‘Tokenistic engagement’ as risks escalate, ‘alarming’ warn Health and Social Care Professions (HSPCs)

• Systematic failures, lack of accountability and clinical concerns for Progressing Disability Services (PDS) ‘extremely alarming’
• Urgent public response required from HSE, Department of Health and Department of Children amid HSCP claims of ‘tokenistic engagement’

Six Health and Social Care Professions (HSCPs)  are expressing urgent and serious concerns over clinical governance in Children’s Disability Network Teams,  as a breakdown in serious relations in the steering group set up to tackle ongoing issues has resulted in the resignation of parents representatives.

Professional organisations for Speech and Language Therapists, Occupational Therapists, Physiotherapists, Psychologists, Dietitians and Social Workers are again highlighting serious concerns with the current direction, impact and safety of Children’s Disability Services.

In a joint statement 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.

We have repeatedly identified systemic failures within the roll out of PDS that are placing children, families and Health and Social Care Professionals (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. 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 2 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.

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.” 

Notes 

The Health and Social Care Professions (HSCP) are the second largest clinical grouping of the healthcare workforce.  The organisations supporting this statement are:

AOTI – Association of Occupational Therapists

IASLT – Irish Association of Speech & Language Therapists

IASW – Irish Association of Social Workers

INDI -Irish Nutrition and Dietetic Institute

ISCP – Irish Society of Chartered Physiotherapists

PSI – Psychological Society of Ireland

Children's disability services are for children and young people up to 18 years who have complex needs. The organisations voicing their concerns are included in the children’s disability network teams (CDNT) providing specialised support and services for children who have a disability and complex health needs associated with their disability.