Marc Ó Cathasaigh (Waterford, Green Party)
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689. To ask the Minister for Health when consultants will be able to schedule public appointments for patients they had been treating in a private capacity prior to the Covid-19 crisis; and if he will make a statement on the matter. [9319/20]

Simon Harris (Wicklow, Fine Gael)
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A major part of the Government's Action Plan in response to Covid-19 was to substantially increase the capacity of public healthcare facilities to cope with the anticipated additional demand. In order to urgently ramp up capacity for acute care facilities, an arrangement was agreed with the private hospitals to use their facilities as part of the public system on a temporary basis, to provide essential services. A Heads of Terms of an Agreement between the HSE and the Private Hospitals was agreed at the end of March 2020 and all 18 of the acute private hospitals signed up to it. Under the arrangement, all patients in the private hospitals are treated as public patients and their treatment is prioritised based on clinical need. Provision was made under the agreement to allow for continuity of care for patients who were in a private hospital or attending for treatment at the time the Heads of Terms of the Agreement were agreed, on the grounds that these patients would be treated as public patients.

The agreement was reviewed at the end of May and the Government decided that the existing arrangement should not be extended beyond the end of June. It has however mandated the HSE to negotiate a new arrangement with private hospitals which would provide the HSE with full access to private hospital capacity in the event of a surge of Covid-19 and separately with ongoing agreed access, to enable the HSE to meet essential and elective care needs

In response to the COVID-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for COVID-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, the measures set out in the Action Plan in Response to Covid-19 and the recommendation of NPHET. The NPHET has now recommended that steps be taken to resume non-urgent scheduled care in the context of the safe care guidelines set out by its Expert Advisory Group.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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690. To ask the Minister for Health his views on calls to facilitate visits by relatives and loved ones to the elderly in residential settings, for example, by using outdoor areas and timetabled visits with at least one or two family members per week; if he will request that nursing home managers prioritise planning to allow for such visits in the immediate future in view of the trauma inflicted on residents during the lockdown; and if he will make a statement on the matter. [9326/20]

Jim Daly (Cork South West, Fine Gael)
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It is important to recognise that the current social distancing measures were introduced for the overarching public health good and for the protection of all people in Ireland, particularly those who are most vulnerable to this virus. We all recognise the unprecedented impact on people’s daily lives and I am aware of how difficult the current restrictions on visiting are for both nursing home residents and their families. However, the current expert guidance should continue to be adhered to. 

Appropriate evidence-based guidance to support the work of health and social care providers on a range of issues, including infection prevention and control, has been developed by the HSE and the HPSC and is updated regularly, as appropriate, and made available on their websites. The latest HPSC Interim Public Health and Infection Prevention Control Guidelines on the Prevention and Management of COVID-19 Cases and Outbreaks in Residential Care Facilities and Similar Units was published on 2nd June (version 5). These are available on the HPSC website.

This guidance provides the most up to date advice and information on the public health management and infection prevention and control measures, to inform and advise local planning and management in community residential facilities.   

The Taoiseach recently announced a Roadmap for the future easing of restrictions on a phased basis. Phase 3, from 29 June, will see the commencement of a phased approach to visiting at hospitals, residential healthcare centres and other residential settings bearing in mind the particular features of types of settings and each individual centre. I am hopeful we will be able to make progress on this and other innovative measures to allow some level of interaction between residents and their families in line with the Roadmap.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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691. To ask the Minister for Health the date on which his Department received the HIQA report containing a list of nursing homes which it was of the view might struggle with the Covid-19 crisis; the actions taken on foot of this; if direct contact was made with these residential settings; and if he will make a statement on the matter. [9327/20]

Jim Daly (Cork South West, Fine Gael)
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On 13th March HIQA provided the Department with a list of 19 HSE/HSE funded nursing homes identifying that as these had multi-occupancy rooms this created infection prevention risk. This information was sent by the Department on the same day to the HSE for their attention and the HSE has confirmed on-going risk management of these centres.

On 29th and 30th of March key officials from the Department, HIQA, HPSC and HSE met to discuss nursing homes. It was agreed that representatives from the Department, HIQA, HSE and HSPC would collaborate to prepare a paper, encompassing a framework of necessary information, for consideration by the NPHET at its meeting of 31st March on the specific issues and risks relating to COVID-19 infections in residential healthcare facilities. To inform the development of the paper, HIQA provided an information framework document to the team on March 30th. A variety of potential risks were identified. These included the risk of small providers, access to infection prevention and control (IPC) advice, access to PPE and timely access to testing. Following consideration of the paper referred to at the above NPHET meeting of 31st March, NPHET requested HIQA to risk assess all nursing homes and liaise with relevant national and regional governance structures as necessary in light of mitigating actions. This was part of an overall package of public health measures recommended following this meeting. 

At the NPHET meeting 17th April an action was agreed that ‘HIQA publishes and assesses a COVID-19 Quality Assurance Regulatory Framework’. This Framework has been designed to ensure that providers are prepared for, and have contingency plans in place for, an outbreak of COVID-19. As part of the programme HIQA has developed a self-assessment tool for nursing home providers. This self-assessment tool sets out the minimum standard required to effectively respond to an outbreak of COVID-19 in a designated centre. This involves a self-assessment by the registered provider and an onsite assessment by inspectors of social services to verify the provider’s compliance against specified regulations. 

If further action is required by the registered provider to ensure compliance with the specified regulations, a compliance plan will be issued to the registered provider by the inspector of social services following the in-site assessment.