2. Anne Gallen – HSE Director of Nursing & Midwifery Planning & Development Alan Corry Finn – WHSCT Director of Nursing Primary Care & Older People 1 Dec 2014 Co-operation and Working Together (CAWT) Cross Border Senior Nursing and Midwifery Forum Co-operation and Working Together (CAWT) Cross Border Senior Nursing and Midwifery Forum

3. CAWT  Co-operation and Working Together (CAWT) is a cross border health partnership, comprised of the statutory health and social care services in both jurisdictions in the border region of Ireland/Northern Ireland.  Established in 1992

4. Role and Function of CAWT  Enable health services to be more accessible within border areas  Attract EU funding to support the development of ‘additional’ services, based on local need  Innovate – pioneer new ways of delivering health services and improving health and social care on a cross border basis

5. CAWT partner organisations Republic of Ireland  Health Service Executive border counties Northern Ireland  Southern Health and Social Care Trust  Western Health and Social Care Trust  Health and Social Care Board  Public Health Agency

6. Cross Border Senior Nurses & Midwives Forum Established 2013 Western Health & Social Care Trust & HSE North West Catalyst for its creation: “the worst national disaster to hit any Irish hospital in the history of the island of Ireland” DDTV: CAUGHT ON CAMERA - MOMENT FLOOD WATERS CAME THROUGH LETTERKENNY HOSPITAL - YouTube

7. Main hospital corridor

8. New A/E only opened 4 months

9. More Flood Scenes

10. From Crisis to Opportunity EVERY CRISIS PROVIDES THE OPPORTUNITY FOR US TO DO THINGS THAT WE COULD NOT DO BEFORE Nurses & Midwives led the change

11. WHSCT and HSE (NW) Proximity WHSCT Population: 300,000 HSE West Population: Donegal 147,000 Sligo/Leitrim 100,000 Distances: Derry to Letterkenny 22 miles / 36 kilometres (30 minute drive) Enniskillen to Sligo 41 miles / 66 kilometres (1 hour drive)

12. Implications of LGH Flood  ED in Letterkenny GH rendered non functional  Emergency patients re-directed to Altnagelvin Hospital  Altnagelvin was already at full capacity & under pressure  ED and inpatient wards were overwhelmed  Staffing, quality and safety were concerning and not sustainable in the medium term  Initial contact made with professional colleagues at Letterkenny GH to seek additional nursing support  Registration was a huge issue and barrier  Role of NMC

13. WHSCT/HSE (NW) Proximity - considerations  Health and social care governed by borders but not always recognised by the population or their needs  Examples of issues challenging quality of patient care  Child with nut allergy  Childbirth and early discharge  Cancer and palliative care patients – cross border NW Radiotherapy Centre  Tissue Viability  Mental Health patients

14. Establishment of Cross border Forum  CAWT Cross Border Senior Nursing and Midwifery Forum  Established in 2013  Facilitated by Directors of Nursing in WHSCT and HSE  Aims is to engage in joint working which will result in practical benefits to nursing and midwifery services and enhance the patient/client experience

15. Terms of Reference  Objectives  Priority Themes  Membership and subgroups  Establishment of Task and Finish Group  Acute Care in the Community  Quality Improvement  Person and Patient Centred Care  Workforce Planning and Education  Complex Care for Children  Informal Networking and sharing of information  Common challenges irrespective of border  Enthusiasm and willingness to work together

16. Cross Border Professional Practice in Nursing and Midwifery  Common themes  Sharing of Best Practice  Research and Development  Workforce Planning, Training, Registration, CPD, Revalidation  Supporting Supervision and Regulation  E/Nursing Records

17. Current and future priorities  Registration  Dementia Care  Cancer Care  Palliative Care  Intellectual Disability  Paediatric Care  Leadership Development  Education and Training  Workforce Planning and Development

18. Next Steps  Partnership is established  Empowered leadership  Facilitation of appropriate flow of patients  Enabling and supporting patient safety and quality improvement across border corridor  Shared learning resulting in enhanced knowledge and skills  Workforce flexibility and potential for joint appointments

19. www.cawt.comwww.cawt.com http://www.youtube.com/cawtpartnership Cross Border Senior Nursing and Midwifery Forum ‘Enabling Patients, Communities and Professionals in Practice’