Southern Health Board annual report 1995
Item Type Report
Authors Southern Health Board (SHB)
Rights SHB
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Caring for People
Annual Report ;\nnuai Repon 1995
- INDEX -
PAGE
Index
Introduction : Chief Executive Officer
Board Members and Management Team
Community Care Programme
Acute Hospitals Programme
Mental Health & Mental Handicap Services Programme
Department of Public Health
FiceDepamnent
Personnei Department
Technical Senices Department
Management Senices Department ANNUAL RFPORT 1995
1995 saw c.5e sr--aued Fnplmen~zz:cri sf :he ?Jaclonai .i'eaiz:= Strategy 2nd a cmprener.si7e szogress reporr ;gas submizted rc che Geparrxenc cf .?eair:-.. The Xinisrer _'or, 3eaic:: and cificlais frsm .?ls. . ceparrzenr net 50rh cie 3oard and t.+e :!aagemenc _"?am in June 1395. %e ,~isiz:.?as 3 ver:/ successf;.l and significan~one.
!1EW ;:?JC?II^:I +.lcnasises c:?e r2quizzx?r.r ;f snsuzi:q z.$e deiirJery cf i quality service. .A wr:/ successful "Pocus on Quality" Seminar was heid in Blarney In October 1995. Guesc speakers lame izom Zngland, ocher .Yeait?: Boards, - Deparzaenc :f .Veal t.9, irisn Society for Quality I.? Heait-lcare and zwo of our own szaff representing the group of trained Quality Facilitators jn the Board. Work commenced in December 1995 on a Quaiity Improvement Strategy and t.9i.s will be launched in 1996.
The Health Strategy, in recognising the major contribution of health care staff, emphasises the need for further nmuragement and support. 1 am pleased to say t.9at much k-as achieved in 1995 in encouraging and supporting the sersonal and professionai development of staff.
I wish to record my personal thanks to all staff for their continued dedication and commirment to our task of "Caring for People".
I also wish KO record my appreciation of the loyalty and commitment of the Management Team t.5roughouc the year and I thank the Chairman and Members of :he Board for their support througnout 1995.
SEAN HURLEY CHIEF EXECUTIVE OFFICER --
SOUTHERN HEALTH BOARD .MEMBERS AND MANAGEMENT TEAM at December 31st. 1995 L
CHAIRMAN AJd. J. Dennehy
VICE-CHAIRMAN - Dr. A.J. Stynes
APPOINTED BY CORK CORPORATION:- .Uderman J. De~ehy,"Avondale", Westside Estate, Togher. Cork Sen. D. Cregan, 7, Elmgrove, Ballinlough, Cork Cllr. F. Xash, 1 Gouldmgs Cottages. Dillons Cross, Cork. Cllr. C. O'Leq, 1 St. Rita's Avenue, Gurranebraher, Cork. Cllr. D. Wallace, 63 Memon Court, Monrenotte, Cork.
APPOXNTED BY CORK COUNTY COUNCIL.- Cllr. M. Creed, T.D., Codrum, Macrooq Co. Cork. Cllr. F. Crowley, T.D., Strand Street, Kanturk, Co. Cork. Cllr. V O'Callaghan, Barmy Bay Hotel, Bantry, Co. Cork. Cllr. B. O'Keeffe, T.D., 8 Westcliffe, BallincoUig, Co. Cork. CUr. S. O'SuUivan, 11 Crestfield Downs, Hazelwood, Glanmire, Co. Cork. Cllr. J. Roche, Clough, Rockchapel, Co. Cork. CUr. T. Ryan, "Ardiield", Dripsey, Co. Cork.
APPOINTED BY KERRY COUNTY COUNCIL- Cllr. M. Cahill, Rossbeigh, Glenbeigh, Co. Kerry. CUr. T. Fleming, Scartaglen Viage, Farranfore, Co. Kerry. Cllr. T. Foley, 28 St. John's Park, Tralee, Co. Keny. Cllr. J. Healy-Rae, Main Street, Kilgarvan, Co. Kerry. CUr. B. O'Connell, 15 Main Street, Castleisland, Co. Kerry. Cllr. M. Spring, 37 Racecourse Lawn, Tralee, Co. Kerry.
ELECTED BY REGISTERED MEDICAL PRACTITIONERS:- ?&. S. Baker, F.RC.S., "Carhukeal", Bantry, Co. Cork. Dr. C. Bred'i Consultant Physician, Cork University Hospital, Wilton, Cork. Mr. T.F. Buckley, Consultant Neurosurgeon, Cork University Hospital, Wdton, Cork Dr. J.G. Corr, M.B., Glenbrook, Co. Cork. Dr. C. Molloy, G.P.,'Lucerne', Hettyiield, Douglas, Cork. Dr. P. Murray, Consultant Psychiatrist, Child and Famiiy Clinic, Lota, Glanmire, Co. Cork. Dr. T. O'Connor, Consultant Obstetrician, St. Fibarr's Hospital, Cork. Dr. AJ. Stynes, 26 Templevale, Ballintemple, Cork Annual Report 1995
ELECTED BY REGISTERED PSYCHIATRIC NURSES:- Ms. H M. Henry, Nurse Tutor. Our Ladv's Hospital, Lee Road. Cork
ELECTED BY REGISTERED NURSES:- MS. Mona Clancv, Public Heahn Surse. Cathenne Street. Youghal. Co Cor'ic
ELECTED BY REGISTERED DENTISTS:- Dr. Eoin O'Flyq Principal Denral Surgeon. 4, Rochestown Rise, Rochesrown. Cork.
ELECTED BY REGISTERED PHARMACEUTICAL CBEMISTSIREGISTERED DISPENSING CHEMISTSIDRUGGISTS:- .Mr. P. Duffy, WSI, Oak6eid. Hettyiield, Douglas Road, Cork.
APPOINTED BY THE MJA7STER FOR EIEALTH:- Mr. D. Lyons, Tower, Blarney, Co. Cork. Cur. D. Moman, T.D., Gonnascarty, Ballyrnakeera, Co. Cork. Cllr. John O'Donoghue, T.D.. i4 Main Street, Caherciveen Co. Kerry
MANAGEMENT TEAM
Mr. S& Hurley, Chief Executive Officer Mr. Tony McNamara, Genera1 Manager, Cork University Hospitals Group Mr. Pat Madden, Programme *Manager, Community Care Mr. Tom O'Dwyer, Programme Manager, Mental Health & Mental Handicap Services Dr. Elizabeth Keane, Director of Public Health Mr. Denis Fenton, Personnel Officer Ms. Raymonde O'Sullivan, Finance Officer Mr. Joe Casey, Technical Senices Officer Mr. Jack Somers, Managernenr Services Officer COMMUNITY CARE PROGRAMME
REVIEW OF 1995
Southern Henlth Board 'Caringfor People' i COWWNITY CARE PROGRAMME
Framework of Communitv Care Sewices
The hadrange of services are under five sub-proerammes : Community Protection. Community Health. CommuniN Welfare. Handicapped Services, Support Services. Communitv Protection Proeramme
The key areas of activity in this area are the immunisation and vaccination programme, pre- school and chiid heaith services: health education programme and environmental heaith service. Progress in 1995 The Board's services under this sub-programme continued in 1995 with the following spec& events worthy of comment : * The employmenr of a Health Promotion Officer The establishment of a Child Health Advisory Group Environmental Health Service Developments:- * The establishment of a computerised data base system for Environmental Health Officersto assist in the recording of data in accordance with E.U. Legslation. Planning of the new Public Analyst Laboratory continued during 1995 and the Board was pleased to receive the approval of the Department of Health to incorporate a new Food Hygiene Laboratory as part of the overall development. .A new system of professional staff training was introduced together with a broadening of the availability of hygiene education carried out by Environmental Health Officers
Communitv Health Proeramme This sub-programme covers areas such as senices for the elderly including domiciliary nursing; dental services; ophthalmic and aural services; maternity and infant care; community drugs schemes; and general practitioner services. Progress in 1995 Considerable progress was made during 1995 under the sub-programme. The more notable developments were : The commencement of a review of the Public Health Nursing Services. The setting up of a Steering Group in connection with the review of Services for the Older Person. The computerisation of the stores system for the Cork City and South Cork Community Care areas. Comrnun~r).Care 1995
Comrnunitv Welfare
The senices includeri under this sub-programme are the personal sociai services inciuding child care and famdv suppon. cash weifare payments and home helps.
Progress in 1995
The Board's child care. family suppon and personal social seMces continue to be areas of major development and 1995 saw a considerable increase in activity. The implementation of the Child Care Act 1991 requires a sustained programme of investment to provide additional staff in tne cornmumy, and to develop new and improved res~dentialand community responses.
The Department of Health provided E1.7m to hnd The Board's Child Care Action Plan for 1995
A total of 45 additional child care posts were approved.
.-\ range of other developments were put in place and are outlined in the Review of Child Care Se~ces,1995.
Bandicaooed Services Programme
This sub-programme includes the payment of allowances and grants to the disabled and the provision of rehabilitation, training and services for those with a physical or sensory handicap.
Progress in 1995 ,' There has been a continued emphasis placed on the development of services for those with a physical or sensory handicap and a concerted effort is being made to improve the quality of life of those affected by such a disability. Ln 1995 additional hndiig was provided to allow the Board to employ :
0 3 Speech Therapists 0 1 Senior Physiotherapist 0 4 Nurses
The additional allocation also allowed the Board to make extra fundig available to a number of voluntary organisations.
The development of respite care continued in the Boards area. Community Care 1995
Sunoon Services Procramme This sub-programme includes suppon services ior the Community Care prozramme such as area headquarters administrative staff. community medical staff. community weifare officers. physiotherapists. community workers and other paramedical staff who provide support services for each of the carious sub-programmes. Other areas include the G.P. Unit, Regstration Department, Public Analyst Laboratory, Nursing Homes Unit and the S.T.D.Clinic.
The 1995, Department of Health allocation enabled the continuation of the Board's support services to the Community Care programme. Sigmficant progress has however also been made in a number of areas, including:
A Senior Community Physiotherapist was appointed to the Cork City and South Cork area. Two Senior Comrnuni~Occupationd Therapists were appoinred - one to Cork City & South Cork and the other to Keny. -- Plans were initiated for the development of a Public Analyst Laboratory to be based at St. Finbarr's Hospital. The G.P. Unit facilitated further improvement in the interface between General Practitioners and other health services including hospital services. The Unit also assisted in improving the cost effectiveness and the organisation of general practice generally. Progress commenced on the implementation of the Department of Social Welfare Integrated Short Term Scheme System (I. S.T.S.) relating to the Supplementary Welfare Allowance Scheme operated by the Community WelEve Officers. £200,000 was spent on the upgradiing of a number of Health Centres.
8 A new confidential Alcohol and Drug Abuse Freephone Helpline Service was established at Arbour House (Phone No. 1800-507400) . Registration The implementation of the Stillbirths Act 1994 required the establishment of special - facilities and staff skilled to cope with the trauma of the Registration of Stillbirths, both current and retrospective. The Act was very successfully implemented by the Registration Department. Refurbishment of the public waiting- area in Liberty Street continued and included clear sign-posting and improved facilities for the public. Refbrbishment also took place at the Regkaration O5ce in North Cork. The aforementioned met with widespread appro& from the public. Commencement of refurbishment of the room used for Civil Marriages in Grattan Street commenced in 1995 and decoraMg is on-going. Comrnunitv Care 1995
District and Geriatric Hosnitals
There are eighteen Distncr Hospitals. thee Geriatric Hospitals (IOllamey, Clonakilty, Midleton) and two Welfare Homes (Youghal and Ferrnov) in the Southern Health Board area. Their hncrions. while vamine siiehtiv from hospiral to hospital. inciude the provsion of
Medical and nursing care of the type which cannot reasonably be provided in the patient's own home where the dlness would not warrant the patient's admission to an acute consultant staffed unit:
.Minor surgical treatment of the tye which the general practitioner might generally be expected to provide in his own surgery;
Long-stav accommodation for eiderlv chronic sick patients who are no ionger capable of being nursed in their own homes;
Accommodation for convalescent patients after their treatment in acute medical and surgical units;
Respite care accommodation for those who are screened though the District Care Team;
.A limited out-patient clinic service, provided by consultants from acute units.
Progress in 1995:
0 ~i~Rooms opened in Killarney and Macroom District Hospitals t Building work started on the Day Care facility in Skibbereen District Hospital.
Programme of improvement works to the physical environment of District Hospitals was continued, including large scale projects in St. Columbanus' Home, Wamey and Mount Carmel Home / Hospital, Clonakilty.
Considerable progress was made in replacement and upgrading of equipment
StafF?-'atient ratios improved in all hospitals
0 Geriatric assessment Teams linking with the Nursing Homes System were established in Cork City.
Community support through local hd-raising enabled new equipment and facilities to be provided in 1995. ACUTE HOSPITALS PROGRAMME
REVIEW OF 1995
Southern Health Board 'Caringfor People' General Overview
1995 saw a number of exciting developments in the Southern Health Board's acute hospirals.
Perhaps the most significant of these was the debate prompted by the Comhairle na nospideai Report on Consultant Staffing in the Southern Health Board's area. This had been published in December 1994 and was immediately the subject of much discussion among clinicians, managers and Health Board members. The report acknowledged si&cant deficiencies in consultant staffing levels in the public hospitals. given the size of the Southern Health Board's population and the number of regional and sub-national specialities located in Cork City. The repon highlighted the number of established consultant posts that had remained uniilled for a variety of reasons. acknowledged the need for additional posts in a number of specialities, especially those with existing single-handed consultants, and accepted the need for posts in a number of specialities not represented anywhere in the public hospitals in Cork and Kerry. The Repon recommended the creation of eight citywide speciality divisions of all consultants in the public hospitals each making recommendations to a Speciality Co-ordiiating Committee chaired by Professor John Hall, Dean of Faculty of Medicine at UCC, on the prioritisation of consultant posts.
Co-operation with the two public voluntary hospitals took place on the structuring of a number of new consultant posts for which approval had already been secured, and on a city-wide review of MEservices.
The Management Project to develop structures for involving clinicians in management continued in 1995. A number of models have been considered by senior clinicians, management and the Department of Health and a report has been prepared for discussion on the management arrangements most suitable for the Cork University Hospitals Group.
Cork University Hospital Senior staff were presented with the Cork University Hospital Site Review Plan by the hospital's original architect, Mr Matt Mehen. During 1994, the Department of Health agreed to fund an exercise to review the changed demand for accommodation within the hospital since its opening, reflecting changes in clinical practice and developments in particular specialities over the preceding meen years. All clinical and non-clinical departments had been asked to submit their new accommodation needs in late 1994. The Site Review Plan made recommendations on the siting of future capital developments needed to reflect service changes in such a way that the funding and timing of no single development would compromise the hospital's ability to accommodate later developments in their optimum location. Cork Cniversiry biy~itaiGroup and Associated Hosplrals 1995
7tour new consultants joined the Cork Crivers~tvHospitals Group during 1'505. hk Earnom Kiely, Consultant Uroio@ai Sxseon. Dr Domhnall O'Halloran Consultam Diabetoiogist; Dr John Buckley: Consuitanr Radiologist with a speciai interest in ',..ascular and Interventionai Radiolom:-. . lIr. Germ Barry, Consultant Orthopaedic Surgeon was appointed to a newiy ;:eared post innsing the complement of orthopaedic surgeons to five. with 2 sixth locum consultant employed for the Department of Health-funded Waiting Lij~Lnitiative.
Progress was made towards that attainment of the Southern Health Board's top pnontv of amalgamating the existing fragmented matemiry and neonatolog services in Cork City in a new building at Cork University Hospital with the agreement being secured of ail the public health agencies in Cork that Cork University Hospital should be the sire of the new service. The Southern Health Board submitted plans to the Department of Health on interim measures necessary to bring about immediate improvements in staffing, equipment and buildings pending minisrenal approval of the construction of the new building.
Cork Universitv Hosoital 1995 Highlights The reception area in the Department of Radiology was upgraded in February 1995.
The hospital's continued efficient clinicai performance, measured through its participation in the HIPEICasemix Scheme, was rewarded with a favourable adjustment of £488,000 to the 1995 budget. The Department of Health funded Waiting List Initiative continued in ophthalmology, plastic surgery, urology, neyology and rheumatology
St. Finbarr's Eosvital
In June 1995 a conservatory attached to St. Philomena's Ward for the Young Chronic Sick was opened by Mr Brian Crowley MEP
The Orthodontic Unit was officially opened on 9 June 1995 by the Minister for Health, Mr. Michael Noonan TD. As part of the development control plan for the site, the Southern Health Board's Central Purchasing Department was established on the tint floor of the former nurses' home. St. Marv'c Orthooaedic Hosnitnl
On 12 July 1095 the hospital celebrated the fortieth anniversav of its opening wirh a function artended bv clvic dieniraries. S.H.B. members and existing and former hospital staff
In October i395. Block Eigint was reopened after reiixbishment and upgrading costing f250.000. Previously a rive day unit, the block now houses the hospital's private and semi-private accommodation. The upgrading of Block Eight was another phase in the re-development plan to move all the patient areas of the hospital to the south side ofthe site with all blocks connected by comdors.
The Department of Health funded Wairing List Initiative for onhopaedic surgery and plasric surgery continued during 1995.
Erinville Hosoital
Ante-natal "booking clinics" started in January 1995 whereby a mother's first ante- natal attendance now gives the opportunity for a discussion with a midwife on the fiture pattern of ante-natal care and the mother's feelings about her forthcoming labour and post-natal care.
A new Ultrasound machine was purchased for the Department of Diagnostic Imaging.
A successfiA inaugural GP Study Day was held in October 1995 attended by around s~ayGPs from Cork and Kerry.
The Neonatal Unit was converted to open-plan during the year to facilitate improved treatment for the neonates. Additional equipment was purchased through a Department of Health special allocation.
Mallow General Hospital
The new Physiotherapy Department opened in January 1995.
The hospital took delivery of a new cardiac ambulance in July 1995
An aliocation of E90,OOO was made by the Department of Health in November 1995 for the purchase of theatre and laboratory equipment. Cork CTnivers~ryHoso~tal Group and Associated Hosp~rals1995
Tralee General Aosnital
The Sateiiite Rend Dialysis Cnit was c~ficialivopened on 16 March 1095 by An Tknaisre. ilr Dick Spring TD. The L-nir opened its door to nine patienrs during February 1995 whose treatment has prev~ousiybeen camed out at Cork Gniversity Hospital.
.in Occupational HealtNInfection Control Sister took up duty in September 1995 providing seMces to the Southern Heaith Board's sraEin Co. Kerry.
Major renovations to the hospital's main enrrance were carried out during the year.
.A new st& library was developed during 1995 r The Department of Health hnded Wairing List Initiarive in gynaecology continued during 1995.
The Department of Health in the 1995 Southern Health Board allocation approved the establishment of a Department of Medicine for the Elderly in Tralee General Hospital.
Bantrv General Hos~ital
The new Physiotherapy Department opened in June 1995.
Orthopaedic outpatient clinics recommenced in September 1995 .AMBULANCE SERVICE I
Kev lndicators
During 1905 the Ambulance Service travelled a total of 755,;"- miies. an increase of 5% on i994 activities.
A total of 3 1.097 seriousiy ill and injured patients were conveyed. an increase of 6% on 1994 activities.
X total of seven new ambulances were purchased at a total cost of £291,807.
New ambulances were allocated as follows:
Cork City 1 Mallow 1 Kanturk 1 Tralee 2 Fenoy 1 Listowel 1
The total cost of operating the service in 1995 was £2,996,363,
Cost Per Mile E 3.82 Cost Per Patient £96.36 Cost Per Head of Population £ 5.64
1995 Hiahliaht
In June 1995 the Board's Major Accident Plan was replaced by the Cork Joint Major Emergency Plan. This fouowed lengthy and detailed discussion with the Garda Siochana (East Cork and West Cork Division), Cork Corporation and Cork County Council.
The new plan replaces the individual plans of the five authorities and will ensure a more co-ordinated approach in dealing with any future disasters. The new plan retains the main elements of the Boards old plan which proved successful in dealing with a number of major accidents over the last 20 years.
The Board is at present having discussions with the Garda Siochana and Keny County Council with a view to producing a similar joint plan for Co. Kerry. - MENTAL HEALTH & MENTAL - HANDICAP SERVICES PROGRAMME - REVIEW OF 1995
Southern Health Board 'Caringfor PeopleJ NESTAL HEALTH SERlTCES
Four Year .%ction Plan Mental Health Services 1995-1998 In 1092 the Boara published a Seven Year Deveiopmenr P!an ror Mental Health Semces. This plan was reliewed and up-dated in 1995 on the basis of the Xationai Heaith Strategy and a new Four Year Action Plan on liental Heaith Senlces was unanimously adopted by the Board in Mav i995.
Killarden House Hostel. Tralee This 20 bed high suppon hostel opened in Janua~1995. The residents are former patients of St. Finan's Hospital. Killarnev. The facilitv also incorporates a dav centre. The building .xas otficiallv opened on 33 June 1995 bv An Tanaiste Mr. D. Spring, T.D.. and Minister ;br Forelgn .Main.
Training Centre Caherciveen .A ten place purpose built training centre in Caherciveen Co. Keny, opened in October 1995, as the third phase of a development in the younds of the district hospital which commenced in 1989 with the opening of a day centre and saw the opening of a high suppon hostel in 1993. The training centre received a substantid contribution from a local benefactor.
Acute Unit, Bantry General Hospital Work on the development of a new 18 bed acute unit was completed in 1995 and the facility ulll open in January 1996.
Day Hospital. Bantry A new day hospital facility was developed in conjunction with the acute unit.
Hostel Skibbereen Refurbishment work on the former acute unit at St. Anne's Hospital, Skibbereen, related to - its development as a high support hostel, was undertaken in 1995.
Training Centre, Hollyhill, Cork An application for capital funding in the amount of £370,000 under the European Regional Development Fund was approved in 1995 in relation to the extension and refurbishment of this facility which is owned by the Board and which will provide places for approximately 100 persons in the development involving the Board and the Rehabitation Institute. Sale of Grey Building, Lee Road. Cork The saie ci the Grey Building took piace 3.1 auctlon in Xovember 1995 for the sum of t9!Cl.OOO The proceeds will be utiiisea fcr tne conr~nueddevelopment of the rnenrai b,ealth ienxe.
.Acute Gnit. Cork University Hospital .Approvai was received from the Depanmenr of Heairh to increase the number of acute beds ?om 25 to 46 and necessary rehrbishent work to achieve this was undertaken in i995. The additional beds will open in 1906
ECT Facilities. Cork University Hospital .As pan oithe retixbishment ivork at rhe acute unit. a new ECT facility was also deveioped
.Acute Gnir. 3Iercy Hospital. Cork he Minister for Health approved this projecr to render srage during i995 ana construcrion ,work wiil commence in Januar). 1996. The estimated compietion date is November 1997.
Suicide Research This project, under the direction of Dr. M. Kelleher, Clinicai Director, commenced in 1995 and is funded by the Southern Health Board, .Mid-Western Health Board and the Department of Health on the basis of a two year pilot project.
StStephen's Hospital 40th Anniversary A meeting of the Psychiatric Services Committee took place in the hospital on 19 May 1995 to ceiebrate the 40th Anniversary of the hospital. X commemorative plaque was unveiled by Dr. P. A Murray, Chairman Southern Health Board.
Garden Fete, StStephen's Hospital This is now an annual event and is widely supported by the local community.
Watergate Day Centre, Bandon This purpose-buiit day centre opened in December 1995. The development was the subject of a substantial contribution from a local voluntary organisation.
Sensory Garden, St. Stephen's Eospitd A Sensory Garden was developed in the grounds of the hospital with support from Cork Mental Health Association. The facility was commissioned by the Chief Executive O5cer at a ceremony held in June 1995.
Hostel, Western Road, Cork Refurbishment work on this existing hostel was undertaken in 1995 and plans established to link it to a day centre to be established in 1996 in the adjoining building owned by the Board. Day Facility, Macroom During i99S agreement was reached with the Rosminian Fathers at Upton. Co. Cork. ..cirh reeard- :o the transfer of ten residents at St. Colman's Hospital to a dedicated mental handicap service. 3swiil enable the Board to deveiop a day faciiitv at St. Colman's Hospitai in 1996. suqiect to capital funding.
Hostel. >lacroom, Co. Cork Followine- a successiul appeal by the Board to An Bord Pleanala, appropriate permission concerning fire precautions was granted in relation to the development of this facility in a building which is adjacent to the existing St. Colman's Hospital. The work wdl be completed early in 1996.
Hostel. Rathmore. Co. Kerry The Board, in association with Kerry Mental Health .&sociation. developed in 1995 a hostel for eight residents in Rathmore, Co. Kerry. Plans are at an advanced stage to increase zccommodation and it is hoped to open the facility in 1996. _-- Bostel. Killarney, Co. Kerry KAPPS is another voluntary organisation which works closely with the Board. In 1995 KAPPS obtained a property which now accommodates five former residents of St. Fi's Hospital.
Focus on Quality A project entitled "Focus on Quality" commenced at St. Anne's Acute Psychiatric Unit in October 1995, following the Board's very successll seminar on quality.
World Congress on Mental Health This Congress, which was supponed by the Board, was held for the first time in Ireland in August 1995 and proved very successful.
National Public Speaking - Mental Health Association of Ireland The 6nai of the National Public Speaking Debate, organised by the Mental Health Association of Ireland, was won by a team from Christ the King Secondary School Dougias, Cork. The team subsequently attended a meeting of the Psychiatric Services Committee of the Board.
White Paper on Mental Health The White Paper on Mental Health was published in August 1995 by way of follow-up to the Green Paper published in 1992. The Board submitted a comprehensive response to the White Paper and now awaits further developments in the area of legislative change in the mental health services. \lenral Health & AIental Hanaican Sew~ces1995 I
I MENTAL HANDICAAPSERVICES PROGRAMME
1995 HIGHLIGHTS. I Additional Resources for Persons with Mental Handicap. X total of £1,111,100 jhU year cost) and 5800,000 once-off expenditure for capital developments was allocated by the Deparrment of Health to the Southern Regon in 1995 in I respect of development of services for persons with mental handicap. The additional resources enabled the following initiatives to be undertaken: I (>nerd reszdenrlai and dqv places. A total of f606.000 revenue (full year cost) was allocated which enabled the provision of 74 residential and 75 day places in respect of 7 new developments being undertaken in the 1 region by voluntary agencies in 1995. C - Trmjersfrom p~ychiatricho~pitals. The Department of Health made available an allocation of 2200,000 capital and f130,000 revenue to facilitate the transfer of 10 residents with a mental handicap inappropriately I accommodated in St. Coleman's Hospital, Macroom, to more appropriate residential and day service at the Rosminian Fathers Centre, St. Patrick's, Upton. I Home Support / Respne Care Services. It was agreed by all service agencies in the region in 1991 that an innovative approach will be adopted to the Home Support 1 Respite Care allocation. An allocation of £114.000 (111 1 year cost) was made available to the Rosminian Fathers at Upton to develop a new regional Respite Care 1 FdySupport Service at their facility in Garrettstown which they have I developed from their own internal fundraising at a capital cost in excess of Elm. The initiative was focused on the provision of services to those clients 1 families who have no service or inappropriate services at present.
Servicesfor Persons with Autism. An allocation of £50,000 (full year cost) was made avadable towards the development of I services for persons with autism. The allocation was made available to the Cork Association for Autism for the further development of their facility in Greenville House, Canignvohill, as a specialist centre for adults with autism in line with the Department of I Health policy document and on the basis of agreements which have been reached with the Association as to the approach to be taken to the future development of services for this client group. 1 klental Heaith dc Mental Hanaicap Services 1995
Emergency Places. .An allocation of i50.000 revenue was made available :o provide for ciients in need of emergencv admission to a se~cefor whom no existing service is being provided.
Clients presenrrg wrrh Disrrirbed Behnviot~r. An aailocation ofE60,OOO was made available to address rhe needs of clients presenting with disturbed behaviour.
Hepantis B. In line with the commitment made in the Heaith Strategy, an allocation of £54,000 was provided to meet the costs of provision of Hepatitis B Vaccine for staff working in the Mental Handicap Services and for client groups who are considered at risk. m
m DEPARTMENT OF PUBLIC HEALTH
REVIEW OF 1995
Southern Health Board 'Caring for People' DEPARTMENT OF PUBLIC HEALTH
The Sourhem Health Board Depanmenr oiPublic Health came into being in .Ifarch of 1995 ivlti: :he appointment of Dr Elizaberh Keane as Director of Public Health. 1996 i\iiil see the development of this depanmenr with the appointmenr eariv in the year of four joecialists in Pubk Health medicine and a number of support st&.
The main concerns of the deaartment are:-
* The establishment ofthe heaith status of the population of Cork and Key.
0 The assessment of the heaith needs of people in Cork and Kerry.
The monitoring of the effects of the environment on public health.
The surveiilance and control of inkctious disease.
The development of heaith information systems.
The measurement of the outcome of health services.
The evaluation of health services.
The promotion of health gain and social gain.
In 1995 attention was ~ivento the followinp:-
The health status of the children of Cork and Keny.
Preparation of an epidemiologicai study of the prevalence of drug misuse in Southern Health Board area.
A survey of the levels of immunity to Measles in school children in Cork was - canied out in 1995. This involved sweying 2,000 children in 8 schools the Cork City area - the results have influenced national policy in relation to a MeasledRubeUa @4R) Immunisation Campaign.
Ongoing review of and research into Menin~ococcalDisease in Cork and Keny.
The development of a Smokin~Cessation Policv for the Southern Health Board which was based on a swey of staff undertaken by Public Health Doctors in July 1995. Depanment of Pubiic Health IQ95
In the area of the etrvrrotmret~tair~nunc! 011 prrhiic ireailh, extensive preparatory work was undertaken in the idenr:ficarlon of resources. faciiities and asencies of assistance in the management of env~romentalemergencies. s Food Safem Reuorr. - For the first time 2 combined techcai repon was prepared. This was based on focused sampiing ci specific food products which facilitated informed statements on the state of food saety in Cork and Keny.
Cork Health Surveiilance Project msro establish information svsterns to monitor the health of the population. This project was progressed with:
the establishment of a Concenrlai Atromaiies Reenter:-
- an analysis of existing coneeniral anomalies records
identification of GP epidemioiogicai information systems
- establishment of links with the National Cancer Registry
- participation in research in conjunction with the Cancer Registry
Senior Registrars in Public Health Medicine undertook two research projects
An epidemiologxal study on the quality of life and health status of women post Breast Cancer diagnosis was commenced and will be completed in 1996.
The quality of life of patients with chronic mental illness following discharge into the community was undertaken and will be analysed and reported in 1996.
Womens Health. Consultation process in response to Department of Health 'Discussion Document on Wornens Health' commenced in September 1995. Submissions were invited &om all those interested in Womens Health. Workshops for members of the public and womens groups were held in a variety of venues throughout Cork and Keny. The consultation process will continue until March 1996.
National agreement is needed on the collection of data essential to monitor the health of the population. Preparation oi this Public Health Common Dataset was undertaken with Directors of Public Health from the other Health Boards. When available this wiU facilitate the production of the Health Boards first Public Health AndReport for 1996. FINANCE DEPARTMENT
REVIEW OF 1995
Southern Health Board 'Caringfor People' FINANCE DEPARrnhT
1995 was a significant year for the Finance Clepartment, with several new deveiopments.
Ault by Comptroiler and Auditor General Budgetary Briefings for Senior Managers Implementation of Asset Register *. Lmpiementation of Paypath for 1,800 staff . Production of updated procedural manuals
Audit bv Comatroller and Auditor General
c\s a result of new legislation, the Comptroiler and Auditor General now has responsibiiity for the audit of the Health Board. This hction was previously carried out by the Local Government Auditors. 1995 was the first year of the new arrangements. It is gratlfving to note thar the C&AG has indicated that he was pleased with the operauon of the Finance Department and has praised the staffs eEciency, organisation and heipfulness.
Badeetarv Briefings
T)urmg 1995, Budgetary Briefings were presented by Finance Staff. Over 300 senior managers ere invited to attend. The response received was tremendous. All briefings were completed by md-April 1995, in a variety of locations throughout Cork and Keny.
Imoiementation of Asset Reeister
Throughout 1995 work was ongoing on the mtalhtion of a computerised asset register. The system is now up and running. The Southern Health Boardbecame the fist Board to install a totally comprehensive asset register system. The system records all of the Board's assets including land, buildings and equipment.
,. October 1995, 1,800 weekly paid staE transferred to fortnightly pay by paypath. Briefing sessions were held at a variety of locations. Great credit is due to all staff involved for the successful implementation ofthe changeover.
Uodatioe of Procedural Manuals
Procedural Manuals were updated and revamped by Finance Department staff during 1995. A procedural manual is now available in respect of all lknce systems. Finance Department 1995 I
Southern Health Board 1995 Budget Allocation Total = f222,035m
Community Care
Direct Labour Unit
CUH & Assoc Hosp
a GenlComm Hosps
UCUH & Assoc Hosp E88,170,417 OGenIComm Hosps E17,253,968 UPsychiatry & M.HICap f35,534,588 UCentral Services fl6,839,ll2 I Community Care f60,093,774 QDirect Labour Unit E4,143,141 I Finance Depanment 1995 - CENTRAL CONTRACTS DEP.iRT;MENT
During 1995 a Central Contracts Department was established. The main objective of the Depanment is to ensure compliance with EU Procurement Directives and to ensure that the Board achieves maximum value for money in relation to purchasing.
The Depanment has a st& complement of 6 people. all redeployed from other areas. The Depanment is headed by Mr. Sean Barry, .\?atenals Officer and repons to the Finance Officer.
The EU Procurement Directwes state that all purchases made by the Board in excess of £150.000 must be advemsed in the EU Joumai. Purchases in respect of each hosp~taland cornmuni~care area must be aggregated to establish whether the threshold applies. Failure to comply with the Directives can result in severe penalties and fines. .- PERSONNEL DEPARTMENT
REVIEW OF 1995
Southern Health Board 'Caringfor People' 1 PERSONNEL DEPART%IENT I
The role of the Personnel Department includes the provision of advice services and ~idanceto the Management Team and to deal effeclivelv with ail matters concerning Recruitment. Industriai Relations. Trainhe, Deveiopmenr of Staff and Xlanoower Planning. In addition it is the function oi ;he Department to deal with St& welfare and to foster good working relationships. The department is divided inlo three areas:- Recruitment, Staff Relations and Training. ;\n overview of these areas is given below, together with the highlights of 1995.
Recruitment This section deals primarily with the appointment of all permanent staff. It handles applications for job-sharing, career breakdspeciai leave and transfers, and liaises with :he Department of Health re: emplovment control approvals to fill all new posts created. Developments in 1995 Informing candidates of their panel places in keeping with the Board's policy of Accoumabity and Openness as espoused by NEW DIRECTION. The reconsideration of the Board's position regarding the restriction of job-sharing to basic grade posts. The decentralisation of N.C.H.D. recruitment to the Cork University Hospital. Updating of the computerised recruitment system. Agreement on the transfer policy for Nursing st& transferring from city to district hospitals. A project under the Quality Facilitators Programme was undertaken in the Department during the year, its objective being to obtain feedback from recently recruited Child Care Staff on their expectations and perception of recruitment process.
Staff Relations This section can be separated into three areas, i.e. Industriai Relations, Superannuation and Temporary Service. Lndustrial relations encompasses a wide area including conditions of employment of labour legislation, interpretation of agreements and entitlements, grievance and disciphmy procedures. Superannuation deals with an employee's entitlement on resipnationlretirement. Temporary Service Unit is responsible for the billing of stafffor the purchase of service that they have served in a temporary capacity. This unit is self-funding. Personnei Dsoartrnent 1995 Personnel Department 1995
Training and Staff Develonment 1995 saw the first Training Plan which was based on the pnnciuies and issues identified in the Southern Health Board Training Stratea issued in late 1994. The three key areas addressed by the Training Strategy were: 'Management Deveiopment, Career Development and Induction. In 1995. over £400,000 was spent on Training Plan events and to suppon employees who embarked as approved courses. Hereunder is a summan. of events airanged by Training and Development.
Type of Training No. of Training Days Quality Facilitation 160 ''Focus on Quality" Seminar I41 Management Development I Personnei Department 1095
Type of Training I Yo. of Training Davs I StaBInduction I 16 Communication iI 16 people x iO classes
( (ii) Cueilgc ! 52 people x 10 classes I (iii) Customer Care Retirement Plannine 100 Total 6109
The work of the Training and Development Department is cioselv associated wirh the principles of NEW DIRECTION. Much of our efforts are to support staff to cope with the rapidly changing environment we operate in. hJW DIRECTION, which is a merger of 'Shaping a Healthier Future' and the Southern Health Board internal initiative emphasises the importance of customer-focused service.
Many of the customers of Personnel Department are internal customers and it is our objective to provide a high quality service and to address issues which arise during evaluation processes.
Health and Safety issues continue to be of critical importance. The training implications include the Health and Safety update for responsible persons and safety representatives.
Safe lifting practices continue to be an important part of our work and current issues such as the report of the working party %olence in the Workplace also have considerable implications for the Training Deparrment.
The scope of the department's activity is very wide. In 1996 there will be hrther supervisory and management training, computer awareness, budgeting, employee assistance, team development, recruitment and selection interviewing sldlls, presentation skills and retirement planning pro-p-rammes.
Of particular interest to individual employees \1111l be the Board's continued commitment to support permanent staffwho embark on courses which are relevant to their work. A standard course application procedure is in place. An individual applies in the first instance to hidher immediate manqer who comments on the request. This is passed back to the employee and sent to Training Depanment for consideration. One of the core objectives of this opportunity offered by the Board is to help the personal and professional development of The Board's Staff. Persomei Department 1995
.All training events. in-service and accredited, need to be carefully evaluared. This helps the planrung process for Trainins and Deveiopment. Another vitally important function is to ensure that learnins md howledge 3re transferred back into the workplace. Each riainins opponu~tyinvolves a three way "contract" between the employee, the manager and the trainer. Obviously traimg is very expensive when all costs are considered - fees, locum costs. travelling, catering etc.
The greatest benetit is derived when people know their own iearning objectives and the expectations of their managers. Time spent on this process is time well spent and this transfer of knowledge is likely to be more successful if all three parties to the "contract" are clear about their objectives.
Training plays an integral part in supporting the NEW DIRECTION. We are very happy with an evaluation of work achieved over the past i 8 months since Training was established as a unit in its own right.
Obviously the nature of the work is concerned chiefly with processes - in particular the process of change in the re-orientation of how the Board conducts its busiiess. The close links being bdt up throughout all pans of the organisation ensure that it is a stimulating and interesting environment to-work in. We welcome the foresight of the Board in setting up the training idastructure to support these process and developments and look forward to continued progress in 1996 and the coming years. TECHNICAL SERVICES DEPARTMENT
REVIEW OF 1995
Southern Health Board 'Caringfor People' TECHNICAL SERLICES DEPARTMENT 1 The Techrucai Senices Department proxides the Board with a service covering Lfaintenance, Minor Capital Works. Fire Safety, Health and Safety Co-ordination, Energ Management and Waste Managexent. The Depanment is administered from ;he Board's head office and the Tecbcai Services Officer, 4Ir Joe Casev.. . has a technical staff of four Engineers. two Fie and Safety Officers, one Draugntsrnan and ei&t Maintenance Officers. The Mainrenvlce Officers supervise a total of 195 staff at various locations throughout Cork and K~.T.
Highlights 1995
During 1995 the department submitted ten planning applications for various capital works, prepared tender documents and managed various projects. These included:
Dayroom Extensions to Schull. .Midleton Kinsaie and Kanturk Hospitals, St Columbanus Home and Mitchelstown md the Health Centre at St Annes Road, Warney.
Upgraded Dental Clinics in Bantry, Skibbereen, Schull, St. Fibarr's, Blackpool, Macroom and Listowel.
Upgraded: Block 8, St Mary's Orthopaedic Hospital; Health Centres - Grove House, Mahon, Slievereagh, Castleisland, Ardfert, Ballinskelligs and Charles Street, Listowel; Reception Area, Traiee General Hospaal; St. Martha's Dayroom, St. Fibarr's Hospital; Toilets in Mount Cannel Hospital, Clonakilty; Macroom De La Salle:
Feasibility Study for Chemotherapy Unit and Theatre 9, Cork University Hospital.
Fie prevention upgrading in Block 6, St. Stephen's and Macroom De La Salle.
Provided Psychiatric Unit and Helipad at Bantry General Hospital, Occupational Therapy Unit in Caherciveen Hospiral and Recreation Area in Block 6, St. Stephen's Hospital.
Electrical Rewiring of ground floor of Caherciveen Hospital.
Received planning permission and fire certificate for Goleen Health Centre.
In addition, the department assisted in the project planning for the New Public Mysts Laboratory and Food Hygiene Laboratory at St Fibarr's Hospital and the proposed unit for mentally handicapped persons at Ballydribbeeen, Killamey. Techcai Senices 1995
Health and Safetv
The Techcai Services Officer is the Safe? Co-Ordinator for the Board for the purposes of implementin= :ne Health. Safety and Welfare at Work Xcr 1989 During 1994. Safety Statements $1 the remaining work locations in Cork and Kerry were finahsed. Safety Audits ;a ident~hazards and risks continued and measures were taken to deal ~viilrhsafetv issues on a prioritv basis. Programmes for training in liftins and other Health and Sker) courses were arranged bv the Training Depanment.
Fire Safetv
In reiation to Fire safe^, the major project to provide a comprehensive automatic detecrion and alarm and emergencv lighting system at Cork Universitv Hospital continued and is now nearing completion. Fire Safetv improvements were also carried out in Clonakilty, Banrrl;: Listowel, Kenmare. St Maes Orthopaedic. St. Stephen's_ Castietownbere and Schull, aU as part of an ongoing programme to provide a uniformly good standard of Fire Safetv in all the Board's premises. Fire instructions, drills and lectures were provided by the Board's two Fire and Safety Officers in Cork and Kerry.
Enem Manaeement
The Board's expenditure on energy in 1995 amounted to f.2.5m. The main feature of the year was the publicauon of the repo,rt from the Office of the Comptroller and Auditor General on Value for Money in rilation to Energy Management in the Health Service.
The report, which dealt with the ten years up to 1993, indicated that energy costs in the Southern Health Board went fiom f3.14m. in 1984 to E2.4m. in 1993 representing a decrease of 23.5% compared to a decrease of about 12% nationally.
In terms of the Board's efforts to minimise the unit costs of fuel, the examination found that the Southern Health Board has the lowest and second lowesr prices for Gas/ Oi and Bulk L.P.G. respectively.
Cork University Hospital had the most cost effective performance of the national large acute hospitals. This reflects the initiatives taken there over the last ten years to control energy costs, and this is now further enhanced by the Combined Heat and Power Plant com&sioned in November 1994.
The information contained in the report wiU be of considerable benefit to the Board in reviewing our strategy for further improving energy management and the monitoring of progress in its implementations. Techtucal Services 1995
Waste 1Vanaeement
During 1995. the Working Group appo~nted by the Chief Executive Officer to formulate a \Taste Management Plant for the Sournern Health Board completed its work and the Plan was adopted by the Board at its meeting on April 3rd. 1995.
The treatment of hospital waste by shredding and microwaving was introduced at Cork University Hospital and the incinerator was also ciosed down in Tralee, in line with Government Policy to phase out the incineration of hospital waste. New segregation practices were introduced in most hospitals to reduce the volume of waste for treatment and to improve recycling and minimisation practices. Towards the end of 1995, competitive tenders were sought via the European Journal for a comprehensive contract for the collection. treatment and disposal of the Board's clinical waste and a new contract wlil shortly be entered into for a minimum period of one year. The National Policy is to seek tenders for an overall Nonh/South contract. The Board's new short term contract will bridge the period up to the appointment of a national contractor. It is intended that the remaining smaller incinerators will be phased out during 1996.
Estate Manaeement
The main event of 1995 was the withdrawal of interest by U.C.C. in Our Lady's Hospital. The property was placed on the open market for the second time at the end of August and sold at public auction for $910,000. MANAGEMENT SERVICES DEPARTMENT
REVIEW OF 1995
Southern Henlth Board 'Caring for People' MAN.4GEhENT SERVICES DEPARTMENT
Hiehliehts 1995
Use of the Board's X-ray patient administration system was extended to Banuy General Hospital. The system had previously been implemented in Cork University Hospital and Tralee Generai Hospital Radiology Departments.
A computerised staff recruitment system was developed and successhUy implemented in the Board's Personnel Depanment.
A contract for a Laboratory Management System for Cork University and Tralee General Hospitals was signed and installation of equipment and communications network commenced towards rhe end of 1995. It is planned that use of the system on a 'live' basis will begin in May 1996.
Use of the StaffRostering System was extended to additional areas within the Cork University Group of Hospitals and St. Stephen's Hospital.
Implementation of the Aran Environmental Health system commenced in Tralee in November. Extension of the system to other Community Care areas is planned for 1996.
A system to facilitate the issue, tracking and costing of medical appliances issued to oatients in the communitv was installed at St. Finbarr's Hosoital and in Communitv~, Care ofices in Cork City during 1995. It is planned to extend its use to other areas in 1996.
1995 was a very significant year for Management Services Branch in terms of European Projects. The Southern Health Board competed success~yfor two Telematic Telemedical Projects under the European Union 4th Framework Progmmme. Both Projects are three year projects, beginning January 1996, concentrating on Technology Assessment in Telemedicine (TASTE Project) and the development of Telemedicine Services (Remote Diagnostics/Consultation) for islands, remote rural populations and ship vessels (NWEMES Project). Both Projects involve Trans-European collaboration uiig leadiig edge technologies. The objectives of the NIVEMES Project is to create one of the most up-to-date teleconsultation/ /telediagnostic systems available. The objective of the TASTE Project is to produce comprehensive guidelines on Telemedical Assessment (especially in Tele- Neuromedicine). Both Projects have a strong user-driver focus.
More EU funding is expected in 1996 for other Projects involving the Southern Health Board.