In June 2002 the National Disability Authority (NDA) formally proposed the development of National Standards for Disability Services to the Department of Health and Children. Since then, the NDA and the Department have actively worked in partnership on this project which eventually resulted in the NDA recommending the standards for approval by the Minister of Health and Children in September 2004.
The aims of these first-ever National Standards for Disability Services are to ensure:
- that the safety, dignity, independence and well being of service users are protected and promoted,
- that person-centred service provision is established and nurtured in these services, and
- that all services are provided to an agreed level of quality and performance and that the level of quality is consistent on a national basis.
The National Standards for Disability Services apply to all statutory and non-statutory agencies that provide health-related disability services for children and adults with autism, intellectual, physical and/or sensory disability, funded by the Department of Health and Children.
Per annum non-capital expenditure on health-related services developed specifically to meet the needs of people with different types of disability (excluding mental health services) is now over €1.2 billion (Department of Finance 2004). More than 25,000 people with an intellectual disability and 40,000 people with physical and sensory disabilities avail of these services (Health Research Board 2002, 2004). Services are provided by approximately 500-600 non-statutory (i.e. voluntary organisations) and statutory bodies (i.e. health boards).
As customers of these services, people with disabilities expect responsive, flexible and quality services. The NDA believes that, by working through a system of implementation and transparent and rigorous assessments, the National Standards for Disability Services will ensure that services are delivered to a high quality and ultimately make a positive impact on the lives of the people who use the service.
The development of National Standards for Disability Services has been a challenging and ambitious task requiring extensive consultation with a variety of stakeholders, and ensuring that the standards are in line with legislation, policies, good practice and other international and national standards.
This process has been supported by a NDA Standards Advisory Committee, a Health Boards/Authority Working Group, people with disabilities, their families, carers, service providers, government agencies, representative bodies and other stakeholders.
In September 2002 the NDA embarked on a national consultation process to support the development of the standards. More than 500 submissions were received and they helped to form the basis of the first draft standards.
The first draft standards were launched at a national conference in January 2003, followed by seven regional consultation meetings, attended by over 510 people. A further 78 written submissions were also made. Following this feedback, a second draft set of standards was issued in April 2003.
The second draft was piloted with 20 services providers. In total, more than 200 people with disabilities and their families, and more than 120 staff members, participated in the pilot. The pilot project formally commenced in September 2003 and was followed by an independent evaluation.
Earlier this year, the findings from the pilot were presented to all of the stakeholders involved and the NDA and the Department of Health and Children agreed to a final round of consultation between April and June 2004, including a call for submissions from other interested parties. As a result of these deliberations further improvements to the standards and the audit tool were made.
The project achieved a number of key results:
- The National Standards for Disability Services focus on ensuring that services for people with disabilities in Ireland are provided, organised and designed around what is important to the service user from his/her perspective. The direct experiences of service users forms the basis of the assessment process
- The National Standards for Disability Services are presented as a quality framework which sets out minimum criteria for quality assurance and criteria to ensure continuous improvement.
In other words, the standards not only concentrate on essential criteria that an organisation is obliged to meet; they also aim to ensure that continuous improvement becomes a key objective of the organisation.
- The quality framework is designed to measure both organisational capacity and the impact on stakeholders of organisational investment
This means that the organisation needs to provide evidence that it has the resources and policies in place, and that this has a positive impact in the lives of service users.
- The external assessment will be carried out by a team of experienced, independent and trained external assessors, including people with disabilities.
Uniquely, a majority of criteria include an indicator measuring the impact on the lives of service users. In order to capture adequately the views of service users, the assessors will interview a randomly selected sample of service users who have consented to participate. Assessors will use varying methods to ensure the interview process is accessible to all.
The development of nationally agreed standards for health services was identified in the Department of Health and Children’s Health strategy as a key action item to improve the overall performance within the health service.
In the current Social Partnership Agreement 2003-2005, Sustaining progress, the government expressed its commitment to complete the development of these standards.
The NDA believes that these commitments have now been fulfilled. The standards provide a foundation for any service to ensure that it reaches an agreed level of performance and enables it to improve further the quality of service provision.
The NDA has forwarded the final version of the National Standards for Disability Services to the Department of Health and Children and the Minister on 13 October 2004. and the Department is now reviewing the documentation. In the meantime, all queries should be directed to the Disability Services Division within the Department of Health and Children.