Gerry Adams (Louth, Sinn Fein)
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1098. To ask the Minister for Health the number of children registered in each CHO area as having a life limiting condition. [37845/17]

Gerry Adams (Louth, Sinn Fein)
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1099. To ask the Minister for Health the number of children in County Donegal registered as needing palliative care treatment, end of life care, and associated respite care services; and if he will make a statement on the matter. [37846/17]

Gerry Adams (Louth, Sinn Fein)
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1100. To ask the Minister for Health the existing services for hospice care for persons under 18 years of age in each CHO area. [37847/17]

Gerry Adams (Louth, Sinn Fein)
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1101. To ask the Minister for Health the services for hospice care for persons over 18 years of age in each CHO area. [37848/17]

Gerry Adams (Louth, Sinn Fein)
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1102. To ask the Minister for Health the palliative care services that exist for children under 18 years of age in County Donegal; the way in which children access these services; and if he will make a statement on the matter. [37849/17]

Gerry Adams (Louth, Sinn Fein)
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1103. To ask the Minister for Health the palliative care services for children under 18 years of age in each CHO area. [37850/17]

Gerry Adams (Louth, Sinn Fein)
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1104. To ask the Minister for Health the respite services for children under 18 years of age with life limiting conditions and highly complex needs in each CHO area. [37851/17]

Gerry Adams (Louth, Sinn Fein)
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1105. To ask the Minister for Health the service level agreements in place between the HSE and services in Northern Ireland for the provision of hospice care for children under 18 years of age. [37852/17]

Gerry Adams (Louth, Sinn Fein)
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1106. To ask the Minister for Health the service level agreements in place between the HSE and services in Northern Ireland for the provision of palliative care for children under 18 years of age [37853/17]

Gerry Adams (Louth, Sinn Fein)
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1107. To ask the Minister for Health if there are discussions under way between the HSE and services in Northern Ireland to specifically examine cross-Border palliative care, and palliative respite care for children under 18 years of age; if so, if he will provide an update in respect of these discussions; and if he will make a statement on the matter. [37854/17]

Jim Daly (Cork South West, Fine Gael)
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I propose to take Questions Nos. 1098 to 1107, inclusive, together.

As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Gerry Adams (Louth, Sinn Fein)
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1108. To ask the Minister for Health the recommendations made further to the review of the 2016 children's palliative care programme; the number of the recommendations that have been explored in further detail; and the number of the recommendations that have been implemented to date. [37855/17]

Jim Daly (Cork South West, Fine Gael)
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The evaluation of the Children’s Palliative Care Programme, which was published in November 2016, contains 20 recommendations for the further development of children’s palliative care services. The Evaluation noted that the Children’s Palliative Care Programme had made a major difference to the lives of children with palliative care needs and their families and recommended a strengthening of the Children’s Palliative Care Programme to include more children’s outreach nurses, a second consultant paediatrician post with a special interest in children’s palliative medicine and a continuation of the education programme in Crumlin. To date, all but one of the recommendations (recommendation 3) have been explored in further detail, and 17 of the recommendations are being progressed. Some of the most significant areas of progress are highlighted below.

The aim of the children’s outreach nursing service is to co-ordinate seamless continuity of care between the acute paediatric unit, community services and the child’s home. The nurse develops strong working relationships with colleagues within the acute and community settings e.g. paediatric medicine, general practice, community paediatric services, disability services, nursing services, specialist adult palliative care home teams, and voluntary services such as Jack and Jill, Laura Lynn, etc. Two additional Children’s Outreach Nurses were recruited in 2017, one in Donegal and one in Dublin. A third new nurse will be appointed in Kerry in 2018.

The Consultant Paediatrician with a Special Interest in Palliative Care leads the specialist paediatric palliative care team in Our Lady’s Children’s Hospital Crumlin. Preparations are under way to recruit a second consultant paediatrician with a special interest in children’s palliative medicine who will be based in Temple Street. This post will be funded by the IHF for the first year, and by the HSE thereafter. The Children’s Hospital Group has agreed that the posts will be located in the New National Children’s Hospital when opened.

A business case has been submitted to the HSE’s office for Nursing and Midwifery Service Development for the continuation of the training courses in Crumlin on caring for children with life-limiting conditions. There is a commitment to provide training to meet the needs of community based adult palliative care teams and hospital based paediatric medical and nursing staff.

The IHF and Laura Lynn have agreed to fund a national coordinator for children’s palliative care for a three-year period. Discussions are underway with the Children’s Hospital Group and the appropriate Integrated/Clinical Programmes on the job description and the full integration of the role into paediatric services.

With regard to the recommendation on the provision of adequate and needs based respite services, discussions have commenced with HSE Primary Care and Disability Services on the integration of children’s palliative care with existing and future in-home and out-of-home services.

The HSE is addressing the lack of available and standardised bereavement care in conjunction with the IHF. A scoping exercise is required to identify existing services and gaps in service provision.

As highlighted by the Evaluation, integration with disability services, primary care, complex care, the new National Children’s Hospital and the paediatric clinical care programme is being pursued as a key part of the implementation of the recommendations.