Therapy hours for children with disabilities fall despite rise in staff levels
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The number of therapy hours provided by children’s disability services in Ireland decreased slightly last year, despite a 3% increase in staffing levels.
The latest annual workforce review of the country’s 91 children’s disability network teams (CDNTs) operated by the HSE and agencies including Enable Ireland, the Brothers of Charity, and the Central Remedial Clinic, reveals there was an average vacancy rate of 36% in staff positions across the sector at the end of 2023 — up from 34% in 2022.
The report shows there were a total of 817 approved, but vacant positions in such teams in December, of which 226 were categorised as “unable to fill”.
The latest figures show over 1.13m therapy hours were provided to children with disabilities last year — down over 3,522 hours, or less than 1%, on 2022 levels.
However, the reduction in therapy hours was more pronounced in several of the HSE’s nine Community Health Organisation (CHO) areas — including a 22% decrease in the North-West and border region, and an 8% decrease in the Midlands and in the area covering Kildare, West Wicklow, and southern and western parts of Dublin.
A breakdown of figures showed the reduction in therapy hours was as high as 65% in Trim, 52% in South Louth, 41% in Leitrim, 40% in both North Donegal and Carlow, and 39% in Clonmel.
Significant increases in therapy hours were also recorded in parts of several cities, including Cork and Waterford.
The decrease in therapy hours last year coincided with whole-time equivalent staffing levels increasing by 42 to 1,438 during 2023.
An extra 138 additional roles to the teams were approved in 2023, which the HSE said reflected significant Government investment in children’s disability services in recent years. It equates to a 7% annual increase to bring the total of approved roles to 2,255.
Despite the increase in both filled and approved staffing levels in 2023, the report shows vacancy rates also increased in across the disability network teams.
While there was a national average of 36% of approved posts being unfilled in the sector, the figure ranged from a low of 23% in Limerick, Clare, and North Tipperary to a high of 50% in the North-West and border region.
The teams operated by the HSE in Dublin’s north inner city was the only one of the 91 teams to report having a 0% vacancy rate at the end of 2023.
The report highlights how the Cork and Kerry organisation areas had the highest number of filled whole-time equivalent positions on teams, with 242.5, which was up 11% on 2022 levels.
In contrast, there are just 93.6 whole-time equivalent roles for the areas covering Donegal, Sligo, Leitrim, Cavan, and Monaghan — where staffing levels fell by 16% last year.
The report also reveals that 15% of all workers on the teams were not on duty on the day a staff census was conducted last October. Annual leave accounted for 38% of staff not working on the day, while 24% were on sick leave.
Commenting on the report, the HSE said there was an acknowledged shortage of personnel with the necessary qualifications, experience, or skills to fill vacant posts in the teams.
The HSE expressed particular concern about the national vacancy rates among speech and language therapists (43%); occupational therapists (41%); and psychologists (43%), which totalled 536 roles as they were the disciplines essential for the delivery of legislative obligations for the assessment of need of children with disabilities.
It pointed out that seven of the disciplines working in the teams have been included on the Department of Enterprise, Trade, and Employment’s critical skills occupation list for issuing employment permits for qualified foreign workers to address such labour shortages.