STATEMENT: AOTI, PSI & IASLT Call for End to HSE Assessment of Need Preliminary Team Assessment

Joint statement regarding experiences of the Health Service Executive Assessment of Need Preliminary Team Assessment process

In January 2020, the Health Service Executive (HSE) implemented a new Standard Operating Procedure (SOP) for Assessment of Need (AON) across the country. The Association of Occupational Therapists of Ireland (AOTI), the Psychological Society of Ireland (PSI) and the Irish Association of Speech & Language Therapists (IASLT) have expressed significant concerns regarding the procedure since its initial proposal in 2018. 

It is with a great sense of regret, and worry, from each of the representative bodies that the HSE has, despite concerns previously articulated by the three organisations, implemented this new procedure.

The new AON Preliminary Team Assessment (PTA) has replaced a comprehensive professional assessment process with a uniform brief screening session and seeks to redesignate comprehensive assessments as ‘health needs’ assessments. Occupational Therapists, Psychologists, Speech and Language Therapists are already seeing the entirely predictable result, where the PTA screening of a child’s needs indicates that the child requires a comprehensive assessment. This results in the child being referred onto another waiting list for further assessment. This further assessment does not fall under the Disability Act so there are no statutory obligations for these assessments to be completed in a timely manner.

A survey of members of the three representative bodies found that the overwhelming majority of respondents report that:

• The PTA in its current iteration is not fit for purpose;
• The PTA does not assist children in having their needs identified in a timely manner;
• Implementation of the PTA will result in lengthier waiting lists for assessment and intervention in early intervention, school age and primary care teams;
• Significant numbers of frontline clinicians have left, or intend to leave, their posts in Child Disability Services as a result of the implementation of the PTA.

Odhrán Allen, Chief Strategy Officer with the AOTI, says: “The PTA is the direct opposite of what is intended by the Disability Act, 2005. The Act provides the right to an independent assessment of need for all children. This is an assessment of the full range of the child’s needs associated with their disability. The PTA amounts to little more than a tick-box exercise as a way of getting around the legal requirement to complete the assessment of need within a designated timeframe. Meanwhile children and their families are still awaiting a comprehensive assessment and intervention to meet their needs.”

The PSI Past President Mark Smyth says: “Frontline clinicians want a system of assessment and intervention for children that is timely, effective and meets the needs of children in an evidence-based way, the PTA achieves none of this. It is not an assessment any clinician could or would stand over as good practice and, as a result, highly experienced clinicians are planning to leave Disability Services. Services are already under resourced, we can’t afford to lose staff or their experience, this has to be stopped now before any more damage is caused.”

Marijke Morris, IASLT Chairperson, says: “The implementation of this new approach has exacerbated an already intolerable situation for the children of Ireland and their families. Our members are concerned that compliance with the SOP could lead to them being in breach of their professional body and CORU codes of conduct and ethics and are very clear about the impact of this SOP on an already very stretched and overwhelmed disability service.”

In light of the above, the Association of Occupational Therapists of Ireland,  the Psychological Society of Ireland and Irish Association of Speech & Language Therapists are again calling for an immediate cessation of the HSE Assessment of Need Preliminary Team Assessment.

The full findings of the AOTI survey of members' experience of the PTA approach to AON can be read here