurses, Eimear and Ita, work with them to come up with a programme that works for them. Many of our referrals come from hospitals and community settings because we can give the time to provide that support. The reason it works so well is that, while we have our health and continence service, we are not just a medical model, as Ms Jarvey said, and as came out in the research. We also provide psychological supports that can go around having continence issues. We have mobility and occupational therapy services, so if seating or positioning is an issue we can bring that service in. It is a wraparound service.

We discovered through working with families that there was a gap in that SNAs in schools were not being trained so our team, including Ita and Eimear, took that on. Eimear developed an SNA training programme to align with the hospitals. We are currently the only setting providing SNA training for continence in Ireland. We have trained 120 SNAs in the past year and a half.