First prize winner in category Innovation in Public Administration in EPSA 2023-24
Context
In 2016, the Irish Taoiseach (Prime Minister) requested that an assessment was made of the challenges being faced by the communities of the North East Inner City (NEIC) Dublin, and that measures were proposed to support the area’s economic and social regeneration. The Mulvey Report identified that one of the key measures needed in the area was a multi-disciplinary team that could provide support to schools, children and families impacted by intergenerational poverty, crime, addiction and gangland violence. Thus, in September 2020, the NEIC MDT was established to cater to the needs of 10 primary schools. The initiative was born out of the interagency collaboration between Ireland’s National Health Executive and the Department of Education’s National Educational Psychological Service.
Objectives
The NEIC MDT aims to deliver a high-quality, collaborative, school-based service across the disciplines of occupational therapy, speech and language therapy, and psychology. More specifically, the team has eight core objectives: 1. commitment to developing academic, social, emotional, communication and independent living skills for all children; 2. providing a professional school-based and child-centred service in a timely manner; 3. responding to the presenting needs in the school, home and wider community with evidence-based assessments and interventions; 4. providing consultation, assessment and therapeutic interventions through a tiered model of support; 5. enabling school staff to identify needs and intervene with appropriate teaching approaches, improving outcomes for all children; 6. supporting the development of inclusive practices in schools and the promotion of well-being for all children, staff and families; 7. align NEIC MDT practice with existing school structures as set out in the ‘Guidelines for Support of Pupils with Special Education Needs’ (2017); 8. developing collaborative partnerships with schools, families and the wider community to ensure efficient, integrated service delivery.
Implementation
The NEIC MDT was established to improve the academic, social, emotional, communication, independent living skills and well-being for children, aged between 4 and 13 years old, in ten primary schools. Therefore, a governance structure was built to ensure optimal performance. The NEIC MDT is supported and directed by a Steering Committee and a Steering Committee Subgroup, the NEIC MDT Working Group, which is tasked with supporting the organisation and delivery of the work in schools.
The NEIC MDT caters to the needs of 1800 students. They are organised into three clusters, each accommodating up to 600 pupils with a designated educational psychologist, speech and language therapist (SLT) and an occupational therapist (OT). They respond to the needs of children, their families and their schools through targeted training, advice, prevention work, assessment and therapeutic interventions.
Between 2020 and 2023, 195 consultations were held with key stakeholders (parents, school staff, other professionals), 1039 assessments were completed and 2442 interventions were provided. Twenty-one training sessions are delivered each year for parents and school staff across a range of topics, including trauma informed practice, communication skills, emotional regulation and fine motor skills.
All (100 per cent) of principals reported that the needs of children were being met with timely access to the NEIC MDT services. If these children were awaiting traditional services from HSE Primary Care they would be waiting 12 to 36 months for SLT, OT and psychology services.
In terms of sustainability, funding was initially secured through a government funding stream for initiatives that support children in areas of significant disadvantage, aimed at maximising their potential and improving outcomes in all areas of development. With the early identification of positive impacts in school attendance, calmer classrooms and teachers more confident in their ability to support children with special needs, the funding of the NEIC MDT was mainstreamed through Health and Education government departments.
The NEIC MDT Working Group has maximised opportunities to engage with government departments and political figures in the constituency in North Inner City Dublin, to highlight and report regularly on the outcomes of the NEIC MDT’s work in schools to ensure continuous funding. Each year an annual report is published and is available on the government’s website. In addition, members of the team have presented at international and national conferences, and there has been interest both at home and abroad in the model of service that the NEIC MDT has developed.
The NEIC MDT initiative has won two national prestigious awards, one in 2022 and one in 2023.