Joint Statement Issued by AOTI, PSI and IASLT
Joint Statement regarding implementation of a new Standard Operating Procedure for Assessment of Need under the Disability Act 2005
In January 2019, the Psychological Society of Ireland (PSI), the Association of Occupational Therapists of Ireland (AOTI) and the Irish Association of Speech & Language Therapists (IASLT) welcomed the publication of the Oireachtas Joint Committee on Health Report on the New Standard Operating Procedure for Assessment of Need under the Disability Act 2005. It was hoped that this report would form the basis of a HSE revision of the first proposed Standard Operating Procedure (SOP) so that the HSE would meet its obligations under the Disability Act and not dilute professional standards of assessment for vulnerable children in need.
It is with a great sense of regret from each of our representative bodies that the HSE has, despite our clearly articulated concerns, implemented a new Assessment of Need (AON) SOP on the 14th of January 2020. This new SOP does not address the recommendations of the Oireachtas Joint Committee on Health or the concerns of each of our respective professional bodies.
PSI, AOTI and IASLT each endorsed the recommendations of the Joint Committee and, in particular:
Recommendation 1: The Committee, while acknowledging the benefits of early intervention, recommends that the Government allocates sufficient resources to support this programme. The Committee also acknowledges the societal and financial benefits of early intervention as well as the potential positive developmental outcomes for children with additional needs. It is universally recognised and acknowledged that early intervention is essential in order to maximise the potential for positive outcomes, especially in young children with additional needs.
We strongly support the recommendation that early intervention programmes be adequately resourced to meet the needs of this vulnerable population in a timely manner. To date, this has not occurred, and vulnerable children continue to languish on excessively long waiting lists due to adequate resourcing not been made available. The effective HSE freeze on recruitment as a result of paybill management in 2019 was a contributory factor to not having enough staffing in place to address this issue.
Recommendation 4: The Committee recommends that the new Standard Operating Procedure is not brought into use before consultation with front-line therapists and parents. Such a consultation process should involve discussions regarding specific concerns of stakeholders as well as informing all parties of the requirements and specification for the new SOP. The Committee welcomes the HSE’s commitment to engage with assessment officers and instruct that the current AON process should be in use. However, the Committee is concerned that, at present, communication between the HSE and assessment officers is not effective.
The HSE gave assurances in a meeting in September 2018 that meaningful communication would occur between the HSE and the relevant HSCP professional bodies before implementation of the AON SOP would occur. There has been no communication from the HSE with regard to assurances given since that meeting in September 2018. It is of grave concern that the HSE has not adhered to the recommendations of the Oireachtas Committee with regard to communication and consultation.
Recommendation 5: The Committee recommends that the HSE give further consideration to the testimony of stakeholders and their concerns regarding the Preliminary Team Assessment. The Committee has concerns that the proposed Assessment does not prioritise the child’s best interests and may further delay access to services. The Committee recommends further consultation between the HSE, parent advocate groups and the therapists.
The PSI, AOTI & IASLT retain a range of substantial concerns in relation to the Preliminary Team Assessment, and do not believe that it is in children’s best interest to proceed with this protocol and is a dilution of best practice standards. This places our members in a difficult position whereby they may be expected to work contrary to their ethical codes of conduct.
Recommendation 8: The Committee has grave concerns regarding the current waiting lists on the Assessment of Need process. The Committee is of the view that in order to address these waiting lists, the following must be achieved without delay: (i) reconfiguration of CHOs, (ii) recruitment of additional therapists for Disability Teams (iii) provision of adequate resources to Disability Teams.
The PSI, AOTI & IASLT shared the concerns of the Joint Committee and parent advocacy groups about the extent of existing waiting lists for Assessment of Need and agrees that adequate resources must be provided without delay to address this issue. Given the complexity of presentation of many young children with additional needs, we assert that not only should additional therapists be recruited for Disability teams, but adequate numbers of senior clinicians should also be placed on such teams to provide supervisory supports within team structures.
Recommendation 9: The Committee recommends that the recruitment process for hiring staff is reformed to ensure a quicker, more efficient system.
A number of HSCP representative bodies released statements at the end of 2019 which noted how the current national panel-based system was a direct impediment to hiring much needed staff in the health service. We are not aware, as of yet, of any proposals to begin the consultations necessary to reform this not fit for purpose system.
The Psychological Society of Ireland, Irish Association of Speech & Language Therapists and Association of Occupational Therapists of Ireland call on the HSE to again pause the implementation of the AON SOP, revisit the recommendations of the Joint Committee and commit to meaningful engagement with HSCP professional bodies and service user representatives (including DCA Warriors) as previously agreed.
A copy of AOTI's 2018 statement on this issue can be found here
ENDS. For further information and/or to arrange an interview, please contact:
Odhrán Allen, [email protected] 087 169 6926
