Tuesday, 11 May 2021
Nithe i dtosach suíonna - Commencement Matters
Health Services Staff
I want to raise the very important issue of the appointment of eye care liaison officers, ECLOs, to the hospital groups throughout the country. When somebody is diagnosed for the first time with sight loss, the consultant will have a one-stop-shop person to whom to refer the individual. This is a person who will advise them on the various step-down services, peer counselling and supports, from the National Council for the Blind and guide dogs to peer counselling. That officer will also assist with follow-up medical interventions, appointments, advice and so on.
This has been piloted in Dublin between Temple Street Children's Hospital and Crumlin Children's Hospital. At a very early stage, the number of referrals to the step-down support services has increased dramatically and the result that people go on to live independent lives has been demonstrated in recent years. Quick diagnosis, early intervention and fast engagement with services has proven to be invaluable. This has worked very well in the UK and, as I said, it is working in Dublin.
I tabled a Private Members’ motion on this during the previous Seanad in 2019 and it was accepted unanimously that this would be rolled out to all hospital groups. Following my re-election to the Seanad, I have continued advocating on this specific issue. The various consultants involved are stressed and are working to the limit. Some have a very strong knowledge of the aftercare and support services, while others have just a working knowledge. To bring continuity to everybody in this country, irrespective of where they live, I want ECLOs rolled out in Waterford, Cork, Limerick, Galway and Sligo, and an additional ECLO in Dublin.
A meeting took place prior to Christmas between Liam Woods of the HSE and his team and the National Council for the Blind of Ireland, NCBI, which is in charge of the pilot taking place in Dublin. This was committed to very clearly at that meeting and the HSE agreed with and saw the benefit of the policy, and was happy to commit that the seven additional ECLOs would be rolled out in 2021. I completely understand that we are in the midst of a global pandemic and I know that things are stressed and stretched. However, I also know that other healthcare is progressing and there are developments in other areas of healthcare. That is why I believe we need immediate action on this issue. It has been committed to, including in this House. Equally as important, it was committed to by the HSE at that meeting before Christmas. It is now May so if the commitment to see ECLOs rolled out throughout the country is to be delivered in 2021, we need action.
That is the ask and it is a very reasonable ask. It is a project and an intervention that has worked enormously well abroad, and where it was piloted here in Dublin city, it has been proven to work extremely well. I look forward to the Minister of State's response.
I thank the Senator for the opportunity, on behalf of the Minister for Health, Deputy Donnelly, to address the issue of appointing eye care liaison officers, ECLOs. The ECLO service provides practical and emotional support to patients and their families to meet their needs when a diagnosis of sight loss is made. The officer works closely with clinical teams and provides a link between acute and community-based services. The service helps to ensure that patients and families are well informed and understand the condition and the supports available to them. This service is currently available in the Mater University Hospital, the Royal Victoria Eye and Ear Hospital, Temple Street Children's Hospital and Crumlin children's hospital.
I understand that the HSE met with the NCBI in December 2020 to discuss the issue of expanding the service. The NCBI identified the potential benefits associated with the introduction of ECLO posts and experience from the introduction of such posts in hospitals. I regret that the HSE was not in a position to allocate specific resources to support this development in 2021.However, the HSE is examining the potential to support NCBI in 2021 with the current resources. The HSE will engage directly with NCBI in this regard. The HSE primary care eye services review group report, published in June 2017, sets out the way forward for a significant amount of eye services to be delivered in a primary care setting. Supported by the clinical programme in ophthalmology and its model of care, the report recommends integrated care provision with hospital ophthalmic services. This will ensure that hospital ophthalmic departments are focused on patients who require more specialised diagnostics or treatments. The recommendations of the report are being implemented on a phased basis as resources allow. This includes primary care revenue funding and the Sláintecare integration funding for 2019.
Implementation to date has focused on establishing and expanding primary care eye teams in Dublin, Kildare and Wicklow. The initial priority is to address backlogs in waiting lists for paediatric eye care services. Waiting list numbers show significant progress has been made in this regard by the primary care eye teams in these areas. The HSE plans to redirect some adult outpatient care from acute services to these teams too. When this is rolled out, the teams will focus on pre- and post-operative cataract care and the management of stable glaucoma patients. I expect that the roll out of integrated eye care teams will make a significant contribution to reducing waiting lists and ensuring that hospital ophthalmic departments can focus on surgical activities and more complex referrals.
I sincerely thank the Minister of State for his reply and note the good work that has been done by various ophthalmologists and teams around the country. This is specific. It is about having eye care liaison officers appointed who can advise on the step-down services and how people can emotionally come to terms with the fact that they have been diagnosed with sight loss. It is an extraordinarily traumatic experience for people who have never experienced sight loss before. The cost of rolling out these seven eye care liaison officers is €560,000. In the overall scheme of a budget of €24 billion, it is not a huge amount. Can the Minister of State, Deputy Feighan, arrange for Liam Woods and his team to meet the National Council for the Blind to discuss this matter further as a matter of urgency in the next couple of weeks? We are in the middle of the year and a further engagement to recalibrate, establish where we are and come up with a timeframe in which this service can be delivered is critical.
I thank Senator Conway for his interest in the situation. I will talk to the Minister to organise a meeting between Liam Woods and his team and the NCBI as quickly as possible. I know that the eye care liaison officer provides an important and worthwhile service by providing non-clinical support for patients and their families and allowing clinicians to focus on diagnosis, treatment and medical follow up. This approach of allowing clinicians to focus on their specific clinical work is also in line with the integrated eye care teams approach. Eye care liaison officers are and would be a valuable resource in all hospital ophthalmic departments. The Minister has asked the HSE to continue to examine how it can best support the appointment of additional eye care liaison officers and to keep me informed of progress in this regard. We will set up that meeting between the teams and the NCBI.