Rights-Based Leadership and Governance

The NDA, through a WHO/Ireland collaboration, were involved in the development of a paper called ‘Towards a Rights-based Approach to Strengthening Leadership and Governance in Health Services’. This collaboration on Rights -based Leadership and Governance was part of the WHO European Framework for action to achieve the highest attainable standard of health for persons with disabilities.

The paper makes recommendations related to access to services and accessible information, involvement of disabled people in decisions about the services they receive and in the leadership, governance and evaluation of health services. It also recommends that disabled people receive effective services through the collaborative teamwork of different disciplines. There is also a recommendation that relates to safe working environments for staff where they feel valued, empowered and able to advocate for the rights of disabled people using the services.

An assessment tool to evaluate the extent to which health services fulfil these recommendations has also been developed. You can read the paper on the Maynooth University website.


Commissioning

We explored how commissioning could shape disability services through seminars, consultation and reviewing the available evidence and published 'A Commissioning Framework for Disability Services' in 2013.

In summary, a commissioning framework says that the process of funding disability services should consist of four phases -

  • Assessing the needs of a population
  • Setting service priorities and goals (in consultation with people with disabilities)
  • Securing services from providers to meet those needs
  • Monitoring and evaluating outcomes for services users

Resource allocation

We engaged in a programme of work on resource allocation from 2011 to 2015. Resource allocation models typically contain the following elements:

  • A support needs assessment questionnaire
  • A scoring system to translate needs into points
  • A formula to translate points into appropriate budgets
  • A process to look at how needs can be met from an indicative budget
  • A process to address exceptional needs

We published a paper in 2011 'The Introduction of Individual Budgets as a Resource Allocation System for Disability Services in Ireland' which reviewed resource allocation models in other jurisdictions.

Resource Allocation Feasibility Study

We conducted a Resource Allocation Feasibility Study (Phase 1) to examine the appropriateness of two different resource allocation assessment systems, AAIDD’s Supports Intensity Scale (SIS) system and In Control’s RAS 5 system, for application as a resource allocation system for disability services in Ireland.

We received a formal request from the Department of Health, following discussions with the HSE, to widen the original consideration of assessment systems to include another two – InterRAI and FACE. These assessment systems were included in the Resource Allocation Feasibility Study (Phase 2).

In 2015 we prepared an Advice Paper based on the learning from the literature and from both phases of the Feasibility Studies. This report was presented to the Department of Health and the HSE in April 2015, and has been used to inform deliberations on selection of a single resource allocation tool for disability services in Ireland, a decision on which is pending.

Read the reports on the Resource Allocation Feasibility Study and related research on implementation of Resource Allocation Models.