Health and Social Care (HSC) (Irish: Sláinte agus Cúram Sóisialta, [ˈsˠlaːnʲtʲəˈaɡəsˠˈkuːɾˠəmˠˈsˠoːʃiəlt̪ˠə]) is the publicly funded healthcare system in Northern Ireland. Although having been created separately to the National Health Service (NHS), it is nonetheless considered a part of the overall national health service in the United Kingdom. The Northern Ireland Executive through its Department of Health is responsible for its funding, while the Public Health Agency is the executive agency responsible for the provision of public health and social care services across Northern Ireland. It is free of charge to all citizens of Northern Ireland and the rest of the United Kingdom.For services such as A&E, patients simply walk in, state their name and date of birth, are given treatment and then leave. Patients are unaware of costs incurred by them using the service. It is sometimes called the "NHS", as in England, Scotland and Wales, but differs from the NHS in England and Wales in that it provides not only health care but social care too (NHS Scotland also includes social care[citation needed]). Social services are provided by local councils. The Health and Social Care service was created by the Parliament of Northern Ireland in 1948 after the Beveridge Report.
Johne's disease (JD) causes weight loss, diarrhoea, and reduced milk yields in clinically infected cattle. In 2020, Animal Health and Welfare Northern Ireland (AHWNI) launched a voluntary JD control programme (JDCP) which focuses on bio-exclusion, biocontainment and market reassurance. Authorised veterinary practitioners (AVPs) conduct a Veterinary Risk Assessment and Management Plan (VRAMP) and use this information to make up to three recommendations. Between August 2022 and January 2024, 2274 herds enrolled in the NI JDCP and conducted up to three VRAMPs. This study characterised the JD-related risks and veterinary recommendations, identified the risks related to confirmed cases of JD and assessed if farmers changed their practices in response to AVP recommendations. AVPs assigned risk scores to management practices. Practices related to the calving area, particularly an absence of or delayed snatch calving, demonstrated the highest average risk score. Thematic analysis highlighted five main themes within AVP recommendations, including the use of diagnostic testing and management of calving areas. Multivariable binomial logistic regression identified five management practices which significantly increased the likelihood of herds having had a confirmed case of JD, including the segregation of clinically infected or test-positive cows from the rest of the herd in the calving area. Analysis of the risk scores and responses to closed questions from 278 herds which conducted first and second VRAMPs suggested that farmers had not changed their JD-related management practices in response to AVP recommendations. These findings simultaneously outline the challenges in JD control, reinforce the use of VRAMPs in identifying JD-related risks, demonstrate the harmonisation in AVP recommendation themes and provide data which can be considered by industry and policy makers.
Many farmers rely on anthelmintics to control gastrointestinal nematodes in sheep. In response to concerns about rising levels of anthelmintic resistance reported in countries around the world, current advice is to adopt more sustainable practices. A small-scale survey of farmers was used to inform group discussions with farmers, veterinarians and anthelmintic prescribers, to better understand barriers to the adoption of sustainable gastro-intestinal nematode control in sheep flocks across the United Kingdom. Thematic analysis of the discussions identified four barriers to change: not seeing the need for change; lack of specific information and support in implementing changes on farm; lack of confidence in the new approaches; and practical obstacles such as time and cost. Nevertheless, there were examples of sustainable parasite control with some farmers making changes to their habitual practices, typically with the support of their veterinarian or Suitably qualified person. We reflect on the findings through the lens of the Capability, Opportunity, Motivation as drivers of Behaviour model. This draws attention to the need for a process of knowledge exchange that allows advice to be tailored to individual farms and makes use of farmer skills and experiences, rather than expecting farmers to follow generic advice.
Johne's disease in cattle is a significant global animal health challenge. Johne's disease is chronic, affecting the gastrointestinal tract of cattle and other ruminants and is caused by the bacteria Mycobacterium avium ssp. Paratuberculosis. Many countries have introduced schemes and programmes to try and control the spread of Johne's disease, including the UK. Despite efforts to control it, however, Johne's disease remains consistently ranked by UK producers as the top ranked disease negatively affecting productivity, indicating that schemes are not perceived to have solved the problem fully. Building on a global systematic review of the literature on barriers and solutions for Johne's disease control on-farm, we conducted an empirical study with over 400 farmers and 150 veterinary professionals across the UK. The study used workshops and semi-structured interviews to understand better the challenges dairy farmers and veterinarians face in implementing on-farm Johne's disease management schemes with the aim of identifying solutions. The study found that four main challenges are faced in the on-farm control of Johne's - (1) Management of farmer expectations around Johne's disease, with eradication near impossible, (2) Issues regarding space for segregation and the related economics of control (3) A 'free-riding' problem which can be influenced by the voluntary nature of control plans and (4) Challenges in vet-farmer communication, including levels of knowledge. Our findings have relevance for the control of Johne's disease in the UK and other countries, including for regions with voluntary and compulsory control programmes.
Sheep scab, caused by infestation with the ectoparasitic mite Psoroptes ovis, is an endemic disease in the Northern Ireland (NI) sheep flock and constitutes significant economic and welfare burdens for the NI farming industry. Despite its endemic nature, historically, little research has been undertaken to support the control of the disease in NI. This study offers the first attempt to analyse the psychological and behavioural factors influencing farmers’ intentions to implement effective sheep scab control measures in NI. To achieve our objective, quantitative data from a sample of 126 sheep farmers were statistically analysed using an extended theory of planned behaviour approach in an ordered logistic regression modelling framework. Our analyses showed that sheep scab remains an issue of concern in Northern Ireland. The attitudes of the farmers, as well as perceived behavioural control, emotional effect, membership of Business Development Groups (BDGs), and higher education qualifications, were found to be statistically significant factors influencing farmers’ intentions to adopt sheep scab control measures. This study provides a solid foundation for how to promote behavioural changes among sheep farmers to improve their ability to implement effective disease control measures, helping to tackle this challenging disease in a more sustainable way in the future.
BACKGROUND:Bovine viral diarrhoea (BVD) is caused by Pestivirus A and Pestivirus B. Northern Ireland (NI) embarked on a compulsory BVD eradication scheme in 2016, which continues to this day, so an understanding of the composition of the pestivirus genotypes in the cattle population of NI is required. METHODS:This molecular epidemiology study employed 5' untranslated region (5'UTR) genetic sequencing to examine the pestivirus genotypes circulating in samples taken from a hotspot of BVD outbreaks in the Enniskillen area in 2019. RESULTS:Bovine viral diarrhoea virus (BVDV)-1e (Pestivirus A) was detected for the first time in Northern Ireland, and at a high frequency, in an infection hotspot in Enniskillen in 2019. There was no evidence of infection with BVDV-2 (Pestivirus B), Border disease virus (pestivirus D) or HoBi-like virus/BVDV-3 (pestivirus H). LIMITATIONS:Only 5'UTR sequencing was used, so supplementary sequencing, along with phylogenetic trees that include all BVDV-1 genotype reference strains, would improve accuracy. Examination of farm locations and animal movement/trade is also required. CONCLUSIONS:Genotype BVDV-1e was found for the first time in Northern Ireland, indicating an increase in the genetic diversity of BVDV-1, which could have implications for vaccine design and highlights the need for continued pestivirus genotypic surveillance.
