What exactly is the Practitioner Health Matters Programme?

The Practitioner Health Matters Programme (PHMP) was launched in September 2015. It is a strictly confidential service which provides support and medical care for practitioners in Ireland who may be going through a difficult time with stress, burnout, mental health difficulties or who may have an alcohol or drug misuse problem. Doctors, Dentists and Pharmacists can find it difficult to declare they have a problem and often delay in seeking help. This can result in problems being more severe and more entrenched at time of presentation. Because PHMP is as programme designated specifically for health professionals, we can focus solely on what strategies are necessary to support the practitioner in getting back to full health and getting back to safe working again.

The PHMP is a not-for-profit charitable company. It is entirely independent and is separate from professional regulatory bodies such as the Medical and Dental Councils and the Pharmaceutical Society of Ireland. The PHMP has a Memorandum of Understanding with each of the three regulatory bodies and is endorsed by them. However we do not have a reporting relationship with any of the regulators and the practitioners needs will be dealt with in strict confidence. The programme has been supported and recognised by the individual representative organisations and the professional training bodies, as well as the HSE.

GOVERNANCE
The PHMP is set up as a company limited by guarantee. The Board of Driectors are Mr Hugh Kane (Chairperson), Mr Fintan Hourihan (Hon Secretary), Dr Kieran Doran, Ms Frances Nangle-Connor (Hon Financial Controller) and Dr. David Thomas. Our Directors have a wealth of experience in the healthcare field and bring a range of operational experience to the Programme. The Directors do not receive any remuneration for their work on the board.

Clinical governance is provided though a Clinical Advisory Group.

Can we guarantee confidentiality?

Yes, practitioners can be assured of the highest integrity and confidentiality in their interactions with the PHMP. Confidentiality is fully assured for all practitioners who either refer themselves or are referred to us by an outside party. We are not obliged to report to the regulatory body for their profession as long as the practitioner is compliant with the treatment recommendations and that they do not constitute a danger to the public. All emails go directly in confidence to Dr Delargy and are responded to at her earliest convenience. Telephone calls are answered between 9am and 5pm Monday-Friday, you may leave your contact details and you will be contacted by Dr Delargy at her earliest convenience. (Contact PHMP)

We are available to take confidential referrals and to discreetly answer questions and provide guidance in what is often a very delicate situation.

How much does the service cost?

Access to the PHMP will be free of charge at the point of care to all practitioners. We do not want financial hardship to be a barrier to treatment. We will of course welcome any contribution a practitioner may wish to offer.

Where referral to another service or ongoing monitoring is required, patients who have health insurance would be expected to avail of such cover to meet the costs. Others will have treatment provided through the public healthcare system. In circumstances of financial hardship, special arrangements may be required using our charitable funds or through partnering with the Royal Medical Benevolent Fund.

What services does it offer?

The PHMP will provide appropriate interventions, including advice, support, mentoring and appropriate specialist referrals, for doctors, dentists and pharmacists who have a health problem which is interfering with their ability to practise safely. These problems are most likely to be in the mental health and substance misuse areas.

Services will include access to a range of specialists who have a particular interest and have experience in treating doctors, dentists and pharmacists. These specialties will include psychiatry, psychology, occupational health, career mentoring, life coaching, addiction counselling and financial advice, as well as drug and alcohol testing. Other services will be accessed depending on the individual’s health or other needs.

Why should doctors, dentists and pharmacists have a designated treatment programme?

It is well recognised that health professionals often delay getting help if they have a substance misuse or mental health problem. This results in them seeking help when their problems are very severe. There are many reasons for this but some include shame, guilt, stigma, fear around confidentiality and fear for their future ability to practise if their difficulties become known. Using the normal healthcare pathways is often difficult for practitioners and treating these professionals can also be challenging.

How do doctors, dentists and pharmacists fare in recovery?

Health professionals have a very good success rate compared with the general public with most programmes reporting up to 80% abstinence rates following treatment. Recovery rates are particularly good when practitioners participate in a designated practitioner health programme and can access AA, NA and other support services. Most return to work safely and well, and continue to be monitored and supported while back at work.

Have you been involved in an adverse event or the subject of a complaint?

Various international studies have identified that between 3-16% of hospitalised patients experience an adverse event. Ireland is no different with a guestimate adverse event rate of 13.8%. If a patient suffers harm or an unexpected outcome it can impact on you as their doctor, pharmacist or dentist. It is important not to ignore your own emotional care. No healthcare professional is immune to being involved in such an event.

An adverse event can range from a minor incident to near misses as well as major and catastrophic incidents where a patient has died or has sustained a major disability. In the aftermath of an incident (it does not have to necessarily be a major incident) or a complaint it can impact negatively on mental health with feelings of incompetence, isolation, and guilt to name but a few. It is important that such feelings do not fester and develop further.

Talking with a professional in a confidential setting can  help with processing the perfectly normal reactions of being involved in an adverse/ critical event.

How is the Practitioner Health Matters Programme funded?

The PHMP has been set up as a limited company and is in the process of seeking charitable status. To date we have pledges of start-up funds from a range of different organisations and we are working on establishing a secure source of ongoing funding, which will include donations from the profession.

We do not want lack of financial resources to be a barrier for any doctor, dentist or pharmacist who may need treatment. Our experience to date is that some sick doctors, dentists and pharmacists often neglect other aspects of their life, and neglecting their finances is not uncommon. On presentation there are some who cannot afford the treatment, support service (e.g. counselling, mentoring) or monitoring (e.g. drug testing analysis), which may be required. This is why we are establishing the Programme as a charity and envisage making our funds available towards the cost of treatment in certain hardship cases.

What is the PHMP governance structure?

The PHMP is set up as a company limited by guarantee, the directors are: Mr Hugh Kane (Chairperson), Mr Fintan Hourihan (Secretary), Dr Kieran Doran, Ms Frances Nangle-Connor and Dr. David Thomas. All directors have a wealth of experience in the healthcare field and bring a range of operational experience to the Programme. The directors do not receive any remuneration for their work on the board.

Clinical governance is provided though a clinical advisory group made up of representatives from the Faculty of Occupational Medicine, the College of Psychiatry, as well as a former Director of Professional Competence with the Medical Council.

Can practitioners be confident that they will be cared for in absolute confidence?

Yes, practitioners can be assured of the highest integrity and confidentiality in their interactions with the Programme. Confidentiality is fully assured for doctors, dentists and pharmacists who comply with the terms of the Programme.

We are available to take confidential referrals and to discreetly answer questions and provide guidance in what might be an uncomfortable situation.

Providers who either refer themselves or are referred to us by an outside party will not have their identity made known to the appropriate regulatory body for their profession as long as they are compliant with our Programme and do not constitute a danger to the public.

How will medical care and treatments be paid for?

Access to the PHMP will be free of charge at the point of care to all practitioners. We do not want financial hardship to be a barrier to treatment. We will of course welcome any contribution a practitioner may wish to offer.

Where referral to another service or ongoing monitoring is required, patients who have health insurance would be expected to avail of such cover to meet the costs. Others will have treatment provided through the public healthcare system. In circumstances of financial hardship, special arrangements may be required using our charitable funds.

Where will patients be treated?

Care will be provided from a single location in the Dean Clinic, Sandyford, Dublin, which is just off the M50 and therefore provides convenient access for patients. Having a single location for the service will facilitate the development of multidisciplinary case conferences and team identity, and provide for immediate and regular advice, support, and clinical supervision for clinicians working within the service. Suitably confidential rooms are available for face-to-face assessments, limited therapeutic interventions, physical examination and sample taking (for example, blood, urine). Please note that the PHMP is entirely independent of other healthcare services being provided from the Dean Clinic, Sandyford.

Who is the medical director for the Programme?

The medical director is Dr Íde Delargy, MICGP, FRCGP, Dip. Workplace Dispute Resolution. Dr Delargy is a general practitioner and runs her own GP practice in Blackrock, Co. Dublin. She has a special interest in addiction and substance misuse problems and has been working in the specialist area for over 20 years. As well as being Chairperson of the former Sick Doctor Scheme since 2007, her other roles include National GP Co-ordinator for the HSE Addiction Service and Director of the Substance Misuse Programme at the ICGP. Dr Delargy is a member of the European Association for Physician Health.

As a donor, I’d like to know, what will my voluntary contributions be spent on?

The service that the PHMP provides is dependent primarily on voluntary contributions from the professions. Monies received will be spent on providing medical care for doctors, dentists and pharmacists. As a not-for-profit body, none of the directors will receive any remuneration for their contributions.

What services can patients be referred to by the PHMP?

For some patients, referral to another specialty may be required either for another opinion, further specific advice or for specific treatments. These specialties will include psychiatry, psychology, occupational health, career mentoring, life coaching, addiction counselling and financial planning, along with drug and alcohol testing. Other services will be accessed depending on the individual’s needs.

How can I learn more?

You can learn more by reading our briefing paper.

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