Concerns Raised Over 'Three Year Gap' In Appointing A Social Worker To St.Brigid's Hospice In The Curragh

The staff had flagged the issue on a number of occasions to the HSE

A medical social worker post for St Brigid’s Hospice in The Curragh was not recruited by the HSE for years, despite the serious concerns of a palliative medicine consultant and colleagues. Catherine Reilly reports.

The protracted failure by HSE Dublin South, Kildare and West Wicklow (DSKWW) to initiate recruitment of a medical social worker for St Brigid’s Hospice on The Curragh was having a “devastating” impact on patient care, a consultant in palliative medicine warned management last year.

According to an The Medical Independent, in an email sent on 22 July 2022, Dr Miriam Colleran expressed her serious concern that the post was vacant for “over three years”, according to records released by DSKWW under Freedom of Information (FoI) law, following a lengthy delay. 

“As I said in the voicemail, it is having a ‘devastating’ impact on our patient care and service not providing specialist psychosocial care,” outlined Dr Colleran to senior primary care manager in DSKWW, Ms Gillian Farrelly.

The matter of the vacant post became a crisis after the planned retirement in May 2022 of a bereavement specialist/former social worker who provided a family support service.

According to background on the medical social worker post provided by Dr Colleran in her email, a primary care social work service had been withdrawn from the hospice in 2019. “Then […] kindly restarted the family support service that she had previously provided, as an interim measure, to address patients and families need. This was not a MSW [medical social worker] post and was kindly funded by the Friends of St Brigid’s Hospice.”

Dr Colleran stated she had “repeatedly” raised the vacant post at DSKWW management meetings, “sent emails especially after […] gave notice on her planned retirement, submitted risk assessments and also recently an incident form.”

The HSE-operated hospice in The Curragh, which provides inpatient and community services, had no specialist palliative care (SPC) psychosocial service for patients, loved ones and families, warned Dr Colleran in her email in July 2022.

“There is no [SPC] bereavement support service and no psychosocial support to prepare children for the loss of a parent, sibling or beloved relative in SBH [St Brigid’s Hospice].

“This is a serious risk not just for patients but for the mental health of their families and loved ones coping with anticipatory grief and caring for a seriously ill loved one and for poorer bereavement and mental health outcomes in bereavement.”

The palliative medicine consultant also stated that two half-time chaplaincy posts approved for the hospice had not been progressed by DSKWW.

Funding for the chaplaincy and social work roles was approved in 2020, indicated the FoI records. The impact of the absence of these positions was the subject of numerous communications and risk assessments to DSKWW management, according to the records that covered the requested period of April 2019 to August 2022.

On 22 November 2021, in a discussion with DSKWW colleagues on the risk register, Dr Colleran stated that while some progress had been made with the approval of medical social worker and chaplaincy posts, the risks were “still open” as the posts were not filled.

The records showed that, on 5 January 2022, Dr Colleran raised with Ms Farrelly the planned retirement in May of the bereavement specialist who provided the family support service. Dr Colleran advised that the medical social worker post needed to be progressed “as soon as possible”.

Dr Colleran’s communications with DSKWW management, in which she reiterated her concerns, continued over the forthcoming weeks and months.

A risk assessment escalated to DSKWW primary care management, dated 7 April 2022, had warned of the “urgent need to progress” the medical social worker post. It warned there would be no formal psychosocial care service to hospice inpatients or patients in the community from 27 May 2022.

Last week, a spokesperson for DSKWW told the Medical Independent (MI): “The medical social worker post has been accepted, is at contract stage, and [with a] start date for March 2023.”

Sinead McGarry, Representative, Irish Association of Social Workers, Cancer Nurse Specialist,Cllr. Peggy O'Dwyer, and Co-Leader of the Social Democrats Catherine Murphy joined Eoin Beatty on Kildare Today, listen back to the full interview here: