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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: 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: Yes, that is correct.

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: That is very welcome.

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

Ms Magdalen Rogers: A study was done by the European Brain Council in 2010 which estimated that the cost of neurological disorders in Ireland was €38 billion annually. It is reasonable to assume that the figure has increased since then.

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

Ms Magdalen Rogers: Yes, healthcare, social services and so on-----

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

Ms Magdalen Rogers: Are we allowed to name individuals?

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

Ms Magdalen Rogers: There is a backlog and there is also a missed opportunity for those individuals. There is a critical window in which to provide neurorehabilitation. These people are presenting to services in a worse condition than they should be and needing extra rehabilitation to make up for what they lost.

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

Ms Magdalen Rogers: The estimate is that more than 800,000 people are living with a neurological condition. It seems a huge number but we must consider the vast range of conditions, including everything from migraine to epilepsy, multiple sclerosis, acquired brain injury, stroke and Alzheimer's disease.

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

Ms Magdalen Rogers: Thinking about it, each of us knows someone, whether a family member or a person in our circle, who has one or more neurological conditions.

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

Ms Magdalen Rogers: Ireland is signed up to the UN Convention on the Rights of Persons with Disabilities, CRPD, which includes a commitment to provide rehabilitation services at all levels of the pathway. We have committed to that as a country but we are not delivering it, as Dr. Coote said.

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

Ms Magdalen Rogers: We would certainly encourage the review. Feedback from member organisations indicates they certainly feel more could be done with the managed access programme for conditions such as epilepsy and chronic pain. We certainly encourage the timely review.

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

Ms Magdalen Rogers: We are on the steering group for the national neurorehabilitation strategy and we are not aware that those proposals have come to the table as yet. We can come back to the Deputy with any information we have on that.

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

Ms Magdalen Rogers: That is where these teams would come in.

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

Ms Magdalen Rogers: The Wasted Lives report was in the news just earlier this week, reiterating that because of the lack of those services in the community, we have that high proportion of people under 65 living in nursing homes. A high proportion of those would have neurological conditions.

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

Ms Magdalen Rogers: It would be important to explore the issues with the governance model and what can be done to resolve them. Most critically, we need a timeframe for this. Will that timeframe be adhered to in order to have those teams up and running by the end of the year?

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

Ms Magdalen Rogers: There is a saving of three bed days on average if a patient is discharged to a community rehabilitation team, which is an immediate saving.

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

Ms Magdalen Rogers: The Covid-19 pandemic has increased the urgency of this because we are aware that people missed out on neurorehabilitation. They had to be discharged and they were not able to be admitted to neurorehabilitation facilities. There is a burden in the community of people who missed out on neurorehabilitation.

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