Tusla - Ireland's Child & Family Agency

Publication of the report of a case review into the care of ‘Mary’

Tusla – Child and Family Agency and the Health Service Executive (HSE) have today, 29 March 2017, published the report of a case review into the care of ‘Mary’, a young woman with an intellectual disability. The review was jointly commissioned by Tusla and the HSE in 2016 and the report has been submitted to the Department of Children and Youth Affairs and the Department of Health.

Tusla and the HSE have today also published a joint working protocol to support good collaboration and working relationships between the agencies to promote the best interests of children, families and vulnerable adults with whom we work. The protocol governs how children in care access HSE funded disability related services, including what happens when children in care transition to adult services.

Speaking today, Jim Gibson, Chief Operations Officer, Tusla said, “Today we launch with the HSE a joint working protocol for collaboration between our agencies to promote the best interests of children, vulnerable adults and their families. The protocol clarifies and sets out the respective roles, duties and legal requirements of the HSE and Tusla in relation to children and vulnerable adults with a disability or mental health issue. The protocol and its implementation will address many of the findings in the report published today and will improve interagency working between Tusla and the HSE, ultimately improving services and outcomes for the children and families with whom we work.”

Cathal Morgan, HSE Head of Operations, Disability Services, said, “We strongly welcome the development and commitment by both state agencies to implement a National Protocol that will support both agencies in working together in the best interests of children and families. A new approach is required to respond effectively to the significant and fundamental changes taking place with the establishment of the Child and Family Agency and the re-configuration of the wider health services. Appropriate pathways for referral and joint working between both agencies are required to ensure that the needs of children and their families continue to be at the centre of service delivery”.

Review of Mary’s care

Tusla and the HSE jointly commissioned a review into the circumstances whereby a vulnerable young adult continued to reside in a former foster home following retrospective allegations of abuse unrelated to Mary or other residents of the foster home. A central focus of such a review is to identify what learning can be undertaken to improve services. A consistent theme emerging from case reviews, inquiries and policy developments in recent years is that effective interagency work is key to improved outcomes for children and young people.

This report contains 10 findings and identifies three areas for improvement in the work of Tusla and the HSE. Both agencies have already taken steps to address these findings. It is also worth noting that the report refers to a number of initiatives which have taken place in the intervening period which minimises the risk of a reoccurrence of this event, including:

  • Tusla and the HSE have jointly established a number of processes and structures in the area where these events took place to assist in effective joint working, including the care of children with disabilities and managing their transition to adult services:
    • An interagency management group meets regularly to oversee cooperation and collaboration across all areas of joint working;
    • Principal social workers and disability manager regularly jointly review the cases of all children with disabilities who are receiving a service from Tusla;
    • Senior management from both agencies meet to address specific issues in relation to common cases.
  • The establishment of a National Interagency Working Group in relation to children and young people with disabilities (and mental health issues), to include a report setting out relevant roles and responsibilities, duties and legal requirements as well as relevant protocols.
  • Tusla established a local multiagency aftercare steering committee to plan, implement and monitor a comprehensive, integrative aftercare programme for each young person leaving care.
  • Rollout of HSE Safeguarding teams across all Community Healthcare Organisations, led by a principal social worker, which accept cases of referral for vulnerable adults.
  • Tusla has developed a National Child Care Information System (NCCIS), which will ensure that every social work department in Ireland has a robust, secure information system to support the delivery of effective child protection and welfare services. NCCIS is being rolled out on a phased basis and is expected to be fully operational by the end of next year.
  • Appointment of Chair for HSE National Independent Review Panel for disability services which is modelled on the independent National Review Panel for Tusla.

Joint working protocol

The joint protocol for interagency collaboration has been developed together by Tusla and the HSE and both agencies are committed to implementing it across the country. The protocol clarifies the separate and distinct roles, responsibilities and legal requirements of both agencies and will ensure joint and effective management of the transition of young people with a disability and / or complex mental health issues to adult services. While the protocol is between the HSE and Tusla, the principles contained in it apply to all service providers funded by the HSE and the Child and Family Agency, where appropriate and relevant.


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