Speeches

Speech for Minister Brady at the Launch of the Final Reports of the Implementation of a Model of Person-Centred Practice in Older people’s Settings

Introduction

I would like to thank Dr. Siobhan O’Halloran for her kind invitation to be here today and congratulate her on her continued leadership and support in driving quality improvement initiatives such as this Programme.

I would also like to acknowledge the support of the Nursing and Midwifery Planning and Development Units (NMPDU) Facilitators, Dr. Jan Dewing and Professor Brendan McCormack who had the vision to enable the development of a person centered culture in the 17 residential units involved in this project.

I would like to thank Mr. Liam O’Callaghan, Local Health Manager and Ms. Paula Phelan, Director of Nursing in Birr Community Nursing Unit for hosting these celebrations today.

It is my privilege to be here to launch the final report of the national practice development programme ‘The Implementation of a Model of Person-Centred Practice in Older Persons Settings’ and also the resource guide ‘Enhancing Care for Older People’. I know that they will prove to be very valuable at both a local and national level into the future.

The person-centred approaches which develop and enhance care for older people is paramount to my role as Minister for Older People and Health Promotion.

National Positive Ageing Strategy

As Minister for Older People and Health Promotion, I am keenly aware of the importance of ‘positive ageing’, not only for each and every one of us as individuals, but also for our communities and for Irish society as whole.

My Office has been actively involved in the development of the Positive Ageing Strategy for over a year now. In mid-2009, I made a call for written submissions and was delighted to receive 190 contributions from a very broad range of agencies, organisations and individuals and in May 2010, I completed a three month countrywide series of consultation meetings to hear at first hand the views of older people, service providers and representative organisations on issues that affect them. We will shortly be publishing a report which summarises the issues which have been raised in this consultation process. Work is ongoing on preparation of the Strategy.

Government Policy

My aim is to ensure that the vision of a unified approach to the challenges and opportunities presented by our growing ageing population are realised, and that older people receive the highest quality care and support which enhances their quality of life. Recent years have seen dramatic changes in both the concept and practice of services for older people. As Minister for Older People, I am proud of the achievements of this government in the area of Older People over the past number of years. We now have a national system of financial support for all those assessed as requiring long term residential care. We have underpinned this with a quality assurance mechanism of Standards and Care and Welfare Regulations subject to independent inspection by the Health Information and Quality Authority (HIQA). Fundamental to all of these initiatives has been the principle that the resident and their family are at the centre of the service and all decision making.

Fair Deal

The Nursing Homes Support Scheme- A Fair Deal came into operation just over a year ago. The Scheme is designed to remove real financial hardship from many individuals and their families. No longer will families have to sell or re-mortgage homes to pay for the cost of nursing home care. Under the scheme, there is one transparent system of support towards the cost of residential care that is fair to all, irrespective of whether they are in public or private nursing homes. An additional €97 million was provided for the Scheme in Budget 2010. This means we will spend almost a €1 billion for long-term residential care in 2010. Some 16,500 applications to the Scheme have been received by the HSE with almost 12,200 processed to date.

Registration and Inspection of Nursing Homes

The safety of the individual resident guides us in reforming the health service and we in Government place great importance on the policies, standards and legislation we are implementing

We live in an era which standards, monitoring and enforcement are at the heart of everything we do. It is important that we have effective mechanisms in place to maintain and enhance public confidence in the delivery of quality services. A major milestone in this area was the introduction, during 2009 of a single system for the independent registration and inspection of all nursing homes. Our overall emphasis is promoting a high quality resident centred service; delivered to those who require it and in the most appropriate setting.

Person centred practice

Person Centred Care ensures that the needs, values and preferences of patients and their carers are respected and taken into account when designing. planning and delivering services. The direct involvement of the patient in decisions about their own care plays a significant role in improving their health outcomes. It is a holistic approach which takes into account the emotional as well as physical needs of the service user whilst also respecting their values and preferences. A care provider, aptly described person cantered care as” a concentration on the small things of everyday life”.

The Implementation of a Model of Person-Centred Practice in Older Person Settings

In 2005, a team of practice development and research staff from the Midlands HSE NMPDU and the University of Ulster – under the leadership of Professor Brendan McCormack – collaborated on a two year pilot practice development programme.

In order to build on the work of this initial Pilot Project, a collaborative project was developed with five NMPDUs including South East Region, North East Region, North West Region, Midlands Region and Mid West Region in order to:

  • Share and refine the processes used in the Midlands HSE NMPDU project on a wider scale to create national impact.
  • Coordinate a programme of work that can replicate effective PD processes and systematically measure outcomes on practice.
  • Further test a model of person-centred nursing in long-term care/rehabilitation settings and promote it as a multiprofessional model for practice.
  • Generate a large data-set that can inform practitioners of the outcomes of person-centred practice and its contribution to quality care with older people.

Over the last number of years here in Ireland we have rightly, become more focused on the care that older people receive and the context in which that care is provided. Care provision comes in many different guises. One of the key elements in planning and providing services is the involvement of older people in this very important process. This National Programme captured that element of involvement and empowerment for individuals using these services. As with the consultation process that I undertook around the county earlier this year, the work that is being launched today contributes to the development and planning of services now and into the future.

The Nursing and Midwifery Planning and Development Units and the University of Ulster have led the way on this two year collaborative practice development programme in services for older people across 17 residential units. The involvement and participation of residents, families, and carers the healthcare team, managers and other key stakeholders is evident from reading the report. It is important to recongise what has been achieved to date and to use what has been achieved as a step to the next stage along the person centered journey.

This Programme offers an exciting opportunity for all care workers, working with older people, to develop more effective person-centered approaches which they could then put into practice. It challenges participants from all grades to achieve the highest standard of person centered care possible and acknowledges the valuable contribution of each individual participant in “going the extra mile” to achieve excellence in the care of the older person.

The purpose of today’s event is to celebrate what has been achieved and to begin planning and using the outcomes and evidence gathered to continue to work together to improve the lives for older people, their families, carers and healthcare teams.

It is obvious that the outcomes achieved by this project would not have been possible without the active participation and support of the staff, management and residents of each of the 17 sites involved, and therefore, I would like to thank you for your contribution and commitment to this project.

Conclusion

Person safety and quality guides government reform of the health services. We live in an era in which standards, monitoring and enforcement are at the heart of everything we do in health care. This dictates how and where things happen. If we are to be concerned with good outcomes for patients, we must be up to the consequences of patient’s safety and evidence based medicine. I would like to leave you with a quote from Aristotle “We are what we repeatedly do. Excellence, therefore, is not an act but a habit”. I look forward to continuing to work with you in achieving excellence in our work as we strive to provide high quality health care for older people.

In conclusion, I hope you enjoy the day and I am looking forward to meeting with you individually.

Thank you.