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Co-operation and Working Together (CAWT)

Co-operation and Working Together (CAWT). European Co-operation in the Health Sector – “Added Value for people, economy and regions” 27 September 2005 University Hospital, Basel By Mr Tom Daly Regional Development/European Officer

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Co-operation and Working Together (CAWT)

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  1. Co-operation and Working Together (CAWT) European Co-operation in the Health Sector – “Added Value for people, economy and regions” 27 September 2005 University Hospital, Basel By Mr Tom Daly Regional Development/European Officer Health Service Executive - North Western Area, Republic of Ireland 2

  2. Presentation Objectives • Background to cross-border cooperation in the border region of Northern Ireland and the Republic of Ireland • Funding • Some Projects • Positive aspects and challenges • The Future

  3. CAWT REGION 4 Health Authorities – 2 in Northern Ireland (NI)and 2 in the Republic of Ireland (RoI) HSE North Eastern Area HSE North Western Area Southern Health and Social Services Board Western Health and Social Services Board 2

  4. Health System – Northern Ireland • Health and social services free of charge • Planning / purchasing is separate from the provision of health services • Dept of Health, Social Services and Public Safety (DHSSPS) - policy, regional planning and resource allocation • 4 Health and Social Services Boards (Eastern, Northern, Southern and Western) - agents of the DHSSPS / local needs • 19 Health and Social Services Trusts – service provision • Review of Public Administration – consolidation

  5. Health Systems – Republic of Ireland • Mixed public/private health care system • Department of Health and Children (DoHC) – policy, planning and resource allocation • Health Service Reforms • 11 Health Boards 1 Health Service Executive (HSE) with 11 HSE areas • purchaser/provider functions

  6. Border Region – A Common Bond “Borders, by their very nature, create obstacles and barriers to effective economic and social development. The reality of life in a border region is such that, to address these problems effectively, requires practical day-to-day working together and co-operation on both sides of the border.”

  7. CAWT border region – some facts • 25% of the total land area of the island of Ireland • Population of 1 mln people – 21% of the total population of the Island • Similar challenges with common demographic features • Region has experienced peripherality from political and economic decision making

  8. Rationale for CAWT Border region has experienced associated problems of rurality such as: • Deprivation / poor infrastructure • 30 years of violence ‘The Troubles’ Consequently Made sense for health service providers North and South to: • Share ideas and experiences • To pool expertise • In essence, to exploit all opportunities for joint working

  9. CAWT – A Framework for Agreement • Spontaneous local cross-border work during the 1980s • Recognition of the need to formalise relationships • Ballyconnell Agreement – 10th July 1992 • Partners - North Eastern Health Board /North Western Health Board in the Republic of Ireland. Southern Health & Social Services Board / Western Health & Social Services Board in Northern Ireland

  10. Political Context • Belfast Agreement signed on 10th April 1998 - North South co-operation placed on a new basis • North-South Ministerial Council (NSMC) established • Identified 6 new cross-border implementation bodies including Special EU Programmes Body (SEUPB) • In addition, 6 areas agreed for co-operation through existing bodies in each jurisdiction – including health • Endorsement of CAWT as a framework to progress cross-border co-operation within health

  11. CAWT Organisational Structure Director General & Management Board Older People Acute Services Learning Disability Secretariat CAWT Development Centre Public Health Physical & Sensory Disability • Other interest areas: • Traveller Health • - N/S Emergency Planning Finance Family and Childcare Steering to Safety Project Board Mental Health Primary Care Comms Project Boards Health Promotion ICT Human Resources

  12. CAWT Development Centre Executive Officer NWHB / WHSSB Executive Officer NEHB / SHSSB ICT Officer Chief Officer Finance Manager Office Manager Finance Officer Communications Coordinator Clerical Officer

  13. SOURCES OF FUNDING • Department of Health in both jurisdictions(DHSSPS and DoHC) • HSE / Health Board’s own resources • Interreg IIIA • Measure 3.2 Health and Social Well Being • Peace II • Measure 5.2 Public Sector Co-operation

  14. INTERREG IIIA PROJECTS – Business Plan • Steering to Safety • Care of Type II Diabetes in Primary Care • Support for Learning Disability • Planning Services for Children and Young People • Health Protection A New Challenge • Epidemiological Study of Oral Health • CAWT Development Centre • Good Morning North West • Health Impact Assessment – Cross Border Approach • Improving Cross Border Mobility • GP Out of Hours • New Chance – Foster Care • Continence Support • Therapeutic Interventions for Sex Offenders

  15. Steering to Safety Rationale • High number of collisions/deaths from Road Traffic Accidents (RTAs) • 33% higher in the CAWT region * compared to non-CAWT areas * CAWT Population Health Profile 2002 • Highest Morbidity for Road Traffic collisions (RTCs) in Ireland • A major preventable area. • Above circumstances compounded by increased use of roads due to commercial, tourist and social pursuits. 2

  16. National Safety Council Dept of Public Health, HSE North Eastern Area Health Promotion Dept. HSE North Eastern Area National Roads Authority An Garda Siochana Police Service for Northern Ireland (PSNI) Dept of Environment, Belfast CAWT Health Promotion Sub Group Altnagelvin Hospital – Accident & Emergency Depart. Roads Service (NI) Dept of Psychology Trinity College, Dublin Steering to Safety - Project Advisory Committee The Project Advisory Committee comprises representation from:- Project Manager: Maggie Martin Reports to: CAWT Health Promotion Sub Group (Project Board)

  17. Health Protection – ‘a new challenge’ • Different legislative requirements • Different roles and responsibilities • Different reporting mechanisms • Same disease • Same problems • Combined solution • Strong permanent links formed Cross border Legionella Conference - February 2005 2

  18. GP Out - of - Hours pilot project • Cross border feasibility study • 70, 000 people closer to a GP out-of-hours service in the opposite jurisdiction • 70% of these living in socially deprived areas • Project Manager recently appointed • Two pilot areas in the border region 2

  19. An Outcome Framework for Cross Border Children’s Services Training the Trainers – Cognitive Therapy Workplace Health and Wellbeing Project Improving Cross Border Care for Those with Diabetes Cross Border Carers of the Disabled – A Journey of Sharing and Caring Improving Cross Border Communications for the Border Region Promoting Mental Health Awareness Training Sharing Cross Border Cardio Cath. Services Recompression for Deep Sea Divers – A Cross Border Approach It’s Good To Talk – Parents as Sex Educators Oral Health – A Cross Border Outreach Skills Centre EMART – A CAWT Response to CBRN Computerised Cross Border Renal Services Cross Border Oral Maxillo Facial Services North South Emergency Planning Operational Training for Ambulance Staff INTERREG IIIA PROJECTS- N+2 8

  20. Termonmaguirc – ‘a journey of sharing and caring’ Official opening of cross border holiday and respite home in Bundoran, Co. Donegal Republic of Ireland– December 2004

  21. Improving Mental Health - Cognitive Therapy • Cross border training • NI centre for Trauma and Transformation • Response to ‘Omagh Bombing’ of 1998 • Treatment for post traumatic stress disorder (PTSD) • 200 trained in CT Awareness / Train the Trainers programme Participants – Celebration Event July 2004

  22. Oral Health 3 cross border projects: • Fluoridation research study • Oral maxillo facial surgery project • Dental Outreach skills centre Dental Outreach skills centre – opened 22 April 05 2

  23. What Have Been the Challenges? • European Bureaucracy / Deadlines – N+2 and other • Currency fluctuations • Different standards, protocols and auditing • Emphasis on Spend vs Quality • Steering Group rigour v self interest • Recruiting and retaining the right staff • Local Government assembly • Health Reforms North/South

  24. What Has Worked Well • Strategic Direction • Establishment of cross border health services • Delivery Agent for INTERREG IIIA Measure 3.2 • Relationships with Depts. of Health, SEUPB/INTERREG IIIA • Prince II project management methodology • CAWT Development Centre • Energy /commitment of sub group and project board members • Creative Cross Border projects – very motivating and rewarding • Links with other parts of Europe

  25. The Benefits • Track record - cross border health and social care works • Model of best practice • Shared sense of identity and increased understanding • Legacy of capital equipment • Pilot projects large scale projects or mainstreaming • Economies of scale – sharing of resources • Benefits to local border populations

  26. The Future • Current tranche of projects – completed 2006 /07 • Cross border mobility of staff and resources • Mainstream • INTERREG 4 and Peace II extension? • Expertise in place • EU legislation • Local and national political developments

  27. www.cawt.com 20

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