'Early intervention is very important': Wait lists grow for children’s services

Hundreds, if not thousands, of children across Cork are languishing on waiting lists for vital therapies, interventions and support, struggling to access the services they desperately need amid lengthy waiting times, staff shortages and seemingly unheard calls for early intervention.

While Cork Kerry Community Healthcare said it is working hard to address waiting times for services, calls have been made for the HSE to focus on providing early intervention and support for children.

Some 5,081 children were on waiting lists for speech and language services at the end of February this year.

A further 881 children were waiting on Child and Adolescent Mental Health Services (Camhs), along with 756 awaiting initial contact from a Children’s Disability Network Team (CDNT).

Meanwhile, children were also among the 4,056 people on waiting lists for occupational therapy in Cork at the end of February this year, and there were 7,453 awaiting physiotherapy.

The Rainbow Club in Mahon supports 1,300 children, teenagers and young adults with autism, as well as their families, every single week.

Speaking to The Echo, Karen O’Mahony, the founder of the charity, highlighted the importance of early intervention.

“Early intervention is very important for every child’s development and at all the different stages of their life, they need to access the right support through disability services, education, medical and community to live a happy healthy life,” Ms O’Mahony explained.

“The transition to the Progressing Disability Services model and recruitment issues that the HSE currently have are adding to the issues of waiting lists throughout the country.

“That is why there are lists but I do think there will always be lists with the volume of neurodivergent people in the country all needing support, diagnosis or intervention.

“I think there are plans ongoing and lots of great work being done to try to fill the vacancies that are in disability services and this is always going to take time.

“We have a long way to go but I do think Bernard Gloster [HSE CEO] has the right ideas about what is needed and it would be unrealistic to say how long it will take for sure but there is a lot of goodwill there.”

While the Rainbow Club does not replicate services provided by primary care teams or CDNTs, it does provide important support, and Karen explained that, with more backing from the HSE and Government, the charity could do more.

It has been over a year since then-taoiseach Micheál Martin stated that a new, permanent home for the Rainbow Club was on the cards but little of substance has been done since, and the charity’s founder has once again highlighted the importance of securing a dedicated home.

“Rainbow Club provides supports, interventions and activities to the child, teen, young adult and their family on a weekly basis,” Karen said.

“We offer programs, groups, workshops and one-on-one sessions to the autistic person, parents, carers and siblings.

“Our holistic approach with wrap-around support caters for the individual needs of the family or individual, and we create a pathway for them on their journey.

“We are always adapting and building new programs so we can offer as much as possible but, most importantly [to ensure] that it makes a positive impact for the individual person and their family.

“We have built very positive relationships with the HSE and many ministers, senators, local TDs and counsellors, businesses, schools and departments in Government that have been helping us grow our services, increase our offering and expand.

“A new home will be vital for us to continue our work but also to secure a future for Rainbow Club families.

“We are excited to engage further with the HSE as I feel it will be a vital part of our future.

“It has been a long journey for us all, but now having support from the HSE and lots of amazing organisations [means] we can apply for funding that will help us hugely.

“We cannot access lots of funding without having a home with a lease. A new home will open many doors for us.

“We cannot wait to show the country what Rainbow Club model is doing on a larger scale, and has the potential to do long term.”

Addressing the waiting times for speech and language therapy, occupational therapy and physiotherapy, a spokesperson for Cork Kerry Community Healthcare said: “We sincerely regret any waiting periods experienced by families. We would like to emphasise that urgent cases are prioritised to ensure timely access to care for those in need.

“Our primary focus remains on the wellbeing and safety of the children under our care.

“Despite the challenges posed by the staffing moratorium [which has just been lifted] and growth in demand for services, we have implemented several initiatives aimed at increasing productivity and reducing waiting times for children.”

The spokesperson said these initiatives include “streamlining processes to identify areas for improvement, including validation of lists, introduction of text alert system, bespoke group programmes for specific diagnosis, electronic assessment system presently under design for 2-3 disciplines to reduce administrative burden thus increasing clinical time”.

“All of these measures endeavour to enhance efficiency and reduce waiting times.”

The initiatives also include “resource optimisation to ensure the allocation of resources, personnel, skill-sets to ensure services are delivered most effectively”; and “collaborative partnerships with external partners, other healthcare providers, community organisations to expand our capacity and improve access”.

“Telemedicine has been implemented where appropriate allowing for remote consultations and follow up to minimise delays and improve access to care,” the spokesperson added, also highlighting “capacity building initiatives, including training programmes and workforce development efforts to enhance the skills and capabilities of our staff and increasing the overall capacity to meet the growth in demand for services”.

“Whilst these initiatives represent important steps forward, we recognise that more needs to be done to address the underlying factors contributing to waiting times for children’s services,” the spokesperson stated.

“We remain committed to working with stakeholders in finding sustainable solutions, whilst ensuring that every child receives the care they need in a timely manner.

“Validation of waiting lists across these disciplines is ongoing and as part of this process, it is planned to review the pathways/processes for referral, assessment, etc. to ensure appropriateness of all referrals received.”

A spokesperson for Cork Kerry Community Healthcare also added that the HSE’s disability service team has been supporting the Rainbow Club since 2021 to present through a service arrangement for funding.

“The Rainbow Club has been provided with additional funding for delivery of after-school day respite to children,” the spokesperson stated.

“It is anticipated that 4,000 hours of after-school day respite will be delivered in 2024 [and ongoing] supporting approximately 160 children and their families.”

Responding to The Echo’s series on Cork children and their fight for services, a spokesperson for Cork Kerry Community Healthcare said: “We sincerely regret that anyone in need of our services has to wait longer than either we or they would wish. We wholeheartedly apologise to the young people and children who have been waiting for longer times in accessing much needed services and supports.

“Unfortunately, and despite incredibly hard work done by our teams, there are waiting lists in some services which are too long. While there are reasons as to why these waiting lists have occurred, we are aware that what’s important for children and their parents/guardians is the work underway to address waiting lists.

“Intensive work is underway in every part of our services to reduce waiting lists.

“We are using telemedicine, extended clinic hours, triage, working with S38 and S39 agencies, and a wide range of other initiatives and innovative practices harnessing the energies of all staff.

“Substantial efforts have been made across service areas to improve efficiency and patient outcomes and reduce waiting list times.

“For example, the transition to an integrated eye service in the new state-of-the-art Primary Care building in Ballincollig marks a significant step in the new model of eye care provision for 2024.

From March 2023 to March 2024, the waiting list for eye care services for children has reduced from 3234 to 1174 — a 64% reduction.

“Through a wait list initiative last October, we offered more than 3,300 appointments, with 2,252 attending, resulting in a substantial reduction in the waiting list for eye care services for children. We remain committed to seeing high priority patient referrals as early as possible.”

Cork Kerry Community Healthcare also thanked the many staff involved for their hard work and commitment.

“There are areas where this work has already made a difference and we have had significant success with initiatives like waiting list blitzes,” the spokesperson said.

“However, we acknowledge that even more work is needed to address remaining waiting lists, and we continue to make improvements so that we can provide the care needed as quickly as we can. We would also like to reassure the public that across all our services, urgent cases are prioritised, which means that those in the most urgent need are seen more quickly than others. As a general point, we’d like to point out that waiting lists are due in part to the ongoing increase in the number of people needing to access services. For example, Camhs are seeing a 31% increase in referrals. Despite this, we are responding to more than 90% of urgent referrals within three days.”