Helen McEntee (Meath East, Fine Gael)
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I propose to take Questions Nos. 482 and 485 to 487, inclusive, together.

Home care services are critical to allow older people to stay in their own homes for as long as possible. They can also provide respite to carers and support them in their caring role. The HSE provides Home Care Packages which are enhanced supports, over and above existing mainstream Home Help service and can include additional home help hours, nursing services, therapy services that might be needed due to illness, disability or after a stay in hospital or following rehabilitation in a nursing home. Access to HCPs is provided on the basis of assessed care need, carried out by health care professionals and there is no means test.

In 2014, the HSE introduced Intensive Home Care Packages to facilitate timely discharge home from acute hospitals of people who require very significant interventions to an extent not previously provided as part of the Home Care Package Scheme or current community services. This year the HSE will provide 190 such packages.

If a younger person’s assessed needs can be best met by services designed for older people then occasionally such an application may be considered, however access to home care packages by reference to illness type is not provided.

I would like to remind the Deputy that the Department of Health is currently engaged in a detailed process to design a new system of regulation for these important services. This process will also determine the type of scheme that will apply to home care. As an initial step, the Department commissioned the Health Research Board to undertake an evidence review of the home care systems that are in place in four other European countries. This review was published on 11 April. The Review will help us to learn from the experiences of other jurisdictions and will inform the debate and future consideration of approaches to formal home care financing and regulation here in Ireland. Another important step in this process is a public consultation process which I will be launching at the end of May. The purpose of this consultation is to allow all those who have views on this topic to have their say, including older people themselves, their families, and healthcare workers.

The National Clinical Programme for Stroke has been in place since early 2010. The vision of the programme is to design standardised models of integrated care pathways for the delivery of clinical care. Early Supported Discharge is a rehabilitation programme that aims to accelerate discharge home from hospital and provide rehabilitation and support in the home setting in order to maximise independence as quickly as possible after stroke. Pilot Early Supported Discharge programmes in three sites in Ireland have proved to be effective, with up to 35% of stroke patients being discharged successfully.

The HSE has advised the Department that its Integrated Care Programme for Patient Flow has identified the need to strengthen the integrated patient-centred approach. Improving discharge processes is not only necessary to deliver safe and truly person-centred care but also to optimise bed utilisation.

Funding has been allocated by the Clinical Strategy and Programmes Division to the Integrated Care Programme for Patient Flow to support the National Clinical Programme for Stroke to expand the Early Support Discharge Stroke Programme in 2017. This involves increasing staffing in three existing Early Supported Discharge Stroke teams and developing two new teams at a full year cost of €460,051.

Early supported discharge complements the range of measures to improve stroke care including 24/7 access to thrombolysis and increasing the number of stroke units to twenty-two. These measures have reduced stroke mortality, reduced average length of stay in hospital and enabled more stroke patients to be discharged directly to home.

I have asked the HSE to address the operational matters of the Deputy’s Question.