The HSE’s South East Community Healthcare services has welcomed the additional €450,000 funding that has been approved for 2018 and 2019, as part of measures introduced to improve access and develop community services for older people in the South Tipperary area.
Development of these and further initiatives to enhance integrated care pathways between community services and the South Tipperary General Hospital are in progress. In particular, relevant to this additional funding, is the development of an Integrated Care Programme for Older People which will aim to address peoples’ needs in the community as far as possible and thus avoid hospital admissions.
As a separately funded initiative, the South Tipperary Community Intervention Team was officially launched in December 2016 with three treatment centres – one of which is located on the campus in Cashel. This is a nurse-led professional team that provides nursing care to patients in a community setting. The service provides high-quality nursing care in the community for a short period, by working together with patients, carers and other professionals. Thanks to the provision of this service, many patients can return to their homes earlier from hospital. It also provides GPs with another option of care within the community as an alternative to the acute hospital.
Our Lady’s Hospital Cashel was originally part of the acute health service delivery in South Tipperary. Following the centralisation of acute hospital services for the area to one site in Clonmel in 2007, the former Our Lady’s Hospital was developed over two phases as a centre for non-acute health care services.
The campus and main building (including the former Our Lady’s Hospital) has a range of diverse primary care and community orientated services tending to the people of Cashel and surrounding areas. The services range from those operating on a 24-hour day, seven days a week basis to those that use the facility in Cashel as a base to provide care in peoples' homes and communities. The teams based in Cashel health campus include Primary Care Teams, Home Support Services and Disability Services that provide services across a number of care groups to the population of Cashel and surrounding areas. These services continue to have a significant role in supporting all age groups, and in particular older adults, who are discharged from hospital with ongoing non-acute care needs and in preventing admission to hospital.
Phase One of the development at Cashel Health Complex:
Phase one of construction works at Cashel was completed by the HSE in 2009. This phase focused on new residential facilities and the following facilities are consequently in place:
• A nine bed high support mental health residential services unit, which is fully occupied (“Lorica”).
• A six bed residential unit for those with intellectual disability which is fully occupied (“Ré Nua”).
• Assisted Living as part of Ré Nua and utilised by the Irish Wheelchair Association.
• An 11 bed elderly care residential unit (that replaced the previous St. Clare’s Ward in St Patrick’s Hospital Cashel).
• A day hospital for mental health patients (“Carrig Óir”).
Phase Two of the development at Cashel (the former Our Lady’s County Surgical Hospital building):
Phase Two of the works concluded in 2011 and was focused on facilitating day and outreach services in the old main building (the former Our Lady’s County Surgical Hospital building). Among day services and outreach facilities now provided are:
• Outreach service provided by the Irish Wheelchair Association
• Services provided by the South Tipperary substance Misuse Team
• Home help co-ordination for the West Tipperary area.
• Support for those with Acquired Brain Injuries.
As a result of this phase two of redevelopment, the Cashel Primary Care team are based at the Health Campus. Other primary care services provided on and from the site include Physiotherapy, Occupational Therapy, Public Health Nursing, Speech and Language Therapy, Dietetic Services, Social Work, a Dietician, Disability services, Home Help co-ordination and Community Mental Health Nursing. Upgraded space for the Minor Injuries Unit was also provided for in phase two.
Among other services facilitated by the phase two development are the South Tipperary Community Intervention Team, a nurse led service supporting both early discharge from acute hospitals and such hospital admission avoidance. The service also visits patients at their homes in the community as part of its work. There are also administrative supports in place for community health services in place at the Campus.
A more recent addition to the campus (located on the second floor of the former Our Lady’s hospital building) is a centralised services location for children less than 18 years with Disabilities (Occupational Therapy, Physiotherapy, Psychology, and Speech & Language Services), in line with ‘‘Progressing Disability Services for Children and Young People” – a HSE programme which recommends that children should be able to access services they need, as close to their home and school as possible.
The catering services at the Cashel Health Campus (which were upgraded in the phase two development) link to services on site and also provide all catering supports to the nearby St. Patrick’s Hospital in Cashel. Phase two of the Cashel Health Complex development has also provided for the Radiology Services of South Tipperary General Hospital, as regards its outreach Dexa/general x-ray and ultrasound services on site – in addition to an INR Phlebotomy outpatient clinic.
There is also an ambulance station located on the campus in Cashel.
St. Clare’s Unit is accommodated in a building constructed during phase one and initially intended for dementia specific care. Following the completion of phase two works, it was identified as a suitable location to accommodate the transfer of St. Clare’s Ward of St. Patrick’s Hospital, Cashel. Once recruitment of staff to facilitate the move was completed, the transfer of residents occurred.
The HSE will continue to explore and maximise the ongoing and future use of the Cashel Health Complex and services provided will continue to play a significant role in the provision of overall health services within the South Tipperary area.