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Service DesignJul 30, 2024

'Systemic failures' in Irish disability services put children, families and professionals at risk

The Irish Society of Chartered Physiotherapists (ISCP) has thrown its weight behind a call for urgent changes in the way children’s disability network teams are being run in Ireland.

The ISCP has joined an alliance involving five other health and social care professions (HSCPs) to voice wide-ranging concerns over clinical governance and other issues affecting children’s disability network teams.

In a joint statement issued today (30 July), the alliance said: ‘As professional bodies, we remain united in our desire to support the provision of safe and effective services. We continue to advocate for children and their families, the members of our respective professional bodies, and our professions. Over the last two years we have highlighted our concerns with the rollout of Progressing Disability Services (PDS) nationally, including inconsistencies in management structures, staffing, and clinical pathways.

‘Concerns are focused on clinical governance, staffing levels, scope of practice, risk management, clinical supervision, reinstating discipline managers in the governance structure; implementation of pathways, high levels of stress experienced by families and staff; and staff retention.'

Photo Credit: ISCP
'Children and families deserve more'; Marie O Mir is the ISCP's chief executive

Physique
Physique

'Systematic failures, lack of accountability and clinical concerns'

The ISCP, whose chief executive, Marie Ó Mír, is a physiotherapist, is a joint signatory of the statement. It said: ‘We have repeatedly identified systemic failures within the roll out of PDS that are placing children, families and HSCPs at risk. We have called for appropriate consultation and meaningful engagement with services, children and families, clinicians and professional representatives to ensure that concerns raised would be addressed.

'We have engaged with the HSE, Department of Health, Disability Operations, including the National Improvement Lead for Disabilities, Disability Clinical Care Programme and Ministers and have made key recommendations to support positive change within Children’s Disability Services.'

The alliance's statement continued: ‘We are concerned that engagement by the HSE with our professions has been tokenistic, with no meaningful outcomes to date. The promised changes e.g., reinstating discipline managers in the governance structure; reviewing clinical supervision; and implementation of Disability Regional Enhanced Support and Services (DRESS) pathways have not been implemented within the last two years and risks continue to escalate. This is extremely alarming.

‘The recent resignation of parent representatives from their role on the national steering group for PDS highlights further concerns. Their resignation letter shares their experience on the steering group and such serious concerns require an urgent and public response from the HSE, Department of Health, and Department of Children, Equality, Disability, Integration and Youth.

Concerns are focused on clinical governance, staffing levels, scope of practice, risk management, clinical supervision, reinstating discipline managers in the governance structure; implementation of pathways, high levels of stress experienced by families and staff; and staff retention

'Decisive action' required

The alliance added: ‘We echo these parents’ calls for meaningful engagement with all stakeholders and urgent action to address the concerns raised and implement the required changes. Children and families deserve access to evidence based, high quality, appropriate and timely interventions. The lack of accountability and significant ongoing clinical concerns, coupled with the concerns raised by parent advocates means that decisive action is needed in relation to PDS.

'We have considered the impact of speaking out and the concerns this raises for parents, service users and HSCPs working in disability services. However, as professional bodies we must highlight the lack of change and escalating risks in children’s disability services. Children and families deserve more.’  

As well as physiotherapists, the professional organisations in the alliance represent speech and language therapists, occupational therapists, psychologists, dietitians and social workers. 

Children's disability services are for children and young people up to 18 years who have complex needs.

Author: Ian A McMillan
Physique
Physique
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