North Eastern Health Board annual report 2000

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Authors North Eastern Health Board (NEHB)

Publisher North Eastern Health Board (NEHB)

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2000 ANNUAL REPORT

CONTENTS

• •

Members of the North Eastern Health Board Our Support Services as at 31at December, 2000 2 Management Serv~ces 35 Standing Committees 3 Matenals Management 35

Management Team 4 Personnel Department 36 Public Health 37 Message from Chairman 5 Technical Services Department 38 Message from the Chief Executive Officer 6 Co-Operation and Profile of the Region 8 Working Together (CAWT) 40

Our Approach 11

Financial Review 2000 12

Our Services Regional Services

Pnmary Care 14 Adult Mental Health SerYlces 16 Regional Ambulance SerYlce 17 Health Promot1on Services 18 Cancer Strategy 20 Cardiovascular Strategy 20 Women's Health 21 Men's Health 21

Our Services Community Services

Child Health 22 Child Care and Family Support 22 Child and Adolescent Psychiatric Services 24 Services for Older Persons 25 Disability Services 26 Travellers Health 28 Environmental Health Services 28 Community Welfare Services 29

Acute Hospital Services 30

Governance and Strategic Planning 34 North Eastern Health Board Bord Slalnte An Olr Thualsclrt

MEMBERS OF' THE NORTH EASTERN HEALTH BOARD

at 31st December, 2000

Appointed By Local Authorities: Cllr. Hugh McEivaney, Corcaghan, Stranooden, Monaghan. Cllr. Wilhe Me Kenna, No.2, Mullaghdun, Tydavnet Cavan eo. Council: Road , Monaghan Cllr. Patnck Conaty, Klllynebber, Cevan. Cllr. Ceoimhghin O'Caolain, TO. , No. 14, Cllr. Geny Murray, lavey, Stradone, Co. Cevan Mullaghdun, Scotstown Road, Monaghan. Cllr. Edward Feely, Stranamorth, Blacklion, Co. Cavan. Members Elected Under Health Board Cllr. Patnck O'Re1lly, (Jnr.) Murmod, Virginia, (Election Of Members) Regulations, 1972 Co. Cavan. Or. Hugh Oolan, Sandymount Drive, Blackrock, Oundalk, Co. Louth Louth Co. Council: Or. Teresa Carey, St. Oavnet's Hospital, Monaghan, Cllr. Peter Savage, Mlllgrange, Greenore, Co. Monaghan Co.louth. Or. Paul McCerthy, Oonaghmore, Oundalk, Cllr. Oeclan Breathnach, Annaghs McCenn, Co. Louth Knockbndge, Oundalk, Co. Louth Or. Peter M. Wahlrab, cavan Road, Kells, Senator Fergus 0 Oowd, 24 St. Mary's V1llas, Co. Meath. Orogheda, Co. Louth Or. G1lhan Cer1os McOowell, IMTH/Our lady of Cllr. James Mulroy, 1, Matson Lodge, Lourdes Hosp1tal, Orogheda, Co. Louth. Ballymakenny Road, Orogheda, Co. Louth. Or. Alfred N1cholson, IMTWOur lady of lourdes Hospital, Orogheda, Co. Louth. Meath Co. Council: Cllr. M1chael lynch, Cogan Street, Oldcastle, Registered Dentist: Co. Meath. Or. Fergal Connolly, 51, Cemckfem, Keadue, Cllr. John Farrelly T.O.• Hurdlesdown, Ketls, Cavan Co. Meath. Cllr. James Mangan, Rathfetgh, Tare, Co. Meath. Registered Pharmaceutical Chemist: Cllr. Bnan Fitzgeratd, Warrenstown, Kllcock, vacant Co. Meath.

Re-'stered Nurse: Monqhan Co. Council: Ms. Susan Faulkner, Ounmoe, Cllr. Brendan Hughes, Klnnegan, castleblaney, Proudstown, Navan, Co. Louth eo. MonaPn.

ReC}st ered Psychiatric Nurse: Mr. Paudge Connolly, Tullylush, S1lverstream, Monaghan.

Minister's Nominees: Mr. Danny Brady, Orumcor, Loughduff, Co. Cavan. Mr. N•cholas McCabe, Cnnstown, Ardee, Co. Louth. Mr. Thomas Re1lly, Ardsallagh, Navan, Co. Meath. 2000 ANNUAL REPORT

STANDING COMMITTEES

c ...... ~ \u/1 The following is the membership of the two Standing Committees at 31st December, 2000

Hospital Community Mr. John Farrelly, TO Dr. Hugh Dolan COmmittee Chairman COmmittee Chairman & Chairman of the Board

Dr. Hugh Dolan Cllr. Declan Breathnach Chairman of the Board Vice-Chairman of the Board

Cllr. Declan Breathnach Mr. Paudge Connolly Vice-Chairman of the Board Cllr. Eddle Feeley Mr. Patrlck Conaty Ms. Susan Faulkner Cllr. Brlan Fitzgerald Cllr. Brendan Hughes Cllr. Hugh McEivaney Cllr. Michael Lynch Sen. Fergus O'Dowd Dr. Fergal Connolly Dr. Paul Me Carthy Cllr. Patrlck O'Reilly Cllr. Wllliam McKenna Dr. AJf Nlcholson Cllr. Peter Savage Cllr. James Mangan Cllr. Jimmy Mulroy Mr. Danny Brady Dr. Carlos McDowell Mr. Nlcholas McCabe Cllr. Gerry Murray Mr. Thomas Rellly Cllr. Caolmhghln O'Caolain, TO Dr. Teresa Carey

Dr. Peter Wahlrab North Eastern Health Board Bord Slalnte An Olr Thualsclrt

MANAGEMENT TEAM

at 31st December, 2000

Mr. Paul Robinson Mr. Eamon O'Brlen Chief Executive Officer Personnel Officer

Dr. Ambrose Me Loughlin Mr. Jim Curran Deputy Chief Executive Officer Acute Hospital Technical Services Officer and Director of Capital Projects Mr. Geoff Day Assistant Chief Executive Officer Regional Services Mr. Jim Reilly Senior Administrative Officer Mr. Larry Walsh Assistant Chief Executive Officer Ms Rosaleen Harlin Governance and Strategic Planning Communications Officer

Mr. Aidan Browne Ms. Mary Flanagan Assistant Chief Executive Officer Secretary to the Chief Executive Officer Community Services

Dr. Rosaleen Corcoran Director of Public Health and Planning

Mr. Seoirse 0 hAodha Rnance Officer

Mr. Anthony Reilly Management Services Officer 2000 ANNUAL REPORT

MESSAGE FROM THE CHAIRMAN

. :. • lt is with great pleasure that I present the annual Rnally, I would like to highlight that the system for report of the North Eastern Health Board for the health care delivery is advancing at an year 2000. unprecedented pace. This is allied to economic growth which has seen greater fundtng be1ng made In reading the contents of this report, it is obvious available for the health seMces, wh1le the NatiOnal how much the Board has developed and expanded Development Plan (NDP) will ensure that the the range of service proVIsion to the population of facilities available throughout the Board will be the North East. The credit for these positive enhanced to support the deliVery of health care. advances goes to the Board, our staff and the These 1ssues present a number of Significant Department of Health and Children. challenges to our Board members, the CEO, h1s management team and indeed to all our staff. I I would like to thank all the members of our Board am confident that by adopting the collaborative who have given their continued support to me as approach of preVIous years, these challenges w111 Chairman and have worked tirelessly towards the be successfully met and this will result 1n many aim of Improving the health services in the North health and social benefits for the res1dent East region. population of the North Eastern Health Board area. Our Board is fortunate to have at its disposal staff who are leaders in their professions. Our doctors, nurses, para-medical, administration and other staff have advanced the quality of the service we prov1de. I would like to record my gratitude to all our staff for this and their continued commitment. Dr Hugh Dolan I would also like to extend my thanks to Mr. Paul Chairman Robtnson, the Board's Ch1ef Executive Officer, who in his first year 1n post has shown great vision and comm1tment to the Board. In collaboration With h1s management team, we hope that health seMce delivery Will be continually enhanced 1n the coming years.

The Board continued to work closely with the Minister for Health and Children, Mr. Michael Mart1n, and h1s department. Th1s positive and constructive work1ng relationship will prOVIde the foundation for further service developments to be undertaken in all parts of the Board. North Eastern Health Board Bord Slalnte An Olr Thualsclrt

MESSAGE F"ROM THE CHIEF EXECUTIVE OFFICER

The North Eastern Health Board Great emphasis was placed upon the provis1on of continued to develop the range safe services to patients and the availability of a and quality of services available to safe working environment for all our staff. These all during 2000. This is the fifth two issues will focus the attent1on of us all when annual report for our Board and it developing our services further during the com1ng gives a broad outline of the wide years. range of services and activities dunng the year. The report "Health Status in the North Eastern Heath Board" was published during 2000. This On a personal note, 2000 my first year as the was report provides the Board and its Management Board's Ch1ef Executive Officer. I am extremely Team with a benchmark against which grateful for the support and co-operation which 1 improvements in the health status of our have receiVed from the Board and the staff during population in future years can be measured. th1s year, and especially the assistance, loyalty and advice of the members of the Management Team. While this report highlights the Board's Three new members were welcomed to the achievements during 2000 we must be aware that Management Team during the year with the a number of challenges must be met in the appointment of Mr. Lany Walsh, Mr. Aidan Browne coming years. As stated above, the provision of and Mr. J1m Curran followmg the recommendation safe services and a safe working environment of the Local Appointments Commiss1on. These must be addressed continually. We must have indMduals bong With them a wealth of knowledge regard to changing standards and demands in and expenence to the Management Team and are delivering our services. We must 1mprove our most welcome to the~r new posts. communication process both within and outs1de the Board. We must recruit and reta1n staff of the I must also thank the Board's cha1rman, Dr. Hugh highest calibre. We must strive to achieve a status Dolan, who has selflessly and tirelessly worked of maximum regional self-sufficiency. above and beyond the call of duty for the Board and has always been ava1lable to discuss Board These are just some of the many challenges for busmess, as well as representing the Board at the the Board, however, 1 am confident that we have many functiOns organiSed by ourselves and by the Board members and staff available to nse to other orgamsaoons. this challenge.

I would also hke to thank the Board's staff who I look forward to building upon the successes aga,n showed dunng 2000 how oomm1tted they highlighted in this report. are to PI'O'Ad1ng the highest quality health sei'VIce to all. The Board Members, the management team and myself greatly value the1r errorts and PI'Ofess!Onahsm.

The yetll 2000 was another successful year for the Board. From the ~nn10g of the year, the seamless tral'\<iOO of the Board's computer and mediCal equ PO'lent to the new m•llenn,um was Paul Roblnson testimony to the abihty of the starr 1!1\'0ived •n thiS Chief Executive Officer projeCt. The IIOiume of wart< Undertaken wsthm the Board was fleater than 1n any Pll!VIOus year While the money spent on health care PfOVIS10n was also unP"!Cedented.

North Eastern Health Board Bord Sl61nte An Olr Thualsclrt

PROFILE OF" THE REGION

Introduction The two largest towns in the reg1on are both 1n Louth. These are Dundalk, With a population of The North Eastern Health Board (NEHB) region persons and Drogheda, w1th a population covers the counties of Louth, Meath, cavan and 25,762 Monaghan. This area covers a total of 6,498 sq. of 24,460 persons. kilometres. The region extends from the Apart from Navan in Meath, there are no other FermanagtVArmagh border in the north to the towns w1th a population of more than 10,000. boundary with Dublin in the south. To the east Navan has a population of 12,810 (Inclusive of there is a considerable length of coastline and to environs). the west a shared border with counties whose health services are provided by the North Western Cavan has a population of 5,623 (Inclusive of and Midland Health Boards. environs).

The total population for the census year 1996 was Monaghan population in 1996 was 5,842 306,155. There has been no census since 1996 (inclusive of environs). and the next census will take place in 2002. Table 1 sets out the number of people per square The percentage of the population living 1n town kilometre for each NEHB county in 1996. The areas in each NEHB county and in Ireland 1s set population densities vary from county to county, out in Table 2 with Louth having almost two-thirds with Louth demonstrating the highest population of the population living in town areas. density at 110 persons per square kilometre and Cavan the lowest, at 27 persons per square kilometre. (The population density of Ireland is 53 Proportion of the population In NEHB counties persons per square kilometre.) living In town areas

Meath Ireland

Population density In the NEHB region (~996) 63.5% 33.9% 16.9% 28.1% 58.1%

Louth Meath Cavan Monaghan NEHB The substantial proportion of the population living Square kllometer in rural areas brings special challenges in providing services and for accessing services. 839 2,380 1,963 1,316 6,498 Population The number of births to mothers resident in the 92,166 109,732 52,944 51,313 306,155 region in 1999 was 4, 7 44, an increase of 333 on the 4411 born in 1998. This is a birth rate of Persons per sq. kilometer 15.5 per 1 ,000 of the population and compares 110 46 27 39 47 to a national rate of 14.2. The number of deaths registered in respect of residents of the NEHB region in 1999 was 2,534. This is a crude death rate of 8.3 per 1,000 of the Population In the NEHB region population and compares to the national figure of (2000 estimated) 8.5. The mortality pattern in the NEHB region is Louth Meath similar to the national picture with 44% of deaths NEHB due to circulatory diseases, 22% due to cancer, Population 15% due to respiratory diseases, 6% due to 102 500 • 128•000 56,000 56,000 342,500 accidents and poisoning and 13% due to other causes (1997 data). Table la (above) sets out the latest available population figures for 2000 as estimated by th local authonties concerned. e 2000 ANNUAL REPORT

c;;H~~ Table 3 . sets out the number of deaths and the Standardised Death Rates (SDR) for the NEHB The number of Deaths and SDRs for NEHB region from 1993-97. The data suggests that Region, 1993- 1997 NEHB residents as a whole have a mortality profile which 1s broadly similar to the national picture. Deaths from mjury and poisoning in males, for all Cause of death ages and under 65 years, is, however, significantly Sex All SOR Deaths higher than the national average. Deaths from Oeaths(n) All <65(n "deaths SOR cancers in males of all ages and under 65 years 1993-97 Deaths 1993-97 <65 <65 are significantly lower than the national average. All Cause Mortality m 6979 1071.0 1697 24.3 303.0 f 5840 666.9 939 16.0 178.8 Communicable disease Circulatory Diseases Under the infectious diseases regulations 1981, all m 3111 485.8 562 18.0 109.0 doctors are obliged to notify specified infectious f 2697 291.5 188 7.0 37.2 diseases to the health board. The list of notifiable diseases is due to be updated this year to include Cancers emerging infectious diseases such as vCJD. lt is m 1635 246.0<> 409 25.0 77.6v important to receive timely notification to ensure 1329 172.7 451 33.9 88.2 that trends can be monitored and outbreaks identified and controlled quickly. The total number Respiratory Diseases of infect1ous diseases notified to the NEHB in m 973 155.4 97 10.0 18.6 2000 was 530. 858 91.2 53 6.2 10.2

Injury and Poisoning m 497 67.5 <"> 407 81.9 60.5" 185 23.5 99 53.5 16.1 Mortality patterns In the NEHB and in Ireland

SOR - Standardised death fllle

"' S/llfl/fican!ly higher than the na!Jona/ averase

8 Sl/lfl/flcanrJy lower than the na!JonlJIIJVI!flllle

Cm:ulatO!}t Cancer RespuatO!}t InJUry and Other f'olslonong

ONEHB 0 Ireland North Eastern Health Board Bord Slalnte An Olr Thuaiscirt

PROF"ILE OF" THE REGION (CONTINUEO)

Meningococcal meningitis and septicaemia

Communicable Disease Meningococcal meningitis is the most common cause of meningitis. The highest age spec1fic rates 1999 2000 occur in children under 4 years, with another slight Gastro-ententJs (persons increase in incidence in the late teens. The <2yr only) 75 167 causative organism is Neisseria meningitides, which is found naturally occurring in the back of Salmonella 97 104 the throat in about 10% of the population. The majority of cases are caused by Group B or Group FOOd po1son1ng C serotypes. In 2000 there were 50 cases of other than salmonella 95 46 meningococcal disease in the NEHB of which 32 Bactenal meningitis 53 64 (64%) were group B and 11 (22%) were group C. Group B cases were more common than Group C Viral memng~tJs 5 12 cases in all age groups.

Tuberculosis 33 27 In October 2000 the Department of Health and Children introduced a National Immunisation HepatJtJs A 39 35 Programme against Group C meningococcal diseases. The first Phase, which targeted 0-4 year olds and 15 to 18 year olds, is almost completed. Table 4 (above) outlines the main infectious Phase 2, which targets 5 to 7 year olds, and d1seases notified in 1999 and 2000. Phase 3, which targets 8 to 14 year olds and 19 to 22 year olds, are currently being undertaken simultaneously within the NEHB. Meningitis Only 44 of the 50 notifications in 2000 were The total number of cases of meningitis notified to confirmed as definite cases by laboratory tests. the Board for 2000 was 76. A number of This gives the NEHB region a rate of 14.4 orgamsms can cause memngitis. The breakdown of laboratory confirmed cases of meningococcal cases by type of meningitis IS outlined in Table 5 disease per 100,000 of the population for 2000. (below). There were five deaths as a result of meningococcal disease in 2000. This compares to two deaths in 1999 and 5 deaths in 1998. Type 1999 2000

Men1ngococca1 50 50 Food poisoning Bactenal - not spec1fied 1 9 A number of bacteria and viruses can cause food poisoning. There were 104 cases of salmonella, Pneumococcal 0 3 46 cases of other food poisoning and no cases of Other bactenal 2 2 E Coli 0157 notified to the NEHB in 2000. Viral 5 12 FOOd poisoning can be transmitted through various types of food including meat, un-pasteurised milk, Total 58 76 contaminated raw vegetables, contaminated water etc. Thorough cooking of food, proper storage at correct temperatures and high levels of hygiene are essential in the prevention of food borne illnesses. 2000 ANNUAL REPORT

OUR APPROACH

cc...... ~ \u/1 Aims Self Reliance The North Eastern Health Board aims to promote To enable people to be as independent as possible and develop the highest quality health service to and to take responsibility for their Individual health its res1dent population. This objective will be and soc1al well bemg. achieved by delivering services in an equitable Excellence manner and ensuring that we are sensitive and respons1ve to the needs of the people availing of To set the highest standards in performance 1n all our serv~ces. The Board continues its commitment that 1t does and to continually momtor to: performance to attain these standards.

• Positive promotion of good health and healthy lifestyles Quality Approach • Comprehensive programmes for the The Board defines a quality seMce as: prevention, diagnosis and treatment of illnesses 'The provision of the right service, to the right individual at the right time and In the right setting'. • Programmes of care for those suffering from long term illness and disability In order to prov1de a quality seMce, the Board IS working to ensure that all 1ts serv~ces are: • The provision of social services to individuals and families at risk Equitable Persons Wlth 1dentJcal needs receMng the same standard of care regardless of where they live, Purpose where they are treated and what their 1ncome 1s. Our purpose IS to promote and improve the Accessible standards of health and social well being for all Everyone haVIng ready access to the seMCes they people of the region through the work of the Board need when they need them and as far as pos51ble and to influence health and social improvement m and where appropnate, be1ng available locally. collaboration with others. Effective Each person should get the best poss1ble result Values from hiS or her treatment and care.

Respect Efficient For indiViduals, families and groups wrth1n the Services are organised and delivered 10 a way region who have health and soc1al needs, for each wh1ch g,ves the best retum for 1nvested resources. IndiVIdual member of staff and for each person or group who participates Wlth us 1n the delivery of Appropriate health and SOCial seMces 1n the North East. The seMCe should meet needs locally, avoid1ng unnecessary dependence on seMCeS or Dignity mslltutJons and bemg fleXIble enougtl to cope Wlth To reflect the h1ghest standards of courtesy, the need to change. confidentiality and respect for the pnvacy and d1gn1ty of IndiViduals that soc1ety expects. Responsive SerVICes should reflect the needs and entitlements of the people the Board serves. ------~------~--~------

North Eastern Health Board Bord Sl61nte An Olr Thualsclrt

FINANCIAL REVIEW 2000

The level of financial resources available to the serv~ces were also prov1ded by the Board at a total Board 1n 2000 for non-cap1tal seMces was cost of £17 .5m. £276.8m. an increase of 22% compared to the previous year. Planned seMces were delivered The supplementary welfare allowance schemes Within budget With a number of new developments funded d1rectly by the Department of Soc1al, commencing during the year. Commumty and Fam1ly Affairs (DSCFA) are adm1n1stered by the Board's officers at a cost of Table 6 below, outlines the d1stnbut1on of gross £2.1m. Th1s cost IS recouped by the Board from expenditure for the year. DSCFA.

The housmg a1d for the elderly programme Distribution of Gross Expenditure 2000 contmued WJth expenditure of £0.628m. be1ng funded by the Department of the Environment. SeMce £m

1 Acute Hospitals 120.2 European and Cross Border Projects 2 Special Hospitals 22.1 The Board IS 1nvolved 1n a number of Co-operat1on 3 Community Welfare Programme 42.2 and Working Together programmes, some of wh1ch attract funds from the EU and the peace and 4 Community Health Services 27.5 reconCiliation fund. Expenditure on these 5 Community Homes and Hospitals 21.8 programmes 1n 2000 was £0.402m. Other EU funded projects totalled £0.154m. in 2000. 6 Community Support Services 19.0 7 Community Protection Programme 4.4 Prompt Payment of Accounts Act 1997 8 Other Community Services 9.2 The Board is subject to and complies with the 9 Centrally Administered Services 10.4 Prompt Payment of Accounts Act 1997. Under the terms of this act the Board is obliged to pay TOTAL 276.8 creditors within 45 days of receipt of goods or the appropriate invoice. Where payment IS late, The De~rtment of Health and Children proVIded penalty interest must be included with the non-capital health grants of £254.4m. with payment. The Board have now installed a system £22.4m. being raised internally. The cost of pay in to allow all provisions of the Act to be complied 2oo:> was £157.5m. with non-pay gOOds and seMces costing £119.3m. with. The total penalty interest paid in 2000 was £15,951. The delayed payments represents 2% of The National Development Plan provided f d. . the Board's total non-pay expenditure. 2000 . un mg m for a Wide range of capital projects costing £25.549m. an increase of 270% from the £6 9m ~pent in 1999. The development of our . · Annual Accounts Infrastructure ·IS an essent1al· element in planning for ~tu~e services and the enhanced level of The Board's 1999 annual financial statements capital Investment is welcome. were adopted by the Board in March 2000 and audited by the Comptroller and Auditor General Grants to 250 voluntary organisations in the later in the year. The 2000 annual financial community totalled £5.9m. an increase of 80% statements were adopted by the Board in April from 1999. Funding for St. John of God services 2001 in accordance with statute and have been at St. Mary's Drumcar and for the BreastCheck submitted to the Comptroller and Aud1tor General for audit. 2000 ANNUAL REPORT

...... ~ \u/

Balance Sheet Of North Eastern Health Board As At 31 December 2000

31/12/00 31/12199 £ £ AXED ASSETS Tangible Assets 110,522,550 90,059,861 Financial Assets 0 0 110,522,550 90,059,861

CURRENT ASSETS Stocks 3 ,936,913 3,130,880 Debtors 28,177,818 24,481,513 Cash at bank or in hand 4 ,691,041 8,419,965 European Projects Account 85,107 103,083 36,890,879 36,135,441

CREDITORS Bank Loans & Overdrafts 0 0 Other Creditors 51,429,121 35,936,972 51,429,121 35,936,972 TOTAL ASSETS LESS UABIUTIES 95,984,308 90,258,330

CAPITAL AND RESERVES Non-Capital Income & Expenditure Account (1,019,428) 47,858 Capital Fund:- Capitalisation Account 110,522,550 Less Deficit on Capital Income & Expenditure Account (14,357,091) 96,165,459 89,741,144 Deferred Income Account 838,277 469,328 95,984,308 90,258,330 North E81tern Health Board Bord Slalnte An Olr Thualsclrt

OUR SERVICES REGIONAL SERVICES

1.1 PRIMARY CARE

North East Doctor on Call Vaccine preventable diseases notified to the A new co-operat1ve approach to providing out of NEHB, 1997 - 2000 hours general practitioner service commenced on 2000 99 98 97 the 18th of September 2000. Pat1ents have 6 7 18 access to the service through an extensively Whooping Cough 13 pubf1c1sed low cost telephone number. Every Measles 39 4 4 18 patient requiring a GP service has rapid, guaranteed and direct access to a service out of Rubella 1 0 2 6 hours. The development of a GP out of hours co­ 8 operative together with its integration into the pre­ Mumps 0 0 1 hosprtal care serv1ce and close linkages with the hospital seMce will dramatically improve the access1b1hty, the availability, the appropriateness, Vaccination Programmes the efficiency and cost effectiveness of all aspects Vaccination programmes aim to immunise and of out of hours service. In total, 16,866 patients thereby protect the population from disease. In the contacted the service between 18th September past, successful vaccination programmes have led 2000 and 31st December 2000. to the eradication of smallpox and more recently polio has almost been eradicated wor1dWide. In Ireland the childhood vaccination programme has controlled other diseases such as pertussis, diphtheria and measles. When the Hib vaccme was introduced, it resulted in a marked reduction in the number of cases caused by the Haemophilus Influenza organism. The success of vaccination programmes means that parents and professionals may have no experience of many of these infectious diseases and forget how serious they can be. This can result in a fall in vacc1ne uptake, which in tu m can lead to a resurgence of cases of infectious disease once more.

Table 8 (above) outlines the number of vaccine preventable diseases that were notified to the NEHB during the years 1997-2000.

Vaccinations are provided through the childhOOd immunisation programme delivered through GPs and Community care doctors. The occupational health department undertakes vacc1nation of health care staff at risk of contracting d1seases such as tuberculosis and hepatitiS. 2000 ANNUAL REPORT

Primary Childhood Immunisation Scheme Family Planning Within the region we achieved the national target The Pnmary Care Unit 1n conjunction with general of 95% per cent for immunisations given to practltloners provided a comprehenSIVe fam•ly Children at age two, four and six months. However plann1ng service. A family plann1ng websrt.e and uptake of MMR vaccme was only e1ghty per cent. family plann1ng health promobon programmes Work continued With the Public Health Department were developed 1n COOJUncbon with the Health to 1dentJfy areas of poor uptake and to put Promotion Department. measures m place to tackle this problem.

Community Dental Service Meningitis C The Quality lnltlatrve ISO 9002 1n the dental Men1ngJtJs C vaccme was Introduced 1n 2000 and seMce was externally audited With a successful seMces were put m place to 1mmumse all people outcome. up to the age of 22. The vaccine has been 1ncluded m the Pnmary Childhood Immunisation In 2000 s1gn1ficant Investment was made 1n Scheme for babies born s1nce the Introduction of refurbishment and eqUipment replacement the new scheme. throughout the reg,on. New dental surgenes opened 1n Kells and Oldcastle and the Navan dental chmc was upgraded. lnftuenz.a/Pneumoccol A Post Graduate Tra•n•ng Programme 1n dentistry Vaccination Campaign commenced 1n the region 1n 2000. Three vocatiOnal dental practitiOnerS were appotnted and The campa1gn to vaccmate ·at nsk' groups three tra•nees commenced tra•n•ng '" September. commenced from the 1st of September 2000. Th1s seMce was prevK>Usly only ava1lable to all med1cal card holders aged over SIXty frve years and to those who are under 65 who are considered to Dental Treatment Services Scheme (DTSS) be at nsk. The final phase of the dental scheme commencod on the 1st of January 2000 extcndll"l& rou1.1no treatment to the 35 to 64 age group thereby Maternity and Infant Scheme covenng all me

REG IONAL S E R VICES (CONTINUED)

Capital Developments Education and Training Funding from the National Development Plan was The pnmary care umt contmued 1ts comm1tment to made available in 2000 for projects 1nclud1ng tra1n1ng and educat1on for general practitiOners 1n health care units in Clogherhead, Carlingtord, assoc1at1on With the lnsh College of General Oldcastle and Ballyconnell. Practitioners and the Post Graduate Medical and Dental Board. In 2000 the unit proVIded fund1ng to the ICGP for the GP IT Tra1mng Programme . Practice Support Staff In 2000, 71% of the general practices in the region employed a practice nurse. The total CAWT number of nurses employed was 77. In addition, The four Board Pnmary care project continued 1n the number of secretaries and managers employed 2000 and Will formally conclude in May 2001. A has led to improvements in the effic1ency and full and comprehensive evaluation is currently organisation of general practice. 89% of practices be1ng earned out and will be available 10 2001. employed secretaries while 19 practices employ a Out of hours services in primary care are being practice manager. exammed by the four Boards and a feas1b1hty study on a four Board co-operation will be produced wh1ch will 1mprove out of hour services 10 remote Cardiovascular Strategy border areas. and Primary Care Community pharmacists were enrolled by the primary care unit as part of a primary care 1.2 ADULT MENTAL initiative in cardiovascular health. Non-compliance HEALTH SERVICES with the use of prescribed medication was The main objective of the mental health service is identified as one of the risk factors contributing to to promote and improve the standard of mental ill health in cardiovascular patients and community health and social well being of the people of the pharmacists will now assist in improving compliance rates. region. This is achieved by providing a range of community based services and acute hospital mental health care where appropriate. The emphasis is on developing and implementing Pharmacy individual care plans for each person who has In 2000 pharmacists assisted in the smooth contact with the service including consultation opera~on of the new out of hours arrangements by both with family and the person receiving the proVIding an out of hours directory and an on call service. rota system for pharmaceUtical emergencies. The Monaghan home based treatment service A pharmacy strategy document for the continued to develop and a community mental develop~ent of the role of the community health team and home based treatment team pharmacist was published as a result of a CAWT commenced in Co. Cavan. Communication linkS ~ Co- operation and Working Together) cross border with GPs were improved and a single referral Initiative. system to the community mental health teams now exists Research on GP satisfaction with home based trea.tment and the commun1ty mental health team commenced and focus group discussions I . • ws were organised to explore user and relatiVe VIe on the service. 2000 ANNUAL REPORT

Admissions to St. Davnet's Hospital from commun1ty mental health teams reduced by 41% while admissions to cavan General Hospital from Cavan community teams reduced by 42%.

A third mental health team became fully operational in the West Meath sector, with serv1ces 1.3 REGIONAL AMBULANCE being provided in Tnm and l<.ells. SERVICE The role of the ambulance service 1s to prOVIde a A sector headquarters was established in Kells. comprehensiVe and speedy pre-hosprtal care Day seMces also commenced which facilitated the response to accident and emergency InCidents transfer of persons attending Tain Day Centre, within the region. The service works closely With Navan from the Kells area to avail of locally based the other emergency services to ensure day services. comprehensive cover in the region and surrounding In-patient accommodation in acute and long stay areas. During the year 2000, operational demands wards was improved across the region. on the regional ambulance service continued to increase significantly in all areas of operat1ons - Work commenced on obtaining the Q Mark for the accident and emergency calls, urgent G.P. calls, Department of Psychiatry, Our Lady's Hospital, inter-hospital calls, patient transport services Navan. In conjunction with Excellence Ireland, demands and communications. In the year 2000, tra1ning was provided for staff from a range of the ambulance service responded to almost disciplines to enable them to audit the services 23,000 emergency and urgent calls for provided. assistance.

Work on the establishment of a high dependency The level of emergency calls continues to rise sixteen-bed unit in Dundalk progressed. The unit Significantly each year with a twelve per cent nse will become operational in mid 2001 and will have over last year across the region and as high as a significant impact on the services in North Louth. 20% in certain areas. Urgent GP calls Increased regionally by 12% but in specific areas by as much Uaison continued with relevant agencies in relation as 45%. Inter-hospital transfers, pnmanly an to developing supported housing for clients in indication of out of area calls to specialist un1ts 1n counties Louth and Meath. Dublin, increased by 7%. A mental health service for the elderly commenced in cavarvMonaghan, made up of two home based treatment teams, one in each county, acute beds Aeet Management and Replacement at cavan General Hospital and a day hospital at The service made very significant investment 1n St. Davnet's Hosp1tal, Monaghan. A service co­ veh1cles in 2000. Ten ambulances were purchased ordinator was appointed. The psycho geriatric dunng the year, augmented by other specialist wards were upgraded as part of the new mental vehicles Including majOr 1ncident equ1pment camer health serv1ce for the elderly. and mobile control vehicle. Three new response veh1cles were purchased wh1ch Will allow for an 1mproved response to major accidents and other 1nc1dents. The fleet management system was upgraded to allow for the most accurate Information to be ava1lable 1n relation to the up­ keep of our fleet. North Eastern Health Board Bord Slalnte An Olr Thualsclrt

REGIONAL SERVICES (CCNTINUEC)

Major Incident Planning and Large Crowd Events The serv1ce provided medical cover at four large crowd events 1n 2000. Three of these were one day events with the other being a two day event. Each event attracted between 35,000 and 60,000 1.4 HEALTH PROMOTION people. These events required cross agency co­ SERVICES operation within the health board between the ambulance service, health promotion and Health Promotion continued with a comprehensive environmental services and externally with the programme in 2000 embracing and over1app1ng Gardai and local authorities. settings, topics and population group approach.

The Department worked closely with the Health Promoting Hospital Initiatives throughout the Staff Training Initiatives region including Healthy Eating Week, Hosp1tal The service continued with its station training days Challenge Days, Continence Promotion, and as part of our continuing education programme. All Smoking Cessation. The Health Promoting GP frontline ambulance staff are now trained to initiative was intensified. Emergency Medical Technician (EMl) standard. The Drogheda Healthy Cities supported a new Sli Staff have begun the new Emergency Medical na Slainte route with the Drogheda "Your Town Controllers course, and their involvement will allow Your Health" Campaign. In addition Sli na Slainte the serv1ce to influence the direction and content of this course. leaders were trained in conjunction with Irish Heart Foundation and five walking groups were established. The Health Promotion Corner in Our Lady of Lourdes Hospital continued incorporating Health And Safety Issues an extensive range of community, voluntary and A further three easy-load stretchers were public sector groups. purchased 1n 2000 to reduce the lifting of patients in and out of vehicles. A new arrangement was entered into in relation to the supply of medical Schools gases allowing the service to cease the dangerous The Schools Programme continued in 2000 in activity of refilling medical gases. New lightweight partnership with teachers, parent associations, high visibility personal protective equipment was Gardai and others to enhance the health of the IntrOduced for staff comfort and protection. entire school communities including students, staff and parents. At post-pnmary. leve,I SOCI · al Personal Health Education (SPHE) training was offered to all Pilot Study schools in the programme and 250 teachers trom A Pilot study, using specialist cardiovascular 30 schools availed of same including nutn· r10 nal ' equipment began. Initial indications are very smoking and response to tragedy components favourable, Wlth a further 12 months research to integrated into the process. A research programme be completed. The evaluation of defibrillators is on weak ability students was completed. In the continuing. Wlth propOSals to replace our primary school setting SPHE tra1mn- · g was prOVIded defibnllators and monitors in the coming years. to 350 staff. 90 teachers from 50 schools attended fiVe fiVe-day summer schools courses, seven action for life workshops were provided for 105 teachers, and 60 teachers from 30 diffe~ent schools received training in nutritional education 2000 ANNUAL REPORT

...... ~

Physical Activity included sponsorship for both GAA and soccer leagues, and development and launch of a In line with the National Physical Activity Strategy voluntary no smoking code for tra1ne.Wmanagers. the department implemented the "Be Active At These were underpinned by a med1a campaign for Work" programme for 600 health care staff. "Eight parents. The entire programme was underpinned Go For Ufe" workshops for older people were held. by IntensiVe promotional campaigns e.g. "Born a The programme also collaborated with the dietetic, non-smoker", "Have a Smoke Free millennium" school and health promoting hospital initiatives, and local advertising. local authonties and community groups. W1thin workplace and health care settings, the NEHB smok1ng policy was reviewed, refined and Nutrition more effectively implemented, nine smoking cessation clinics were held and one permanent The Nutntion Service continued to incorporate drop in centre was established. In additiOn a clinical and health promotion aspects. Health specialist smoking cessation service was promotion activities included the attainment of a established with counsellors available two days per Happy Heart certification in Cavan General week in each county for one to one and group Hospital and the assessment of fifteen restaurants work. Ongoing tra1ning for healthcare for this award. At year-end, 12 restaurants and professionals, including pharmacists, supported three workplaces had achieved this status. The these initiatives. nutrition service supported the "Active at Work" programme with twelve nutritional workshops, and the schools programme with four seminars, five in serv1ces courses and four guideline-training Drugs sess1ons. The "Cook-lt" Programme, which The Regional Co-ordinating Comm1ttee on Drugs enhances the nutritional skills of lower income Issues completed its report, which Will prOVIde groups, was intensified with 16 courses held. At ongo1ng strategic guidance to the substance the end of 2000, 15 individuals were trained as m1suse programme. This programme a1ms to leaders in the programme. enhance the knowledge, skills and competencies of young people, parents, and commun1t1es to Further initiatives included the launch of the small respond to drugs issues. In th1s context, the health grants fund to encourage staff to engage in health promot1on department facilitated n~ne drug promotion activities, additional joint initiatives with question local answers courses, four fam1ly CAWT partners, qualitative research into physical commun~catlon courses, 12 peer education activity, young people, cancer and suicide 1ssues, courses, six life skills courses, 20 drug awareness needs assessment around issues relating to young courses, 20 drug road shows, and 15 sound people, smoking, mental health and the further deciSIOn night ClUb tra1n1ng sessiOnS. development of policies and protocols. ~----- Smoking Cessation The smok1ng prevention programme encompassed schools, youth, workplace and health care settings. ln1t1atwes Within the schools setting 1n 2000 1ncluded development of smoking pohc1es 1n schools, prov1s1on of support 1n implementation of same, agreement to prOVIde smoke cessation tra1n1ng for teachers and conven1ence advertising 1n 56 post pnmary schools. Youth seMces North Eastern Healt h Board Bord Slllnte An Olr Thualsclrt

REGI ONAL SERVICES (CCNTINUEC)

In addition the counselling service provided a seMce 1n all four counties including one to one counselling, after-care and group services, family therapy sess1ons, methadone treatment, and a reporting service for probation officers and courts, unique to the Republic of Ireland.

Accident Prevention The Childhood Accident Prevention programme aimed at Children was extended in 2000 to include travellers. The National Safety Council, local authorities fire officers, Gardai and communities in conjunction with the Board were involved 1n a fire prevention programme for older people. 1.6 CARDIOVASCULAR STRATEGY Suicide In 2000 a committee was set up to develop a cardiovascular strategy and implement service In line with the National Task Force on Suicide the Mental Health promotion service developed initiatives. An advisory committee was also established to ensure effective partnership support additional local action groups in Drogheda and from external organisations. Cavan with one at an advanced planning stage in Dundalk at year-end. The Meath Local Action The pre-hospital service initiated administra~~n of Group implemented a six-week focus on suicide aspirin training to emergency medical technlcl~n~ prevention course and intensified their work in and the development of protocols for pre-hosplta schools. The Directory of Social Services was care. updated, and the department assisted in establishing a multi disciplinary young men's A training needs assessment was initiated in the health pro.teet in East Cavan. region by the Institute of Public Administration and The Royal College of Surgeons to identify the target areas for action in the coming years.

1.5 CANCER STRATEGY A specialist smoke cessation service was The Board's cancer strate~ agreed 1n 1998 sets established by the Health Promotion Departm~nt the bas1s for local cancer service developments to support Board staff and service users to quit Within the reg,on. RedUCtions 1n cancers can be smoking. achieved by co-ordinated assessment, prevention and treatment. Two Community Dieticians were employed to w_c>rk with the primary care and health promotiOn umts Local serv~ces continued to be developed in hne to promote healthy lifestyles and initiate lifestyle With best practJce and agreed chn1cal protocols. changes for those at risk of cardiovascular The Pubhc Health Department continued to work disease. closely With chmc1ans to monitor and aud1t The health promotion department '" conjun ctin seMces. The cancer steenng group committee ° with the lnsh Heart Foundation established Sh na developed co-ordinated action plans to Implement Slainte routes in the NEHB region. new seMCe developments Wlthtn the reg,on. Phase one of the national breast-screen.ng programme (BreastCheck) was Implemented across the region. 2000 ANNUAL REPORT

• •• 1. 7 WOMEN'S HEALTH response to issues of domestic violence, including the production of an information card. The Board The Women's Health Implementation Group awarded Millennium grants to 10 community continues to set the agenda for service change groups to implement health promotion initiatives. A and development, which focus on the needs of Women's Health Development Officer was women in the region. The key issues to be recruited in 2000, who will co-ord1nate, facilitate addressed were information, health promotion and and develop women centred services 1n the region. women centered services. Ongoing assessment of serv1ces by women in partnership with the Public Health Department remained a key feature. The consultation and consumer feedback process will 1.8 MEN'S HEALTH determine future service developments. The Public There is a grow1ng awareness of the need to focus Health Department continued to support, monitor on issues relating specifically to the health of men and evaluate services to ensure they are sensitive as set out in the Board's Health Status report. to women's needs. These include cancers, cardiovascular problems and alcohol related illnesses. Information on women's health services was improved with the development of a website on Ufestyte is a major determinant of men's health women's health was in the region. Health status, which can be addressed through prevention education and promotion programmes were and health promotion initiatives. Particular developed in an innovative way through smoking disadvantaged groups of men requ1re additional cessation programmes, providing practical focused seMces. The Public Health Department assistance to women regarding healthy diets and undertook research on men's health 1ssues, whiCh the development of physical activity programmes. Identified the following: Commumty parenting programmes were implemented enhancing capacity for supporting • Men equate health With physical well be1ng. core-parenting skills in partnership with local with the1r emotional health g,ven less pnonty. people. Peer led initiatives were developed among special groups e.g. traveller women in order to • Men perceiVe nsky behaviour e.g. speed1ng involve travellers as partners with service providers and alcohol consumption, as part of be1ng 1n dealing with traveller issues. There was male and difficult to change. enhanced support for young single mothers under • Men tend to be less proactive about looking the "Moving On Project". There was continued after their own health, responding to 111 health development of family planning services rather than health promotion. l throughout the year. The Board developed a comprehensive, multi-agency and multi-disciplinary • There are wlnerable groups of men who requ1re more focused support. North East ern Health Board Bord Slalnte An O lr Thualsclrt

ClUR SERVICES COMMUNITY SERVICES

2.1 CHILD HEALTH During 2000 additional key frontline staff were appointed in each community care area to further Of all the European countries, Ireland has the enhance multi-disciplinary child health services. A highest number of chtldren as a percentage of the partnership approach with Enable Ireland has total populatton. Investment in our children in assisted the newly appointed multidisciplinary early terms of health and education is essential to Intervention teams. The manner in which services ensure the future prospenty of the country. With are delivered was reviewed wtth an emphasis on thts 1n mtnd the Health Boards earned out an creating a more child friendly environment. extensrve revtew of existtng child health services for the 0-12 year old age group. The document In Louth Community Care there was significant "Best Health for Chtldren" was the output of that advancement m the multidisciplinary involvement review and 1t sets the way forward for the future with peer led groups, such as the community development of chtld health servtces for thts age parenting programme; accident prevention; primary group. The pnnctpal components of a chtld health health care for travellers; moving on project and seM ce are: local communtty crEches in terms of education and trammg and in terms of health and personal • That all chtldren have the opportuntty to realise social service issues. thetr full potential tn terms of good health, well-bemg and development. A number of public health nurses commenced studying the breast-feeding module in health • That remediable dtsorders are Identified and promotton at Universtty College, Galway. acted on as soon as posstble.

Underptnnmg all of thts ts the tmportance of the role of the parent, supported by professtonal 2.2 CHILD CARE AND expertise and the need to promote children's FAMILY SUPPORT health and to prevent Ill health, rather than just dealing wtth ill health as tt anses. A rev~ew of the The Child Care and Family Support services atm to seMCes prOVIded to 13-18 year olds ts underway prOVIde a high quality, integrated, chtld-centred at present and thts report ts expected to be seM ce to chtldren tn the reg,on who are not avatlable for consK:IeratJon tn 2001. Hopefully 1t receiVIng adequate care and protection. The wtll potnt the way forward tn a stmilar manner as guidtng pnnctples of the seMce include working "Best Health for Chtldren· has done for thts age closely wtth famtlies provldtng focused support to group. try to ma1nta1n chtldren tn thetr own homes and the development of partnerships wtth commun1ty A customer satiSfactiOn survey was earned out With and voluntary sectors 1n order to strengthen the a total of 1038 anendees to chtld health clin•cs range of supports available to vulnerable famtlies. betng sent a pre-p!loted questtonna•re to ascertatn the.r VIew of seMCe. The response rate was 69%. The Board received 1,277 referrals concerning Appomtrnent lime proved SUitable 1n 77.1% of ch•ld abuse/neglect 1n 2000, of whiCh 458 were cases. Early mom•ng and anemoon appotntrnents confirmed as abuse/neglect. proved more SUitable due to 'N()O( comm•trnents A number of actiOns were taken to support the and concerns about ch•ldrcn mtSSmg schoOl. tmplementatton of Chtldren First National Wn•Ung umes at clin•cs did not exceed 15 m•nutes Guidelines for ProtectiOn and Welfare of tn 69.2% (4931 of cases wtth consultatiOn the Chtldren". These tncluded:- duratiOn vary1ng dependtng on the type of clime attended. Respondents were htghly sat•sfied wtth • The appomtrnent of an ImplementatiOn and commumcat10n and the provtSton of tnformation. AdviCe Officer, to dtstnbute the gutdehnes and Thts study h•l1Jhghts the value of seeking a bnef staff on thetr contents. consumer ~ as to the quality of seMCes pro111ded. 2000 ANNUAL REPORT

• •

• Three additional Team Leader posts in the the potential for recruitment of new foster parents Social Work Departments in order to and the delivery of support serv1ces. Additional strengthen response required for the social work posts were created to strengthen Garda/Health Board protocol. services for children in care and ensure the ch1ld placement rev1ews are earned out regularly. • Three Grade IV posts in the Child Care Additional after-care posts were established to Managers office, to provide the administrative deliVer an integrated service for children leavmg backup for the Child Protection Notification both foster care and residential care. System. The demand from couples who applied for • A Manager for Child Care Education & Training, assessment in relation to inter-country adoptions to strengthen the training capacity for the continued to rise in 2000 With 62 new applicants. Board to deliver the required training to meet An additional post was proVIded to the seMce and the standards required in Children First. the waiting time for inter-country adoption from receipt of application to the beginmng of the • A joint training programme of Garda and Health preliminary assessment process was reduced by Board trainers to prepare for the Garda/Health six months. Board protocol. A total of 626 staff attended 31 child care tra1mng The multi-disciplinary interagency Regional courses held 1n 2000, Including courses With Inter­ Planning Committee for services in the area of agency attendance, notably from the Gardal and violence against women completed an eighteen­ voluntary agencies involved 1n child care. month strategic planning process. This resulted in the development of a policy framework for use in A child neglect research study was earned out Health Board services and the launch of an which explored assessment and decision making 1n information card for women in the region. A cases of child neglect in order to develop a tra1ning and development worker post was standardised response. established to assist with the training and ongoing development agenda.

The Board established a "Rian Counselling Serv1ce" for adult survivors of past abuse. A Director of Service and counselling staff were appointed. A freephone service was established to facilitate d1rect access and ensure a rapid response to clients.

A rev~ew of the psycholo~ seMces in the Board was earned out by an external consultant and this resulted 1n the setting up of an Implementation group to address the recommendations of the report.

The pre-school lnspect1on serv~ce completed 193 annual Inspections 1n 2000. 58 follow-up InspectiOns were earned out and 197 advisory VISits to notified and proposed services.

The number of children in Foster care increased from 313 1n 1999 to 374 at the end of 2000. The Foster Care teams were strengthened to improve North Eastern Health Board Bord Slalnte An Olr Thualsclrt

COMMUNITY SERVICES (CONTINUEO)

Outpatient services

1998 1999 2000 The number of referrals to the Child Psychiatric No. % No. % No. % Service, from January 2000 - December 2000, cavanJMonaghan was 454, representing a 16.5% increase in 110 27% 118 30% 132 29% referrals compared to 1999. Table 9 (above) shows the breakdown 1n referrals accord1ng to Meath county and year. 115 29% 107 27% 150 33% In addrtlon to th1s measure of actMty, there were Louth also ongoing cases from previous years, on-gomg 178 44% 165 42% 172 38% work with new referrals, consultations to the paediatric wards and community care, attendances Missing* at the H1gh Court, case conferences, case 32 9 discussions and school and home visits, which Total were all recorded over the past 12 months (see Table 10). 435 390 454

• addresses fot ct1ese case wete ~T~~SS~ng In the database 1999 2000

New Patients 315 435 2.3 CHILD AND ADOLESCENT Follow-up appomtments 2,466 3,462 PSYCHIATRIC SERVICE Anti-bullying Group attendances 45 The a1m of the Child Psych~atnc Serv~ces 1s to pro111de a compreherlSIVe psych1atnc serv~ce to Group attendances 424 396"" children, adolescents and the1r familieS, through assessment, consultatiOn and therapeutic Day Programme attendances 235 mterventJOn. The Child & Adolescent Psych1atnc SeMce IS a multldiSCiphnary seMCe that pnontlses STOP Programme attendances 334 340 the assessment and treatment of children up to 304 591 the age of 16 who are presenting With severe mental health problems - for Instance, anoreXIa nervosa and eating diSOrders, suiCidal behaVIOUr, depressJOn, psychotiC disorders, psychosomatiC problems, severe aruuety disorders, OCO, AOHO, severe emot10nallbeha"V10Ural problems and severe parent1ch1ld relattonsh1p problems. •••~t~e0.,~--~t12000-IOIII;Jf(~ These figures IndiCate a substantial 1ncrease 1n Th1s seMCe enables ch11dren With psych~atne problems to develop psychologJcally, emotionally, actMty levels 10 all areas of the chtld psych1atnc Intellectually and SOCially. lt also enables familieS seMCe With the exceptiOn of the day programme. to Prolllde the necessary nurtunng enwonment tor ch11dren to develop and helps ch11dren and the1r familieS to use psychologJcal d1stress as a Ant.l-bullylng Programme developmental process so that rt does not hinder A number of anti-bullymg imtiatNeS were development. undertaken whtch 1ncluded school VISits, teacher tra1mng sesSions, parent meetmgs, development of appropnate literature and the productiOn of a VIdeo. 2000 ANNUAL REPORT

2.4 SERVICES FOR forum for service users, carers, voluntary sector, OLDER PEOPLE Local Authorities, Gardai and the Board's own service providers to express the1r views of the The ongoing development of appropriate services services currently provided and future seMce for older people is one of the major challenges requirements. The outcome of this day was facing the North Eastern Health Board. In order to published 1n a "Ustening Day Newsletter" and support older people in leading meaningful and circulated to all attendees. rewarding lives while continuing to contribute to SOCiety as a whole, services provided to older A Home Help/Home Care Service was prOvided to people are based on the individuals assessed approximately 2.402 clients dunng the year needs. These include community-based services, compared with 1,592 clients 1n 1999. A total of res1dent1al care, day care, day hospital and 624,663 hours of home help/home care were appropriate level of care in the acute hospital provided throughout the year. Day care seMces sett1ng as requested. were provided in 37 centres throughout the NEHB region with over 86,824 people attend1ng dunng In line with the National Health Strategy 1994 our the year. target is to ensure that no less than 90% of people over 75 years continue to live at home. A The number of extended care, convalescent and key objective is the provision of a quality service respite care are highlighted 1n Table 11: that is equitable, accessible and which promotes healthy aging.

The Board recognises the invaluable services 497 prOvided by carers in support to older people to Extended Care continue liVIng at home and in this regard support Convalescent/Respite 2359 seMces to carers continue to be developed. The Pathways Rehabilitation Unit was opened at In the context of providing the continuum of Usdaran, SeMces for Older People, Cavan. This IS services to those older people in need of ongoing a six-bedded unit wh1ch pi'O'IIdes mtensrve, multi care and support, partnership with the various diSCiplinary rehabilitatiVe seMce for older people. voluntary agencies and other public sector bodies The seMce a1ms to ass1st the 1ndMdual 1n was enhanced. ach1evmg the1r max1mum potential relatiVe to the1r A Usten1ng Day was held on the 10th October as medical condition. Th1s seMce facilitates the part of the development of the Rve Year Strategy Individual to rega1n an acceptable level of Independence wh1le supporting the diSCharge for SeMces for Older People. This provided a process of older people retummg to their OYIIl homes.

The bU1ld1ng of the Battyconnell res~dentJal and day hospital unit was completed. A number of seMCe agreements were developed and 1mplemented With a number of pnvate nursmg home pn:Mders.

New seMCe5 wh1ch commenced dunng the year Included:

• The Day HOSPital seMCeS at Dunshau~hn Health Care Unrt .

• The newly established EMI Unit m St Joseph's Hospital Tnm. North Eastern Health Board Bord Slalnte An Olr Thualsclrt

COMMUNITY SERVICES (CCNTINUEC)

• Day Services for Alzheimer patients by the Alzheimer Society in the purpose built Daycare Unit, on the grounds of St. Oliver Plunkett's Dundalk. This service provides a day service on five days per week accommodating twenty clients per day.

• In Drogheda the Alzheimer day services extended services to four days per week to 15 clients and in Navan services continued to be provided fiVe days per week.

2.5 DISABILITY SERVICES Services to people With physical and sensory disabilities and intellectual disabilities have worked closely with the non-statutory agencies 1n providing a comprehensive range of services. The aim of disability services is to develop and provide h1gh quality locally based services within a social model, which are equitable in their delivery and responsive to the needs of those availing of them.

Intellectual Disability St. John of God's - North East 8 bedded female unit Additional residential places were provided in the region with the development of the following Group Home in Kells, eo. Meath Splaces services: low Support Residential SeMces, Dundalk 4 places

Group Home, Monaghan 6 places

Group Home, Clones, eo. Monaghan 6 places

low Support House, Monaghan 4 places 2000 ANNUAL REPORT

.. c:::•------· Additional Day places were provided as follows: The further development of ded1cated earty intervention services in each community services area has benefited a large number of Children. Day SeMCeS LocatlOil SeMCe User Places

Day Services in Clones 12 service users Physical and Sensory Disability St. John of God Services, Further developments m day services for people Drumcar Enterpnses 5 new places With Phys1cal and Sensory D1sabilrty have taken MTEC, Navan 5 additional places place with the amalgamation of North Eastern Health Board/lnsh Wheelchair Association (IWA) Meath Sheltered Workshop 4 places seMces in Cavan, the commencement of mtenm Sheltered Work - Horticultural Project at Day Services for South Monagharv'Louth 1n Mounthamilton House 6 places Castleblayney, the commencement of SeMces at Dunboyne and the commencement of a new Day Service, Truagh, Database in LouWSouth Monaghan wh1ch 1s one Monaghan 8 new places of three pilot, s1tes 1n the country.

Children's Special Care Unit, Two Project Managers for Phys1cal and Sensory Holy Family School, Adult Special Care, D1sab11ity in Louth and Meath were appomted wh1le Rockcomck, Cavan Children Special Care Unit, a number of new 1nrtiatiVes developed JOintly w1th Athlumney 7 new places Voluntary Agenc1es have enhanced seMces Cross Border Drama prOVIded 1n th1s client group. Project m Louth 20 Additional places The first phase of joint regJonal child assessment. Reconfiguratlon of Day services in Monaghan and treatment. and rehabilitatiVe seMces between the enhancement of supported employment seMces Board and Enable Ireland was commenced. The prOVIded Additional 5 places Home Support, Respite and Summer Camps SeMces of Adults and Children With physical Resp1te Unit, Wilkinstown, Navan 30 places ------disabilities 1n the region were enhanced. Summer Camps and Children's Holiday Respite throughout the region 58 places Worklng groups to develop a model of seMCe for Personal Assistants and Acqwred Bra1n Injury Home Support Services An additional 30 completed their Initial reports. families benefited across the region

Services to people With Autism were further developed With the appomtment of a dedicated team m the Louth and the provision of Summer Camps. New posts of Paediatric Occupational Therap1st, Speech, and Language Therapist. Phys~otherap1st, and Psycholog,sts were recru1ted for people With Intellectual D1sab11ity.

Respons1b11ity for RehabilitatiVe Tra1mng and W()(1( SeMces transferred to the Board folloWing the dissolution of NRB on 12th June, capitation rates to agenc1es prOVIding Sheltered Work SeMCes were enhanced. North Eastern Health Board Bord Sl&lnte An Olr Thualsclrt

2.6 TRAVELLERS HEALTH functions. This ensures that there is a nat1onal approach to food safety protection. The Boards' The Board continued to develop its approach of services will work closely w1th the Food Safety basing service developments in this area in Authority on a range of health 1ssues includ1ng partnership with the traveller community. gathering relevant data on human and animal infections, establishing health pnonties and All service developments involve consultation with establishing control measures which are targeted travellers, their organisations and other statutory and voluntary agencies. Initiatives are undertaken appropriately. to improve the health status of travellers and are A Quality Management System is now in operation underpinned by an assessment of their need in the Board's food control services. Standard following extensive consultation. operating procedures were internally audited during 2000 and the service was externally An Assistant Director of Public Health Nursing is audited achieving accreditation to ISO 9002. now in place in cavan/Monaghan and Louth Accreditation was achieved. Community Care Areas to co-ordinate all traveller health matters. In Louth and Meath, project A number of regular visits were undertaken on a workers, have been appointed to work in programmed basis to food premises in the region development of the Primary Health Care Project. in an attempt to control the growth of food poisoning incidents and outbreaks. Local consultative groups were established in counties Cavan, Louth, Meath and Monaghan to The department also continued to promote good advise on traveller health matters. practice in relation to food safety through education of workers in the food sector. A number of initiatives were developed for this client group including pre school and after school s The department worked closely with food projects, day foster care; early intervention project; businesses in the region in providing advice, dietetic and nutrition services; child abuse support and general information in addition to prevention programme. working with caterers and organisers of outdoor events. In Louth a training programme entitled "Dealing with Difference" for Board staff has been The enforcement of the restrictions on smoking in completed catering premises and food outlets was earned out during the regular visits. This was extended to other premises also in particular b1ngo halls, secondary schools and school buses. 2. 7 ENVIRONMENTAL HEALTH SERVICES The programmes for the sampling of drinkmg water continued with reports and advice being provided The objective of the Environmental Health Service to appropriate authorities a1med at protecting is to control the environmental health factors public health. The department also carried out the which may adversely affect health and to promote enforcement of statutes, a1med at protecting good environmental health standards. standards in housing, planning, environmental hazards, pest and poisons control. The Service is a key agent in new food control structures established in conjunction with the Food Safety Authority of Ireland (FSAI). The Authority has assumed legal responsibility for all food controls and has contracted with all those agencies involved in food control, including health boards, local authorities, and government departments for the delivery of food control 2000 ANNUAL REPORT

2.8 COMMUNITY WELFARE SERVICES The aim of the community welfare service is the delivery of an efficient, equitable and effective support serv1ce. The main objective of the department is to provide an income maintenance seMce under the Supplementary Welfare Allowance Scheme to persons who have either no 1ncome or an insufficient income to meet basic requirements.

The Community Welfare Service also assess income as part of the eligibility for general medical services, i.e. Medical card Scheme, maintenance charges for services for the elderly and institutional admissions, Mobility Allowances, Motorised Transport Grants and Blind Welfare Allowances.

Unkages with external agencies, i.e. Department in direct provision there were approXImately 1000 of Social, Community and Family Affairs (DSCFA), asylum seekers in the region 1n rece1pt of Money Advice and Budgeting Service, Women's Supplementary Welfare Allowance 1n the form of Aid, County Councils and Citizens Information baSIC payments and/or rent supplements at the Centres were enhanced while a series of five end of December, 2000. information days for persons with a disability were delivered across the region in conjunction with NEHB Disability Services.

A national review of the SWA scheme was undertaken by the Department of Social, Community and Family Affairs and a Working Group was established of social, community and family affairs. This review comprised of representatives from the Department, the Department of Finance, the Department of Health and Children and nominees of the Health Board Chief Executive Officers.

Mosney Holiday Centre was commissioned for use as an accommodation centre for Asylum Seekers under the Government's d1rect prOVIsion 1mtiat1ve. In total 200 people were accommodated at the centre. There are now frve centres in the North Eastern Health Board prOVIding accommodation for up to 500 people.

The Commumty Welfare Serv~ce is 1nvolved 1n the pr0V1s1on of additional supports such as weekly payments for personal requ1s1tes and once-off exceptional needs payments. Apart from persons North Eastern Health Board Bord Slalnte An Ol r Thuaisclrt

ACUTE HOSPITAL SERVICES

The last number of years has seen many The activity within the Acute Hospttals Programme significant changes in acute hospital services 1n for 2000 is shown in Table 14 the region, not only in activity, but also in the complexity of care and treatment. Growth in population, demographic changes and the upward Acute Hospital Services Activity 2000

trend in road traffic accidents as well as other Specially In-Patient AdmiSSionS Out Pat1ents factors have influenced these changes. The Medicine _ .:1:=5c....4.:..:5:=2:___ 19,792 movement towards greater specialisation, Surgery 11,05::.:5:___....:20,880 evidence-based treatment and management of Obstetrics 6,142 14,823 clinical risk must be taken into account in planning Gynaecology 2,481 7,495 the delivery of hospital services for the future. The Paediatrics 4,271 6,740 ------'- development of a risk management strategy for =B~irt::.:h=s ------~3~,59_1__ __ both hospital groups has commenced and the Orthopaedics 2,853 17,390 employment of a consultancy firm to assess Fracture Clinics 3,690 clinical risks was undertaken. A review of specialist Dermatology 537 services and consultant manpower in the North ENT 228 806 East is currently in progress and will be submitted Breast------Clinics 389 to the Board in 2001. The acute hospital services Oncology 2, 790 are committed to regional self-sufficiency, Diabetic Day Services 946 integration of services and diversity. Prothrombin Clinics 7,898

Surgery A Consultant with spectal mterest m breast and endocrinology commenced provtding services at the Louth/Meath Group. A new day surgery umt at the Navan site, includtng new endoscopy equipment was commissioned. The enhanced relationship between the Board and 1ts cross border colleagues in Northern Ireland has resulted in over 400 patients havtng benefited from both ENT and ophthalmology surgical procedures. Waiting lists initiatiVes have reduced watting hsts tn areas, including vascular surgery, ENT, ophthalmology and gynaecology.

Medicine The renal dtalysts services were extended in the Cavan/Monaghan Group and addttional services were purchased from Daisy Hill Hospttal, Newry. Approximately 40 addtttonal patients recerved dialysis in 2000. The consultant led geriatric servtces at Our LadY of Lourdes Hospital, Drogheda was further develo~ following the appointment of a new Consultant a the development of a rehabilitation and 2000 ANNUAL REPORT

Accident & Emergency A regional Accident and Emergency Consultant was appointed, facilitating the development of A&E serv1ces throughout the region. A project to review acute hospital emergency seMCes and pre­ hospltal emergency seMces commenced 1n 2000.

ObstetricS/Gynaecology Obstetnc actMty 1n the reg,on was wrth1n targeted assessment unit in Drogheda. This development actiVity wh1le there has been a sh1ft from 1n-pat1ent now hnks the comprehensive geriatric assessment to day-case work 1n g;naecolo~. M1dwrves at the out-patient and day service at the acute unit to Louth Hosp1tal s1te prOVIded a number of midwrfery rehabilitation beds to provide a seamless service led dom1c11iary b1rths. for patients. Followrng the North Eastern Health Board adoption of the document titled "North East Hospitals - the Winter Bed Initiative next Frve Years: A framework for ContJnu•ng Development• June 1998, a Matem1ty SeMces The Department of Health and Children allocated Rev~ew Group was established. The rem1t of the the sum of £443,000 to the North Eastern Health Group was to fully Investigate all the options 1n Board m 2000 towards contracting beds in private relation to matem1ty seMces 1n hght of safe and nursmg homes and to fund provision of aids and best practice. The Group concluded 1ts wor1< and appliances for use by older people. A total of 23 submitted 1ts report to the ctuef ExecutNe OffiCer beds were contracted in LouWMeath and m 21 1n November 2000. CavarVMonaghan. A total of 90 patients benefited from th1s seMce. Two Winter Bed Co-ordinators were appo1nted to manage the seMce and to enhance discharge plann1ng and bed Paediatrics management. Approval from the Department of Health and Children for a Consultant Paedlatnclan wrth a spec1al 1nterest 1n community child health was Orthopaedics prOVIded 1n 2000. Th1s apporntment wrll be based 1n the CavarVMonaghan Hosp1tal Group. A four-bed h1gh dependency umt at Navan was completed to facilitate the expand1ng Reg,onal OrthopaediC SeMce. The complement of five Orthopaedic surgeons wrth sub-specialist Interest 1n Orthodontics foot and ankle surgery, rev~SJon JOint surgery, sp1nal The new OrthodontiC Urnt at Our Lady's Hospital, surgery and paed~atnc surgery prOVIdes a h1gh Navan IS fully operatiOnal and plans are In place to quality, effic1ent and equ1table seMCe. The wa1tmg have the OrthodOntiC Un.t at L.ooth eo. Hospital, list InitiatiVe allocatiOn has prOVIded for 430 Oundalk. fully operational tn 2001. additiOnal orthopaedic surg,cal procedures and haS reduCed wa1t1ng tnnes to less than SIX months. North Eastern Health Board Bord Slalnte An Olr Thualsclrt

ACUTE HOSPITAL SERVICES (CONTINUEO)

Radiology Fundmg has been made available for the appointment of two Consultant Radiologists with spec1al Interests in mammography services. Microfilming eqUipment was purchased for the Cavan s1te, which has greatly enhanced the accessibility of records.

Pathology

The appointment of a Consultant Haematologist and support staff was approved by the Department of Health and Children in 2000 and Will be appointed in mid 2001. This appointment will be based in the Louttv'Meath Hospital Group.

Nursing The successful implementation of a pilot direct Nurse training and development programmes in entry midwifery education programme, at Our Lady line with the Commission on Nursing of Lourdes Hospital, Drogheda, commenced 1n recommendations were put in place. The 2000. This was a new concept, as traditionally placement of student nurses in all of the acute trainee midwives had to have a general nurse hospital s1tes opened opportunities both for qualification before acceptance onto a midwifery­ training and recruitment for the profession. training programme. Under the direct entry Practice development forums and in-service programme midwifery students can enter training traintng and development programmes are now without any other qualification. established, promoting best practice in nursing and a number of clinical aud1t initiatives A recruitment exercise, including a visit of a commenced. recruitment team from the North Eastern Health Board to the Philippines, resulted in the recruitment of nurses for the acute hospitals, ' ' increasing the availability of this staff group to .. A support existing services and new developments. ~ · ... <: •• - - Health Promotion ~4 _.,) f Health promotion initiatives were undertaken ~~ ~~· including the hospital challenge day, health adv1ce ~ II!t seminars and health promotion within the Board's "¥:, hospitals. ~&··} ~ ....'i' ~ f . 1fi ~.., ~ - -- 2000 ANNUAL REPORT

Allied Health Professional Services Physiotherapy and Occupational Therapy took a lead role in developing quality initiatives in 2000 to include, a Cross-Border conference, integrated quality standards and audit for care of the older person m hospital and in the community and for women's health.

A multi-joint assessment and rehabilitation system IS fully operational at Louth County Hospital and is used for the treatment of musculo-skeletal injuries. These injuries occur through sports or occupational trauma. A pharmacy oncology suite was developed for the preparation of cytotoxic drugs for oncology patients at Cavan Hospital. This will be fully operational in early 2001.

Funding was received in November, 2000 for the appointment of two Senior Pharmacists. These appointments will be based at Our Lady of Lourdes Hospital, Drogheda.

Ubrary Facilities Equipment was purchased for the Ubraries in each of the acute hospitals. This equipment is available for staff to assist with educational presentations and provides a very valuable extension of library services.

Risk Management Process To safeguard and enhance the quality of health care provided in the Acute Hospitals and as part of the risk management process, clinical risk reviews were carried out on each of the hospital sites in the reg!on. The outcome of these reviews will mcrease the quality and safety of clinical serv~ces and the workmg environment North Eastern Health Board Bord Slalnte An Olr Thualsclrt

GOVERNANCE AND STRATEGIC PLANNING

The Governance & Strategic Planning Department In the context of Freedom of Information and 1n was formed in September 2000 as part of the conjunction with community services in Board's management restructuring. This Cavan/Monaghan, a staff induction programme for department succeeded the Consumer Services and all new staff was developed. In collaboration with Plann1ng Department and IS now responsible for the Child Care Managers new client records and serv~ce planning, the development of the Board's standards in line with the recommendations of the annual report, strategic planning, corporate Board's working group on the implications of governance, risk management, health and safety, Freedom of Information Act on child care services management and organisational development, were put in place. partnership arrangements, freedom of information and consumer affairs. The need to ensure that the organisation, its staff and management develop in line with the The department is also responsible for adjudication increasingly complex environment 1n which we of Social Welfare allowances, other allowances operate resulted in the recruitment of a and med1cal card appeals as well as being the Management and Organisation Development lia1son between the Board and the Ombudsman. Officer in September 2000. This post will ensure that the Board can further a number of key The annual report for 1999 was presented to the developmental issues in conjunction with all Board, in line with the legislative timescale, and service providers throughout the organisation. The was adopted unanimously. The development of the improved linkages between the Board and the serv~ce plan for the year 2001 ensured a more Office for Health Management resulted in some inclusiVe and transparent planning process than in very positive staff development initiatives including pre\llous years. The new approach sought views staff participation in the Millennium Leadership and full participation of the board, the board's Programme and the Mentoring Programme. The managers, chnic1ans and all staff disciplines in the Board is also actively involved in the Management development of the plan. The new approach was and Personal Development for Nurses and acknowledged as a positive advance and one Midwives Programme at a national level. A wh1ch could be further improved upon in coming years. programme designed at helping the Board to proactively manage the diversity agenda was . developed during 2000 and will be commenced In early 2001.

The Board's Corporate Safety Statement was reviewed and revised in 2000. Safety Statements for Community Care, Acute Hospitals, Services for Older People, Mental Health, Ambulance Serv~ce and Disability Services were revised. The Health and Safety section provided assistance in the preparation of the Board's guidelines on Handling and Storage of Healthcare Waste and Glove Use Policy. Health and Safety training was facilitated across the region to all services. 2000 ANNUAL REPORT

OUR SUPPORT SERVICES

MANAGEMENT SERVICES • Work commenced on extending the community services information system to further centres The management services function is responsible across the region. Access for staff to 24-hour for the delivery of information and communication electromc libranes was mtroduced. technology support services throughout the region, to help staff deliver the best possible services to A proJect to Improve document management was patients, cl1ents and their families. commenced. This Will Improve the record1ng, storage and retrieval and processmg of a Wide Information in all its formats is a key resource of range of documentation. the organ1sat1on. Services to patients and clients increasmgly depend on the availability of The Board's data communications networks information and communications facilities. continued to grow. An mrtiatJve to prOVIde data Achieving the maximum benefit from the data and links to all local health centres was commenced. Information collated and generated through care, Upgrades to telephone systems were also put 1n support and management processes is vital. This place. A vanety of "Free Phone" numbers were demands specific attention to the development established for the public and for public and management of the 'information resources' of representatiVes. the Board. Work continued on the Board's financ1al During 2000 the following work was undertaken: management systems, 1n particular on measures needed to ensure Euro compliance. Computer • A new Information & Communications equ1pment in hospitals was upgraded to meet Technology (lcn Strategy was developed. Th1s 1ncreased demand for ava1labihty and to 1mprove forms the basis for future plans for systems the reSilience of systems. work for the penod up to 2004. The Board has undertaken major ICT initiatives over many years and has developed a solid platform of technology and expertise across all the key MATERIALS MANAGEMENT doma1ns of climcal, management, and The Board spent 1n excess of IR£55 mdhon on the communications needs. goods and serVIces requ1red to delrver d1rect patient serVIces. Th1s represents an 1ncrease of • The first phase of the new human resources over 30% on 1999. management system was implemented 1n Apnl 2000. Th1s supports the streamlining of The role of the Board's reg,onal matenals adm1mstratJve procedures for staff, prOVIdes management seMce IS to provide adviCe and Improved management mformation and support to the Board's line managers, cliniCians enhances the level of automated record and users on contracting arrangements, Inventory keep1ng. Th1s Will form the bas1s for a management, developing With users outcome comprehensrve human resource Information baSed spec1f1CatK>n, cap~tal purchaSinC. improving and management mfrastructure. and developmg the skills or the people responsible for matenals management and •ncreasan& • In order to facilitate the shanng of mformatJon awareness of the contnbutJon or materials between serVIces an 1ntranet (an mtemal web) management to the deilvefy of health care seMCe. was developed. Facilities to enable the tranSITliSSIOO of radiOIOgJCallmages between The corporate matenals maoagemeot structure the board's hospitals and to tertiary centres was enhanced With the employme(lt ol the were mstalled, thereby alloWing the Obtam1ng Inventory and SystemS [)evelopmeot Mana£Cr. of specialist op1n100 Without the patient having Contracts Manager, Equ1pment Officcf and support to travel. staff 1n September 2000. As pat\ of the ~~ development of matenals management staiY. a 2 ~ ------~------,

North Eastern Health Board Bord Slalnte An Olr Thualsclrt

OUR SUPPORT SERVICES (CONTINUED)

Board's tenns and conditions of contract. In total a 20% 1ncrease 1n contract awarded was achieved.

At national level the Board, through the Healthcare Materials Management Board, cont1nued to work with the other regional matenals managers. A number of conJOint contracts 1nclud1ng insurance year tra1ning and development certificate {IR£50m), gloves (IR£2m) and provisions (IR£1m) programme accredited by NITL was started in were completed. In June 2000 the Minister of October 2000. Health and Children launched the National Health Services Procurement Policy. This policy represents In conjunction with the local supplies managers the collective work of the health agencies and and procurement staff, capital equipment provides a template for best practice 1n purchases totalling IR£8 million were completed. procurement. Some of these major purchases included a CT scan In cavan, radiology equipment for Navan, The materials management action group, wh1ch ultrasound equipment and cardiovascular consists of local materials managers and monitoring equipment for each of the hospitals. procurement officers was set up to provide a forum to identify and implement the necessary Savings of almost IR£800,000 were achieved at local and regional level through improved actions for the improvement of materials contracting arrangements and process management at local and regional level. The group improvements. As part of the Board's commitment established guidelines for the procurement of to improving health gain its policies on safe driving equipment at local level and participated in and no smoking were incorporated into the improving the planning of requirements.

PERSONNEL DEPARTMENT During 2000 the Personnel Department continued to work with the management team and serv1ce managers to ensure that the on-going service needs were met through the recruitment and development of staff and the provision of systems and processes to ensure that staff concerns were appropriately dealt with.

The major challenge faced by the Personnel Department in 2000 was the recruitment of staff. Despite the current shortage of staff in the labour market the recruitment section recruited 586 staff in 2000. The details of staff recruited is as follows:- MedicaVOental 13 ClericaVAdministration 80 Nursing 216 Support 176 Para-Medical 101 Total 586 2000 ANNUAL REPORT

The work of the Training Section focused on The Superannuation Section calculated and made assisting managers and staff to develop the skills payment of superannuation benefitS/awards to and competencies required to meet the Board's approximately 120 staff during 2000. This section priorities for service provision. The section will be continued the process of providing quality supported by the Management and Organisational information and assistance to staff on Development Officer in the design of the Board's superannuation matters. As part of th1s process staff tra1mng programmes and the identification of 450 benefits statements were issued. staff training needs. Superannuation Information Sess1ons were provided at two work locations dunng the year and The Regional Education Centre continued to an 1ncreas1ng number of staff took the opportunity develop as an accessible regional venue. In 2000 to come into Superannuation Section to d1scuss the centre accommodated 172 courseS/seminars their entitlements. The Superannuation Section attended by 1910 staff. The range of programmes organised and participated m the del ~very of five offered encompassed the areas of management Pre-Retirement Seminars attended by 80 staff skills, continuing nurse education, child care and (and partners where this option was taken up) plus information technology. organised and participated 1n the delivery of two Mid-Career Retirement Planning Semmars Staff undertaking individual study received advice, attended by 40 staff members. Th1s section financial support and encouragement in relation to complied with requests for Pens1oner 1.0. cards. their study with 160 staff being funded in their 450 1.0. cards were issued in 2000. third level study. The first phase of the computerised personnel The Occupational Health service commenced in Information system {PPARS) was implemented m September 1999 with the employment of an May 2000. Further modules are planned for Occupational Physician and Occupational Health Implementation m 2001. Nurse. This service promotes and maintains the physical, mental and social well-being of all staff, plus contributes to the enhancing of staff performance and morale through reducing risks at PUBUC HEALTH work which lead to ill-health, staff absence and The Public Health Department IS pnnc1pally accidents. Occupational Health also helps concerned With the determination of the health management to provide a safe working status of the populat1on, the monitonng and enwonment for staff. This section also assesses evaluation of outcomes of health serv~ces, the applicants for employment to ensure they are fit development of Information serv~ces, the for and are placed in appropriate work. promot1on and encouragement of healthy lifestyles The ongoing pace of servtce developments and health onentated public poliCies and the throughout the region reqwed a substantial 1nput surveillance and control of commumcable d1seases. .------::::-~ from the staff relations section m relation to new working cond1t1ons and practices. The section was In 2000 the Department published 1nvolved in the negotiation process to ensure the 1ts report on the health status of the smooth transition to and Implementation of these population of the North Eastern HN/th Sl«us new serv~ces. section was also responsible for The Health Board. Th1s report clearly the local Implementation of national agreements Identified the mam factOrs affectlng for nurs1ng, NCHD's, para-medical and other staff. health 1n the reg,on. The report Employees benefit schemes are admm1stered by 1dent1fied cardiOVascular disease, the Personnel Department These mclude s1ck pay cancers and accidents as the ma1n schemes, matem1ty leave, parental leave, career cause of Illness and death. breaks, flexible working and superannuation Depnvatlon, whiCh 1s clearly benefits. associated With morbidity and North Eastern Health Board Bord Slalnte An Olr Thualsclrt

OUR SUPPORT SERV ICES ( CONTINUE O )

mortality, is an important pre-determinant of ill TECHNICAL SERVICES/CAPITAL health. The Health Status report demonstrated INFRASTRUCTURE that there is a greater proportion of people living 1n deprived District Electrical Divisions in Co. Louth Cap1tal Developments m Health Care Facilities has than elsewhere in the region. Since the publication been included tn the Nat1onal Development Plan of the health status report, the Department has 2000 - 2006. In February 2000 the Board been working both within the board and with received its mdicat1ve allocation for Cap1tal external agencies to ensure that the findings of the Expenditure for 2001 to 2006. Dunng 2000 the report are bemg applied to service development. Board receiVed s1gn1ficant cap1tal allocation for the current year. In addition, the Department's work included the development of a methodology to ascertain These allocations enabled the planmng to consumers' views of the community care services, commence on the major cap1tal projects an evaluation of a number of services and associated with the acute hospital services and on initiatives including direct access surgery, accident projects for community based services. and emergency in Our Lady of Lourdes Hospital A capital allocation was also received for Drogheda, suicide helpline, childhood equipment replacement and refurbishment works. immunisation scheme, Happy Heart Catering This enabled the purchase of equipment for the Award and family planning. acute hospital services and the upgrade and The department assisted in the implementation of refurbishment of facilities in the commumty and national strategies and programmes including the hospitals. Cardiovascular Strategy, the National Health The following is a summary of the major projects Promotion Strategy, the Cancer strategy, Best Health for Children, and the Women's Health commenced/completed 1n 2000. BreastCheck.

Research on suicide, men's health, Community Services appropriateness of admissions to hospital, and the Carlingford Health Centre The Louth Project continued, as well as the New Health Centre in partnership with local G.P. surveillance of communicable diseases and practice and Day Centre completed. promotion of vaccination programmes. Clogherhead New Health Centre completed.

Cootehill Construction of new Health Centre commenced.

Drumconrath Construction of extension to existing Health Centre commenced.

Slane Construction of extension to existing Health Centre commenced.

Dundalk Community Services Construction of extension to existing community services building to accommodate orthodontic unit commenced. 2000 ANNUAL REPORT

Ravensdale House for high support hostel purchased.

Services For Older People Bal/yconnell Health Care Unit VIrginia Health Care Unit This project was completed in 2000. The Construction of this major community facility development 1ncludes Residential Un1t with 30 commenced 1n 2000. This development includes places, Day SeMces and Health Center With a G.P. res1dent1al accommodation for older people, G.P. Practice Centre. practice centre, Community Health Centres, D1sab11ity Day Centre, Mental Health Day Centre Child Care Services and Child Care facilities. High Support Unit, Castleblayney Planning permission receiVed for development Navan Primary Care Major refurbishment to the accommodation at Child Residential Unit, Navan Railway Street, Navan was completed. Construction work commenced on Ch1ld Residential Unit in Commons Road, Navan. G.P. Out of Hours Co-op Major alterations and refurbishment works for the Acute Hospital Services G.P. out of Hours Co-Op.services were completed Our Lady's Hospital, Navan in Ardee. New Day Surgery Unit Commissioned 1n 2000 New equ1pment purchased Mental Health Services Ladywell High Dependency Unit, Dundall< Louth County Hospital Construction of 16 bed residential unit Accident and Emergency Department Refurbished commenced. New equ1pment purchased

Staffed Hostel Monaghan Our Lady of Lourdes Hospital Planning permission received for Staffed Hostel in New Steam Boiler installed. Monaghan Ufts refurbished. Part of Nurses Home refurbished. Disability Services New equipment purchased. Challenging Behaviour Unit, Castleblayney Construction of Challenging Behaviour Unit in Monaghan General Hospital Castleblayney commenced. Female Medical Ward refurbished. New equ1pment purchased. National Training Development Institute, Monaghan Cavan General Hospital Construction of traimng centre completed. Ward refurbished. l.Jfts refurbished. New equipment purchased. Also dunng 2000 the ProJect Teams for the development of the two Hospital Groups on the five hospital s1tes were established and the Draft Plann.ng Bnefs for the developments prepared. North E.. tern Health Board Bord Sl61nte An Olr Thualsclrt

CC-OPERATION AND WORKING TOGETHER (CAWT)

The Co-operation and Wonungrogether (CAWD November. The aim of the conference was to look partnets the North Eastern and North Western at a range of practical solutions to address issues Health Boards In the Republic of Ireland and the such as security, safety, vulnerability, ISOlation and Southern and Western Health and Soctal SeMces loneliness and how they can impact negatively on Boards Ill Northern Ireland continued to co-operate a person's mental health. ltllmPfOW'C the health and soctal well-bemg of their resident populatJons. These four boards cover The year 2000 has seen the continued the whole of the land boundary between the development of cross border acute seMces. Both Republlc of Ireland and Northern Ireland and the Western and Southern Health and Social between them they compose a population of one SeMces Boards and the four acute Trusts 1n million. Northern Ireland are now actively wooong With thetr counterparts in the Republic of Ireland. They common demographiC features and common ptOblems n terms of rural ISOlatiOn, intmstructure, populatiOn trends and unemplcloJment. There IS frequent cross border and 1n some cases. services provided 1n a consumer's natural hinterland are provided by the ~member state on an agency basis.

Tom Fra-Me)' resillled as the Dtrector General of CAWT to undertake a new role 1n Northern os Ombudsman and ComiTliSSIOiler of Complaints. Mt. Frawtey has been succeeded as Dll'ec:tor General by Mr. Paul Robinson. Chtef Eu!aJtNe Otr!cer, Notth Eastern Health Board.

The Centre b Cto6s Border Stuches was cornrniSslCined to undertake an evaluation of the CAWT • The rtnal report was publiShed in Oocember 2000 and be considered 1n 2001.

DAI1:tlllf'~ bet'Neen the health boards 10 thtNe thin the Prirnery care Sub­ c:ontnled etbts or the P'OJCCt Case across Borocrs aoc1