When Adrian Ahern says he was “a very shy young fella” at school and college, it really is quite hard to believe. As well as running Leopardstown Park Hospital in Dublin, with its workforce of 300 people, he is also an articulate advocate for human-centred healthcare and self-confessed “disruptor” who challenges the status quo. So what changed since he was a shy student?
Adrian laughs. “I went to do mental health nursing and an old charge nurse said to me: ‘You have to get out and talk to people. That’s how you get their stories’. Even now, in the job at Leopardstown, that’s my philosophy. I’m somebody who rambles around the place and has cups of tea with people.”
There are plenty of cups of tea to be taken at Leopardstown Park, a 127-bed facility specialising in services for older people, including residential and respite care, sub-acute rehabilitation and day care services. Appointed as interim Chief Executive Officer in early 2024, Adrian’s in-tray includes plans to build a new residential facility with 125 high-spec individual rooms and related facilities.
“The facilities we have now date from the early 1900s up to the 2000s, but this is a purpose-built facility where everyone will have their own space,” says Adrian, animated about the plans. “We have put a lot of thought into this.”
Leopardstown Park’s unique history dates to 1917 when a manor house and extensive grounds in the foothills of the Dublin Mountains were donated for the treatment of soldiers wounded in World War I. It became a specialist hospital for shellshock, surgical care and artificial limb fitting, before ultimately opening to the general public in the 1970’s.
Reflecting its origins, the hospital includes an independent living facility, the Clevis Welfare Home, which has 30 individual rooms for people who are aged over-65 and have low-dependency needs. Clevis residents come and go as they please but can access the hospital facilities, which include a pharmacy, nutrition services, physiotherapy and occupational therapy, as well as a concert hall, chapel and library.
“I don’t think there is anywhere else quite like Leopardstown Park in the country,” says Adrian. “Despite the fact it’s there since 1917, it has always been a place where there is a lot of change happening.”
As Director of Nursing and Person in Charge at Leopardstown Park since 2017, Adrian is across every aspect of the hospital, right down to the big-font yellow-and-black name badges its staff wear for easier reading. His elevation to interim CEO is the latest chapter of a career that stretches back to when he was an Order of Malta cadet whose dream job was to do medicine.
He got the academic grades to study medicine at University College Cork but hit a speed bump when he failed an exam two years into the course. “I thought I wouldn’t get it in the autumn [repeat sitting] so I applied for nursing, got nursing and stayed there,” Adrian says. “I have no real regrets about that.”
After stints in general nursing, mental health nursing and maternity work, he was part of a group selected to set up new addiction services in the Irish Midland region. “It was a bit like Big Brother,” he jokes. “About 30 of us started it. At the end of every module, people would be called in and told ‘you don’t necessarily have the skills for this’. We ended up with about 12 people.”
Adrian survived and went on to work with colleagues on moving addiction services from the inpatient mental health setting to a specialist model of supported home care. “It was the 1980s and quite novel at the time,” he says with some understatement. “There was a lot of people saying it would never work.”
The new approach to addictions must certainly have seemed radical. “We challenged the notion of ‘once an alcoholic, always an alcoholic’ and introduced people to controlled drinking programmes,” Adrian explains. “We had the opinion that, if somebody tells you ‘you’ve had one drink, now you’re beaten’, sure you might as well keep going.”
Recognising that many people develop addictions in response to issues such as abuse, mental illness and unemployment, they developed a programme to focus on the related issues. They set up a programme specifically for the Irish army and worked with the Courts Service on an education-centred programme for people involved in drunk-driving.
With colleagues, Adrian was also involved in setting up the Irish Association of Alcohol and Addiction Counsellors. He credits a number of “very progressive” people in the Midland Health Board at the time, including then CEO Denis Doherty, for supporting innovation in new services.
Alongside his work, Adrian did an honours degree in economics at London School of Economics and “drifted in administration” in the Health Service Executive (HSE), the Irish public health provider. In his role as General Manager of Mental Health Services, he ultimately had responsibility for all aspects of cradle-to-grave services in his region, managing a budget of €70 million.
Adrian describes a person-first approach, involving patients, families, staff and unions and the wider communities. “The health services are a people organisation,” he says firmly. “We’re not making widgets in a factory, where you can make 100 widgets and they’re all the same. Every person is different and their experience of the health services is different.”
Designing a facility for the Child and Adolescent Mental Health Service, for example, they included a bungalow for families to stay while supporting their child. His work also included identifying properties for community-based services, which sometimes meant overcoming local opposition.
“You need to get out there and make contact with people and get things done yourself,” Adrian says. You can’t sit in an office and do these things, you have to be out there.”
He recalls one occasion where residents opposed a new house being used for mental health services. “We said to them: ‘So you’re telling us that if one of your neighbours has a baby and gets depressed, you don’t want her living near you anymore?’ When you tell the human story, the penny drops.”
Adrian took a redundancy package from the HSE in 2012, during a national austerity drive to cut costs in the public sector following the economic crash. “It was quite a frustrating time. There was lots of pressure on people to do more with less,” he reflects.
Reflecting his economics degree and a postgraduate qualification in Health Services Management, he cites organisational theory in noting how complex public health services have become. “It’s all well-intentioned but you are moving more and more, further and further, from the person in the bed,” he says.
From 2013 to 2017, he was Operations Manager at a private nursing home, which presented a different set of challenges. “There’s a myth that money is more readily available in the private sector. But if you don’t have your beds filled, you mightn’t have the money to pay wages. That’s the reality.”
The call to join Leopardstown Park as Director of Nursing recognised not just Adrian’s track record in building services and facilities but also the fact he had maintained his nursing registration throughout his career. A number of other people at the hospital, including its then CEO and HR Manager, were also relatively new to their positions which contributed to a dynamic environment. “We managed to form a very good team, which stood us in good stead during Covid,” he says.
The hospital leaned into technology during the pandemic period, introducing e-payments and electronic pay slips for staff. It uses the Epic Care patient administration system, part of Irish company Clanwilliam. Meanwhile, the onsite pharmacy at Leopardstown Park has used Clanwilliam’s QicScript Plus pharmacy dispensing software since 2019.
“We have close relationships with an acute hospital; during Covid, we could give them access to the electronic patient records so they could assess and prescribe remotely,” Adrian explains. “Nobody had to come onsite to visit our people.”
He says that Leopardstown Park champions patient dignity and assisted decision-making, adopting the philosophy of ‘Nothing about me without me’. “Our parents always drummed into us to respect the value of the person, not where they live or what they do. I’ve spent my time trying to tap into that,” he says.
“Any discussions I have about a resident, any discussions I have about staff, they are involved in it. We have a policy of no restraints, we have no locks on doors, we have nobody who is using bed rails. If somebody wants their dinner at midnight, you give it to them. What harm will it do?”
In relation to his style, he says: “I know some of my colleagues would see me as a disruptor.” Does he see himself that way? “Oh, a little bit, yeah,” he responds, laughing. “You need to be challenging systems and challenging people. It’s not for the sake of tormenting people but to bring out the good.”
As a boss, he believes in building organisational culture and advocates for openness, giving staff shared responsibility and using personal improvement plans to help people progress. The hospital has ‘town hall’ meetings, more usually associated with tech companies, where staff air issues.
With 21 nationalities represented on the staff, he has introduced intercultural days to share traditions, food, music and dress. “Again, we’re emphasising that this is a people business,” he says. “Our staff retention is quite high and I think that is a reflection on the place we have created here.”
As Adrian describes it, he is only getting going. The planned 125 new rooms are the first phase of a larger plan for Leopardstown Park. “When that’s completed, we plan to build another swathe of rooms,” he says.
“There can be a view that, because they’re old people, ‘sure won’t it do?’ Well, actually,
these are the people who build the State. They paid their taxes. Surely we can give them what they deserve, which is good services and a nice retirement.”
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