Thursday, 15 July 2021
Saincheisteanna Tráthúla - Topical Issue Debate
The Minister of State, Deputy Butler, was due to take this question today but due to the change of time for Topical Issues, she cannot do so as she is bringing legislation through the Seanad. She sends her apologies for not being in the Chamber for this debate.
The Covid-19 pandemic has led to an unprecedented challenge across our health services and none more so than in our nursing homes. The National Public Health Emergency Team, the Department, the HSE and the Health Information and Quality Authority, HIQA, placed a focus on supporting older people in nursing homes throughout the pandemic. Quality care and patient safety is a priority and our continued focus is, and will always be, to deliver safe and high-quality services. From the start of the pandemic, the HSE, through the Health Protection Surveillance Centre, has developed an extensive body of guidance and support tools to assist in the management of Covid-19 cases, including in relation to decisions on transfer of patients and residents between care facilities, where appropriate.
The decision to discharge patients from hospitals to nursing home settings is always subject to clinical assessment. Discharges to nursing homes and other settings are a regular, daily feature of a functioning health system. The period from early March 2020 to mid-April 2020 saw an increase in the number of such discharged patients as the health system prepared itself for an expected surge in Covid-19 cases. From an older person's perspective, being admitted for longer than necessary increases the risk of a patient contracting a healthcare associated infection or deconditioning. The vast majority of these discharges took place from 10 March 2020 onwards, when clear public health guidance was in place across all acute hospitals.
On 10 March 2020, the HSE issued interim guidance on transfer between care facilities, which included preliminary guidance on the transfer of hospitalised patients from an acute hospital to a residential care facility in the context of the pandemic. This guidance was circulated to all acute hospitals, community healthcare organisations and residential care facilities accepting admissions of residents. In order to ensure sufficient acute hospital capacity to manage the anticipated surge in hospitals, emergency funding was made available to ensure patients who were clinically stable and appropriate for transfer could have their discharge facilitated, while adhering to the guidance.
There was also an emphasis on ensuring that those patients who had completed their acute medical treatment should be prioritised for such transfers, either to residential care or with some home support, so as to avoid their exposure to the anticipated surge and prevent hospital-acquired Covid-19. The protocols set out in the guidance, along with infection prevention and control advice and supports, were put in place to assist the nursing home sector, with a view to mitigating the level of risk and transfer of Covid-19.
It must be recognised that the pandemic has not concluded, and at this time a priority focus of Government remains on the ongoing management of Covid-19 and our response to it, to ensure that the positive gains now being experienced are preserved and that those most vulnerable to the virus continue to be safeguarded in the light of residual risk. The Department is continuing to look at options that may be available to the State in listening to the voices of those who have lost a loved one.
I conclude by expressing my sincere condolences to those who have lost a loved one during this difficult time.